Specialty Contact Lenses
Scleral Contact Lenses
A proven, safe, non-surgical alternative to corneal transplants and Intacts.
Over 80% success with good comfortable vision and they provide a non-surgical solution for the following conditions.
Please take advantage of our "FREE", no obligation, scleral lens evaluation by calling 303-651-2020. Dr.Forrest has fit over 100 eyes in these lenses.
 The life-changing lens for these conditions:
Keratoconus
Pellucid Marginal Degeneration
Post RK (radial keratotomy)
Post LASIK Ectasia
Corneal Trauma
Corneal Transplants
Severe Dry Eyes
Patient Testimonials
The white part of the eye is called the sclera and these lenses are designed to vault the cornea and be supported by the sclera with a fluid reservoir between the cornea and the contact lens. The smallest of these lenses will cover the entire colored part of the eye and will then extend a small amount onto the white part of the eye. The largest of these lenses will continue to extend onto the white of the eye so that every part of the eye that is showing, and even some parts that are hidden by the lids, will be covered by this lens.
Only the more oxygen-porous gas permeable materials are used to ensure an adequate supply of oxygen for the cornea. Handling the lenses is rather easy since they are so large, but application and removal of the lenses to and from the eye can be a bit trickier than conventional contact lens designs. The materials chosen are generally clear. This is because a lens with color will show on the white part of the eye which for most people is cosmetically undesirable.
The fitting process as well as the manufacturing process is quite a bit more challenging with this class of lenses. This fact along with the fact that mass-production of these types of lenses is not possible, means that their costs can be significantly higher than the traditional contact lenses of today. There is also more time required when fitting them. This means more time for the physician, more time for the patient, and more time for the laboratory actually manufacturing the product.
Due to all of the above reasons, scleral lenses are not utilized in a routine fashion. These very unique products however, do have their place. For corneas that have become irregular, scleral lenses can sometimes outperform other types of contact lenses. An irregular cornea can be the result of a disease such as Keratoconus, corneal trauma, corneal transplant, and more recently refractive surgery. In many cases, the irregular cornea prevents the proper positioning of a corneal lens but a scleral lens can seat itself properly on the sclera and therefore be in the correct position on the cornea. The vision with a scleral lens as well as the other gas permeable corneal lenses can be vastly superior to glasses or soft contact lenses especially when considering irregular corneas. These lenses provide the optical system a new surface that provides great vision while neutralizing all of the irregular optics of the underlying cornea. For many people with irregularly shaped corneas, these types of lenses provide the only form of usable vision correction.
Additionally, scleral lenses can address many contact lens failures that were secondary to dryness. Since the scleral lenses are so large, there forms a tear reservoir under the lens that can keep the cornea properly moist. Foreign matter and debris also have a very difficult time finding their way underneath one of these lenses. This fact can be the single entity that allows contact lens success while all other contact lenses have failed.
Whenever I show a scleral lens to a patient for the first time the patient’s reactions are almost always the same. The comment is always something to the effect “Are you planning on putting that huge thing in my eye?!” This is followed with “How much is it going to hurt?” The surprising and good news is that the scleral lenses are extremely comfortable right from the beginning. Due to their size, contour, and limited movement, there is actually very little sensation at all.
Although scleral lenses will clearly not become the lens that dominates the contact lens market, when the need is there, this lens can often solve problems that are unsolvable through any other means. The scleral lens will continue to serve a unique role for some very unique situations.
Please take advantage of our "FREE", no obligation, scleral lens evaluation by calling 303-651-2020. Dr.Forrest has fit over 100 eyes in these lenses.
 Corneal Ectasia
Corneal ectasia is a condition resembling keratoconus but comes from a different origin. Almost invariably the cause is refractive eye surgery, specifically LASIK. After LASIK, the cornea has been made thinner. Because the corneal “wall” has been made thinner, internal pressure from within the eye can cause expansion or distension of the cornea. The resultant distorted corneal surface will usually make it impossible to have clear vision with eyeglasses or soft contact lenses. Most of the time, a special gas permeable contact or scleral contact lens will be needed to restore lost vision. These special high tech lenses (which have only recently become available) will act to create a new corneal surface allowing the patient to regain clear, comfortable vision. Fortunately, risk factors that can be looked at before LASIK surgery have reduced Ectasia a great deal.
Keratoconus
Keratoconus is a degenerative condition that progressively thins an area of the cornea causing a bulging or “cone” shape in the thinned area. The cornea is the front clear window of the eye were a normal contact lens rides. The cornea is normally smooth and round like a dome in shape, however in Keratoconus, the cornea becomes very thin, irregular, and starts to protrude like a cone. This protruding cone shape affects the central cornea and causes the vision to become distorted.
Eyeglasses may be used to treat the problem only in the early stages of the disease. Glasses will not provide good vision as the disease progresses. Rigid gas permeable contacts, however, will provide superior vision correction and are certainly the preferred treatment in moderate to severe cases. The contact lens acts as a new regular shaped clear front surface of the eye to focus light onto the retina. As Keratoconus progresses, the tip of the cone continues to thin and sometimes scars. If the cornea becomes too thin and pointed or if the contacts are too uncomfortable a scleral contact lens can be a great option.
Pellucid Marginal Degeneration
Pellucid Marginal Degeneration is a sub-category of keratoconus. This condition typically affects both eyes although one eye is usually a bit worse than the other eye. It also tends to appear between the ages of 20 and 40. The main difference between Pellucid Marginal Degeneration and Keratoconus is that the cornea thins in the area from the center of the pupil all the way down to the bottom of the cornea. Due to this large area of thinning pellucid corneas involve a larger distorted geographic area usually extending from the inferior corneal margins up to the center of the cornea. It is not unusual for 50% or more of the corneal surface to be involved. Because so much of the cornea can be affected, fitting this type of cornea can be very challenging. The problem we face as eye care practitioners is fitting the steep areas of the cornea without adversely affecting the flatter areas. All this must be accomplished while providing clear and stable vision along with a comfortable contact lens to wear.
Although Pellucid Marginal Degeneration can have an enormously negative impact on vision, and glasses often do not correct the visual distortions very well, a scleral contact lens modality can frequently restore vision to a very acceptable level with great comfort.
Post Rx (radial keratotomy)
Radial keratotomy is a refractive surgery that is not used much anymore, but there are a lot of you out there that have had this procedure from years ago. Unfortunately, it can leave you with fluctuating vision throughout the day and it does not always correct well with glasses or conventional contact lenses. Scleral contact lenses almost always give you good, comfortable and safe vision.
Please take advantageof our "FREE", no obligation, scleral lens evaluation by calling 303-651-2020. Dr.Forrest has fit over 100 eyes in these lenses.
Corneal Trauma
Corneal trauma is one of the most common reasons for corneal transplants. Many of you could be a good candidate for a scleral contact lens and you may not have to go through the twelve month ordeal of a corneal transplant.
Please take advantage of our "FREE", no obligation, scleral lens evaluation by calling 303-651-2020. Dr.Forrest has fit over 100 eyes in these lenses.
Scleral lenses can provide a safe, comfortable alternative so you can avoid the traumatic 12 month ordeal of a corneal transplant.
Many keratoconus patients fear that their keratoconus will keep on progressing causing further vision loss or ultimately corneal transplant surgery. This is not necessarily true. There have been many new advances in contact/scleral contacts lens technology. This has allowed the overwhelming majority of keratoconus (ectasia, pellucid marginal degeneration) patients to wear these specialty lenses safely, comfortably and with good to excellent vision for almost all of their waking hours. Please understand that for the overwhelming majority of keratoconus patients, the active progressive stage of this disease seldom exceeds 5 years. I have seen many keratoconus patients over a 30 year period that have virtually little or no change in the status of their corneas.
Corneal transplant surgery is not without risk. Infection and/or rejection of the graft can occur. In addition, the long term use of anti-inflammatory drugs used after this surgery can have undesirable side effects. The great majority of the post-corneal transplant patients whom we have seen over the years have had irregularly curved corneas which required the use of scleral contact lenses to restore useful vision. The fitting of a contact lens on a transplanted cornea can be even more challenging than on a keratoconic cornea, but it can be done.
To sum up, everything should be done to avoid a corneal transplant, but there are still people who need this surgery or have already had it, and they can be very successful. Every year, new materials and technologies are appearing to make it easier for the keratoconus patient to be fit so as to allow better vision and comfort while maintaining ocular health.
Severe Dry Eye
Scleral contact lenses can be safe, comfortable choice for the symptoms of severe dry eyes.
Please take advantage of our "FREE", no obligation, scleral lens evaluation by calling 303-651-2020. Dr.Forrest has fit over 100 eyes in these lenses.
Patient Testimonials
On June 4, 2008, I went for a routine cataract removal surgery, which had been explained to me as a procedure that is done simply and successfully. However, during the surgery, the instrument “overheated” and as a result, my eye was severely burned. The surgeon quickly removed what was left of the cataract and stitched up the eye as best as he could. I went home to heal, but within the next 3 weeks the eye required two additional surgeries: one to repair the initial stitches which had pulled loose due to the condition of the eye tissue, and then, one for a partial corneal graft to cover the large and deep burn area.
Since that time, I have been adjusting to having only a small amount of vision from that eye. Four doctors who have examined the eye have all agreed that it is amazing that I didn’t lose the eye itself and amazing that there was any vision at all. I have been told, more than once, that an eye as damaged as mine is seldom seen. In addition to loss of vision, the injured eye has been painful much of the time, due to my chronic dry eye syndrome.
One year later, Dr. Larry Forrest called and told me that he had heard about my eye injury and he possibly could help me with a Scleral Contact Lens. I learned that he is one of the few doctors in the country who had recently taken a class about this lens, and was impressed with its ability to restore vision and comfort to an eye like mine with corneal injuries. It took some time and patience on his part to convince me that this lens would not further injure my eye and that, indeed, it might be possible to regain vision in my severely damaged eye.
Today, I am wearing the scleral contact lens with great success. My vision, with the lens, is 20/20 and the comfort is so great that I am reluctant to remove the lens after 8 hours of wear. The phone call and ongoing care from
Dr. Forrest have given me back a quality of life that I had never expected to regain.
Linda K.
Eight years ago I had a tumor removed, as a result of this surgery I was left with some facial paralysis on the right side of my face. This condition does not allow for my right eye to blink normally resulting in a pretty dry eye at times. I could no longer wear soft contacts and when wearing glasses I was developing dry spots from poor blinking. Thanks to thescleral contact lenses my eyes stay moist all day. No more itchy eyes at the end of the day and are very comfortable to wear. Thanks Dr. Forrest and Eagle Vision!
Phyllis H.
When I found out I had keratoconus I thought my only options were hard contact lenses or cornea transplants. Hard contacts gave me clear vision but also substantial pain!! When Dr. Forrest introduced me to the Scleral Contact Lens I was skeptical of their large size, but the clarity of vision and comfort out did the hard contacts I was wearing. No longer do I worry about windy days or excruciating pain at the twitch of my eye. Wearing these new lenses with the saline solution literally feels like soothing lotion on my cornea all day. Rather than dreading putting them in, I feel less comfortable with them out. For anyone with cornea problems this is the solution.
Andrea W.
I lost the sight in my eye 45 years ago due to being shot in the eye with a BB gun. Dr. Forrest suggested that I try a Scleral Contact Lens. I can now see again in that eye, and it is going to make my job and everyday activities easier for me. It is comfortable to wear, and will be a great improvement in my daily life.
Mark S.
At the request of my Billings, Montana doctor, I made a trip to the University of Minnesota medical Center on August 23, 1982, and was examined by J.D. Nelson, M.D. He determined that the right eye had four areas of corneal thickening and the left eye had similar findings, but not to such a great extent. There was an iron line present between the deposition and the visual axis. The cornea was markedly thickened in these areas and the diagnosis was spheriodal degeneration of the cornea. The disease was quiescent at that time.
On November 7, 2007, I was examined by Joanne Shen, M.D. at Mayo Clinic in Phoenix, AZ as my vision had worsened, but at that time she did not think I should do anything surgically. In 2009, my Billings doctor, Dr. James Weaver, recommended cataract surgery in the left eye, but my vision stayed blurred. I was referred to Dr. Karbassi who practices in Longmont, CO., but takes cornea patients every few months in Billings. He recommended laser surgery on my left eye which was accomplished in Denver on July 14, 2009.
I was still having vision problems (mostly blurring) when Dr. Karbassi learned of the scleral lens being administered by Larry L. Forrest, O.D. also of Longmont, CO. Dr. Karbassi recommended I be examined and possibly fit for these lenses. I was evaluated on June 4, 2010 and Dr. Forrest definitely recommended I try the scleral contact lens, so I was fitted and trained how to use them the week of June 14. As was explained, this lens took my vision directly to the retina, bypassing my scarred corneas and my new vision was amazing! I am very pleased and my life is so much better because of these lenses. I have some trouble with insertion as my eye openings are small. I have someone help hold up my eyelids when the lenses are inserted. I comfortably wear them from 8-10 hours a day and thank God and Dr. Forrest for my new vision! I highly recommend these lenses for anyone with cornea problems such as mine. 6-21-2011
Louise G.
Corneal Refractive Therapy
Corneal Refractive Therapy (CRT) is a remarkable new advancement that provides an alternative for LASIK to patients who qualify. CRT allows you to see clearly during the day without glasses or contact lenses. Specially designed therapeutic lenses gently reshape the front surface of your eye while you are sleeping.
Imagine great vision all day without contact lenses, glasses or surgery! Nor more problems from dust, allergies or dryness. No more worry about broken frames or torn contact lenses. CRT offers a non-surgical solution to many patients whose prescription is within the range for this great alternative. CRT has also been shown to slow the progression of nearsightedness in children and teenagers if started early enough.
After years of experimentation, this new option has become a reality. Modern materials that provide enough oxygen to your eyes can be worn while you are sleeping. The lenses are custom made for the unique shape of your eyes, using technology that maps the front surface of your eyes. In as little as a few days you could be seeing without glasses or contact lenses being worn during the day! Yes, it really is amazing!
- Additionally, while LASIK has been approved only for those over 18 years of age, CRT is ideal for our younger patients who are active in sports and do not like the hassle of glasses or contact lenses. Since CRT is not available for all prescriptions, we can help make that determination during a routine eye examination. Please call us if you would like further information or to schedule a consultation. You may also get more information and FAQs at the manufacturers website: www.paragoncrt.com .
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2080 Main Street
