A middle-aged Hispanic male who had keratoconus had exhausted all other contact lens modalities, and scleral lenses were the only specialty lenses that could provide adequate vision. However, due to severe, bilateral pingueculae, he suffered from significant irritation and redness during and after scleral lens wear.
Because the edges of his lenses nasally and temporally rested on an unstable landing surface due to the elevations, he was prone to getting debris under the lenses. His chronic inflammation also caused watering and mucus external to the lenses that blurred his vision. This patient benefited greatly from notched lenses.
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