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Corneal diseases are supposed to be the 4th most important cause for blindness worldwide after cataract, glaucoma and age-related macular degeneration. Corneal transplantation served as the golden procedure that restored the visual function when the visual impairment caused by corneal diseases became too severe.

While corneal surgery was the magical wand, which literally provided new eyes, it had its own limitations. According to a study published in JAMA Ophthalmology in 2016, there’s a huge demand and supply gap in the availability of corneas for the procedure with only one cornea available for 70 needed.

There have been a lot of efforts taken to encourage cornea donation as a part of the strategies to prevent and control blindness but it seems essential to also find alternative solutions for the same.

Also, cornea rejection occurs in about 20% of the cases. Graft failure can also occur at any time after the cornea has been transplanted, even years or decades later. These complications are the greatest barriers for the global corneal surgery market, which is expected to grow at a CAGR of 5.2% during forecasted period 2018-2023.

An alternative proposed in the market is a special type of contact lenses called Boston Scleral Lenses. A survey conducted by Boston Foundation for Sight in 2010 showed that 80% had significant success with BostonSight PROSE (prosthetic replacement of the ocular surface ecosystem) treatment. For many of the thousands of patients suffering from complex corneal disease, PROSE may be the ideal, and sometimes only, treatment capable of restoring visual function and reducing eye pain and light sensitivity.

Till date, the benefit was limited in India because of the high cost. L V Prasad Eye Institute (LVPEI) has a facility in Hyderabad that produces special type of contact lenses (Boston Scleral lenses) in collaboration with Boston Foundation for Sight, USA, with the goal of increasing access to specialized forms of contact lenses for the treatment of corneal problems, avoiding corneal transplantation in some cases. 

According to Dr Ashutosh Richhariya, Associate Director of Engineering Group of Srujana Innovation Centre in LVPEI, the Centre has started manufacturing PROSE and Scleral lens in India. The cost has come down significantly but the bigger advantage is said to be of the turnaround time. Previously, it was usually one to three months, which has been brought down to three days. He says that making the Scleral lens available to all who need it is the agenda of this project and they are providing this to many more practices in India and abroad.

Scleral lenses are commonly known for their use in patients with Stevens-Johnson syndrome, keratoconus, corneal grafts, chemical and thermal burn injuries, and ocular pemphigoid, among other uses. The increased spotlight on scleral lenses has led to their use in more number of patients with severe dry eyes due to Sjögren’s syndrome, autoimmune diseases, chronic graft-versus-host disease, post-LASIK dry eye, and irregular astigmatism.

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