Scleral lens surface crazing in an eye with giant papillary conjunctivitis and keratoconus: Outcome of lens surface polishing

We present a case of scleral lens surface crazing in a patient with keratoconus (KC) and chronic giant papillary conjunctivitis (GPC). A 45-year-old Asian male with known keratoconus (KC) and allergic eye disease in both eyes, who is an experienced scleral lens user, presented with a 3-month history of lens intolerance in the right eye. On examination, the right eye scleral lens showed extensive lens surface crazing with poor surface wettability. The upper tarsal conjunctiva showed conjunctival hypertrophy – active GPC. After allergy treatment and symptomatic improvement, the scleral lens was refitted after intensive cleaning and polishing with aluminum oxide. The lens surface showed significant improvement and good fitting characteristics, and the patient resumed lens wear. At 6 months of follow-up, the patient was asymptomatic, and the ocular condition was stable.