Dr. Matthew McGee, assistant professor at the Illinois College of Optometry, presented a case at the Global Specialty Lens Symposium on an 18-year-old patient whose life had come to a halt due to limbal stem cell deficiency. By fitting the patient with BostonSight SCLERAL lenses and incorporating back surface venting channels, he was able to rehabilitate the ocular surface, dramatically improve visual acuity, and help the patient return to school, driving, and daily life. Watch the highlights above, or read the full interview below.

Read the full transcript below:

BostonSight SCLERAL: Can you tell us your name and what you do?

Dr. Matthew McGee: I’m Matt McGee. I’m an optometrist at the Illinois College of Optometry as an assistant professor.

BostonSight SCLERAL: Can you tell us a bit about the research that you presented in your poster and why you wished to share it with your colleagues?

Dr. Matthew McGee: The research I presented at GSLS was on a case called “The Limbal Landscape: Restoring Vision and the Ocular Surface with Scleral Lenses.” It was on an 18-year-old patient who presented to our clinic after being referred from a provider they had been seeing for about a year. The patient had limbal stem cell deficiency, and their whole life kind of stopped when they first got this diagnosis. They had to stop their entire life because their vision was so reduced and their eyes were so painful. Scleral lenses helped rehabilitate their ocular surface but also helped them regain a little bit of their independence.

BostonSight SCLERAL: When you say their life stopped, what do you mean by that?

Dr. Matthew McGee: They weren’t able to work, they had to stop school, they weren’t able to drive anymore, and they just weren’t able to function. Their best corrected vision in the right eye was about 20/400, and their best corrected vision in the left eye was counting fingers at about 10 feet.

BostonSight SCLERAL: Talk a bit more about the specific challenge you were dealing with and why you chose to use BostonSight SCLERAL.

Dr. Matthew McGee: I chose to use BostonSight SCLERAL mainly because I reach for it every time I have a complex ocular surface disease patient. BostonSight SCLERAL lenses give you the advantage of using back surface venting channels. For this particular patient with limbal stem cell deficiency, we wanted to reduce any suction, increase tear exchange, and reduce any seal-off because we wanted to minimize any excess damage or trauma to the limbal area — providing the tear exchange, oxygen, and proper fit for it to heal properly.

BostonSight SCLERAL: What customizations or adjustments did you make to get the lens to fit properly?

Dr. Matthew McGee: Because this is an ocular surface disease case, we fit this patient a little bit larger — and I know that’s the calling card for BostonSight. The main thing we did was incorporate those back surface venting channels to provide tear exchange and reduce suction. Besides that, the fit was pretty spot-on.

BostonSight SCLERAL: Can you talk more about how the BostonSight SCLERAL lens addressed the patient’s challenges in terms of comfort, visual acuity, and quality of daily life?

Dr. Matthew McGee: Wearing the BostonSight lens really changed the game for her. When she came in, she was 20/400 in the right eye and counting fingers at 10 feet in the left eye. I like to think of scleral lenses — and specifically our BostonSight lenses — as bigger, better bandage contact lenses for our ocular surface disease patients. It not only improved her acuity, where her final acuity the last time I saw her was 20/60 in the right eye and 20/50 in the left eye, but it also protected her from any trauma from blinking, any trauma from the outside world, and just gave her overall better comfort than a normal basic bandage contact lens.

BostonSight SCLERAL: Has the patient shared anything about improvements in their quality of life since the successful fitting?

Dr. Matthew McGee: Since the successful fitting, the patient has been able to get back into her daily routines. She was able to start school again. The last time I saw her, she was planning to go on vacation — where everything had stopped prior to being fit in a scleral lens. Now she’s able to live a more fulfilled and comfortable life than she was dealing with her limbal stem cell deficiency before being fit into those lenses.

BostonSight SCLERAL: What advice or insights would you have for other practitioners who may be tackling a similar situation like limbal stem cell deficiency?

Dr. Matthew McGee: For other practitioners working with limbal stem cell deficiency patients, sometimes it is a long journey when you are fitting these patients in scleral lenses — and a long journey to recovery. They won’t get better right away most of the time. This is an ongoing journey where you have to deal with inflammation that waxes and wanes, and BostonSight allows for a longer warranty period for you to make those adjustments if that does happen. These patients can also present with persistent epithelial defects that just don’t resolve, and a BostonSight lens with those back surface venting channels — allowing increased tear exchange and increased oxygen — makes for a better environment for that eye to heal compared to some other lenses.

BostonSight SCLERAL: Looking back on this case, how did it reinforce the value of BostonSight SCLERAL within your own practice?

Dr. Matthew McGee: This case reinforced reaching for that BostonSight lens more than any other lens because I know it’s going to work for my ocular surface disease patients. I know I can get that increased tear exchange. I know I can make any adjustments I want with FitConnect. I know it has a long warranty period, and it’s just going to improve the overall environment for that patient. For my ocular surface disease patients, they’re all in a BostonSight lens.

        

About BostonSight^®
BostonSight is a nonprofit eye healthcare organization that advances the treatment of irregular corneas and ocular surface disease through specialty lenses. Our ongoing commitment to research and achieving optimal patient outcomes via innovative specialty lens designs, education, and technology has saved the sight of thousands of people around the world. Learn more at www.bostonsight.org