Patient-reported satisfaction and visual outcomes with scleral contact lenses in Indian keratoconus wearers

Objective: This study aimed to evaluate the comfort, visual outcomes, and overall satisfaction of keratoconus patients who transitioned to scleral contact lenses (ScCLs) from other lens modalities. It also explored the impact of ScCLs on dry eye symptoms and midday fogging. Methodology: A total of 39 individuals diagnosed with keratoconus were enrolled after obtaining ethical approval and informed consent. All participants were habitual all-day wearers of ScCLs (17.0-18.2 mm in diameter) and had prior experience with at least one other contact lens type. Data were collected using a structured online survey administered via Google Forms after a minimum of three months of ScCL wear. The survey assessed patient-reported outcomes related to comfort, vision improvement, dry eye symptoms, and frequency of midday fogging. Results: Of the 39 participants, 56.4% were female, with a mean age of 26.7±3.2 years. Most (69.2%) had switched from corneal gas permeable lenses to ScCLs. A majority of respondents reported improved outcomes with ScCLs: 87.2% experienced superior comfort, 84.6% noted reduced ocular dryness, and 89.7% reported enhanced visual acuity compared to their previous lenses. Furthermore, 66.7% did not experience midday fogging, while the remaining 33.3% reported it with varying frequency. Conclusion: The findings underscore the effectiveness of scleral contact lenses in improving both comfort and vision among keratoconus patients. Compared to other lens modalities, ScCLs provided superior visual stability, dryness relief, and patient satisfaction. Although some individuals reported midday fogging, it was a manageable issue that did not significantly detract from overall lens performance. These results highlight the role of ScCLs as a valuable and reliable option in the non-surgical management of keratoconus.