Tear Dynamics During Fenestrated Scleral Lens Wear: A Pilot Study

Damien Fisher; Asif Iqbal; David Alonso-Caneiro; Michael J Collins; Stephen J Vincent

doi:10.1007/s44402-026-00102-7

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Tear Dynamics During Fenestrated Scleral Lens Wear: A Pilot Study

Journal article

Open access

Peer reviewed

Tear Dynamics During Fenestrated Scleral Lens Wear: A Pilot Study

Damien Fisher, Asif Iqbal, David Alonso-Caneiro, Michael J Collins and Stephen J Vincent

Ophthalmic & Physiological Optics, Vol.Advanced access

06-May-2026

DOI: https://doi.org/10.1007/s44402-026-00102-7

PMID: 42090093

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Abstract

Scheimpflug imaging

Corneal oedema

Fenestration

Scleral lens

Tear exchange

Purpose To develop a Scheimpflug-based image analysis technique to quantify tear exchange during scleral lens wear and investigate fluid reservoir tear dynamics during fenestrated lens wear. Methods Nine healthy participants wore a scleral lens (KATT™, Capricornia Contact Lenses) with a single 0.3 mm diameter limbal fenestration in one eye for 90 min. Central (0–2.5 mm from the corneal apex) and peripheral (−1.0 to 0 mm from the scleral spur) stromal cornea oedema was measured using optical coherence tomography. Scheimpflug images were obtained during lens wear at multiple time points following the application of sodium fluorescein to the bulbar conjunctiva. These images were exported and annotated manually to select the region of interest (the fluid reservoir) from which the intensity of each pixel was extracted to provide a measure of fluorescent intensity (in arbitrary units [AU] on a scale of 0–255) throughout lens wear across the central 10 mm. Results The coefficient of repeatability for central fluid reservoir intensity measurements was 7 AU (on a scale of 0–255 AU). Fluid reservoir fluorescent intensity varied with measurement location (p < 0.001), being greater towards the periphery (4 and 5 mm from the centre). On average, intensity differences between the peripheral and central fluid reservoir diminished within 10 min of sodium fluorescein application. Two patterns of tear dynamics were observed and were classified as low and high flow. Low flow participants (n = 6) exhibited greater central (3.72× more) and peripheral (2.25× more) corneal oedema, but the difference was not statistically significant. Conclusions The ingress and mixing of sodium fluorescein within the fluid reservoir stabilised between central and peripheral locations after 10 min of fenestrated scleral lens wear. Two patterns of tear dynamics were observed (low and high flow), with low flow participants exhibiting greater corneal oedema. Future research utilising the developed technique may provide further insights into tear exchange during scleral lens wear with different fenestration sizes and configurations.

Details

Title: Tear Dynamics During Fenestrated Scleral Lens Wear: A Pilot Study
Authors: Damien Fisher - Queensland University of Technology
Asif Iqbal - Queensland University of Technology
David Alonso-Caneiro - University of the Sunshine Coast
Michael J Collins - Queensland University of Technology
Stephen J Vincent (Corresponding Author) - Queensland University of Technology
Publication details: Ophthalmic & Physiological Optics, Vol.Advanced access
Publisher: Wiley-Blackwell Publishing Ltd.
DOI: 10.1007/s44402-026-00102-7
ISSN: 1475-1313
PMID: 42090093
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Data Availability: All data supporting the findings of this study are available within the paper.
Grant note: Damien Fisher and Asif Iqbal were funded by QUT Postgraduate Research Awards and Dorothy Calborg Research Awards from the Cornea and Contact Lens Society of Australia.
Organisation Unit: School of Science, Technology and Engineering
Language: English
Record Identifier: 991229290902621
Output Type: Journal article

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