msd Mini-Scleral Design (from Blanchard CL company)

• designed to vault the cornea and fit on the sclera/conjunctiva, reducing the net-vault of the contact lens over the cornea
• reduction in the chance of irritation and better centering
• keratoconus fits that dont center or dislodge with eye mvmt
• irregular cornea fits
• GP-intollerant patients (chronic awareness)
• sagital depth of the CL
• trial fit progressively deeper vaults until corneal clearance achieved
• compression ring on conjunctiva after full day wear is ok
• if mid-peripheral or limpal touch exists, increase the mid-peripheral zone of the lens to move the surface of the lens off the cornea
• if mid-peripheral space b/w lens and cornea is too great (causing an air bubble), which may cause epithelial desiccation, decreasing the mid-peripheral zone will minimize these issues
• small air bubbles in periphery that move during lens wear don't interfere with vision or cause epithelial surface drying