When modern scleral lenses became popular, the instruments used to help
evaluate the health of the cornea and conjunctiva in the presence of the lenses were
somewhat rudimentary. Practitioners observed the cornea and conjunctiva with the
biomicroscope, used manual keratometry or Placido topography to map the corneal
curvature, and relied on sodium fluorescein to judge the depth of the post-lens tear
reservoir. The instrumentation industry quickly fills unmet needs, and the scleral lens
market is no exception. In fact, the pace of innovation of instrumentation that is used to
evaluate these relatively complex medical devices has been, and will continue to be,
dramatic for years beyond the publication of this textbook. At the time of publication,
currently available instrumentation is reviewed and may likely change with innovation
and technology. Innovations and advances in modern imaging technology have
enhanced traditional methods of scleral lens fitting. While not every piece of equipment
is required for fitting scleral lenses, any additional information provided by unique
instrumentation aids the practitioner to achieve fitting success.
Keywords: Clearance, Confocal, Documentation, Endothelial cell, Frequency
domain, Lens thickness, OCT, Oxygen, Pachymetry, Pentacam, Photography,
Sagittal depth, Scan, Scheimpflug, Scleral topographers, Technology, Time
domain, Topography, Ultrasound, Vault.