Check out my article in GP Insights on scleral lens fenestrations.
The Scleral Lens Education Society, in partnership with B+L, has put together a comprehensive video on the application/removal and care of scleral lenses.
Improvements in specialty lens designs have made this contact lens modality a viable option for patients who have mild to moderate keratoconus. Generally, these soft lenses have center thickness 4X greater than standard soft lenses, which allows them to mask surface irregularity caused by keratoconus. When necessary, they can be manufactured using silicone hydrogel material that increase oxygen to the corneal surface. Specialty soft lenses for keratoconus can be a successful alternative when standard GP designs fail secondary to comfort issues.