This is the fifth episode in the BCLA CLEAR series. Scleral lenses were the first type of contact lens to restore vision and protect the ocular surface. With the advent of rigid corneal lenses in the middle of the twentieth century and soft lenses in the 1970’s, the use of scleral lenses diminished; in recent times there has been a resurgence in their use driven by advances in manufacturing and ocular imaging technology. Scleral lenses are often the only viable form of contact lens wear across a range of clinical indications and can potentially delay the need for corneal surgery. This report provides a brief historical review of scleral lenses and a detailed account of contemporary scleral lens practice including common indications and recommended terminology. Recent research on ocular surface shape is presented, in addition to a comprehensive account of modern scleral lens fitting and on-eye evaluation. A range of optical and physiological challenges associated with scleral lenses are presented, including options for the clinical management of a range of ocular conditions. Future applications which take advantage of the stability of scleral lenses are also discussed. In summary, this report presents evidence-based recommendations to optimise patient outcomes in modern scleral lens practice.

Dr Eef van der Worp discusses some of the key findings of this paper with Dr Melissa Barnett. Eef van der Worp is an educator and researcher. He now runs his own research & education consultancy 'Eye-Contact-Lens' based in Amsterdam (NL). He is on the education committee for a number of international conferences, including the Global Specialty Lens Symposium (GSLS) in the US and the Dutch Contact Lens Conference (NCC) and Dutch Optometric Society meeting (OVN). He is a board member of the BCLA journal Contact Lens & Anterior Eye. Eef is adjunct assistant Professor at Pacific University College of Optometry (Oregon, USA), and adjunct Professor at the University of Montreal University College of Optometry (CA) and he is lecturing extensively worldwide and is a guest lecturer at a number of Universities in the US and Europe.

Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, California. She is an internationally recognized key opinion leader, specializing in dry eye disease and specialty contact lenses. She is a Fellow of the American Academy of Optometry, a Fellow of the British Contact Lens Association and serves on multiple Boards. Dr. Barnett is Past President of The Scleral Lens Education Society.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision.

This is the fourth episode in the BCLA CLEAR series. By reviewing the physiological and anatomical changes which may occur while wearing contact lenses this paper provides eye care practitioners with a better understanding of the key clinical learnings for modern contact lens practice. This report consolidates clinical research information about the various physiological and anatomical changes which may result from using contact lenses. It takes an anatomy-centric approach covering changes to the lids and adnexa, the conjunctival regions and the various layers of the cornea and presents changes which are sub-clinical rather than those which are symptomatic or generally considered as 'adverse events'.

Professor Phil Morgan discusses some of the key findings of this paper with Dr Melissa Barnett. Professor Morgan is Professor of Optometry, Head of Optometry, Deputy Head of the Division of Pharmacy and Optometry, and Director of Eurolens Research at The University of Manchester.  His main research interests relate to the clinical performance of contact lenses and he teaches on the same subject area at undergraduate and postgraduate level.  He has managed an international survey of contact lens prescribing trends since 1996. He is also President of the International Society for Contact Lens Research and President of the International Association of Contact Lens Educators. He is an honorary member of the UK Association of Contact Lens Manufacturers, a Fellow of the British Contact Lens Association and the American Academy of Optometry.

Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, California. She is an internationally recognized key opinion leader, specializing in dry eye disease and specialty contact lenses. She is a Fellow of the American Academy of Optometry, a Fellow of the British Contact Lens Association and serves on multiple Boards. Dr. Barnett is Past President of The Scleral Lens Education Society.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision.

This is the third episode within the BCLA CLEAR podcast series. The most fundamental aspect of a contact lens is its optics; the manner in which the refraction of light is managed to optimise vision to the clinical benefit of the lens wearer. This report presents contemporary information on the optical structure of the eye and the optical models employed to understand the correction of refractive error. The design, measurement and clinical assessment of spherical, aspheric, toric, multifocal and myopia control contact lenses are described. The complexity and variety of multifocal lenses is recognised and detailed information is provided for alternating, simultaneous, diffractive, annular, aspheric and extended depth of field lens designs. In terms of clinical assessment, a contemporary review is provided for the measurement of: visual acuity, contrast sensitivity, through focus curves, reading performance, peripheral refraction, toric displacement realignment and patient reported outcomes. Overall, the paper aims to serve as a resource for the prescribing clinician, who can optimise contact lens corrections for patients by building on the optical rationale of these devices; and also highlights future opportunities for research innovation.

Dr Kathryn Richdale is interviewed by Dr Melissa Barnett, who leads the BCLA CLEAR podcast series. Dr. Richdale is currently an attending in the Cornea and Contact Lens Service and co-director of the Myopia Management Service, and teaches in both the optometric and graduate programs at UHCO. She conducts research in the areas of cornea, contact lenses and refractive error.

Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, California. She is an internationally recognized key opinion leader, specializing in dry eye disease and specialty contact lenses. She is a Fellow of the American Academy of Optometry, a Fellow of the British Contact Lens Association and serves on multiple Boards. Dr. Barnett is Past President of The Scleral Lens Education Society.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision.

Listen to Corrina McElduff and Rebecca Donnelly discuss contact lens care as across the globe we continue emerge from the pandemic. This has required new ways of working and Rebecca will be highlighting how they have used some of this change to continue delivering care to her patients. The podcast serves as an introduction to the topic which will be covered in more detail at the BCLA Vision conference. Remote care is a central feature of their discussions. As this is an evolving type of eye health service in different parts of the world you should always refer to the most up to date guidance that applies to your region. 

Corrina is a qualified optometrist with several years’ experience in both multiple and independent sectors. She currently works as a Professional Services Consultant for CooperVision where she works closely with practices and eye care practitioners to deliver professionally led education and insight into contact lens expertise and management. She is also currently a member of the BCLA Council.

Rebecca is a therapeutic optometrist and currently works as the clinical lead for a group of independents in the Bristol area. She has experience across independent, multiple and hospital services in both Ireland and the UK. She received her undergraduate honours degree from Technological University, Dublin and has a special interest in contact lenses, dry eye management and glaucoma.

This is the second episode in the BCLA CLEAR podcast series. While severe complications with contact lenses are rare, the majority can be systematically identified, managed and prevented in practice. The paper on contact lens complications is part of the BCLA Contact Lens Evidence-based Academic Reports (CLEAR) – a global consensus report put together by the BCLA. This report summarises the best available evidence for the classification, epidemiology, pathophysiology and management of contact lens complications. Complications are considered from an aetiological perspective to help practitioners to determine the most appropriate management strategy and key signs and symptoms underlying major groups of complications are described to support the decision- making process.

Professor Stapleton is interviewed by Dr Melissa Barnett, who leads the BCLA CLEAR podcast series. Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, California. She is an internationally recognized key opinion leader, specializing in dry eye disease and specialty contact lenses. She is a Fellow of the American Academy of Optometry, a Fellow of the British Contact Lens Association and serves on multiple Boards. Dr. Barnett is Past President of The Scleral Lens Education Society.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision .

In this podcast series we will focus on separate reports, highlighting key findings and other areas of interest.

This episode features, Professor James Wolffsohn, who will discuss the work in the report on evidence based contact lens practice. This report reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as minimising risks of lens wear through encouraging compliance) and an aftercare routine. 

Professor Wolffsohn is interviewed by Dr Melissa Barnett, who leads the BCLA CLEAR podcast series. Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, California. She is an internationally recognized key opinion leader, specializing in dry eye disease and specialty contact lenses. She is a Fellow of the American Academy of Optometry, a Fellow of the British Contact Lens Association and serves on multiple Boards. Dr. Barnett is Past President of The Scleral Lens Education Society.

Josie Barlow, Professional Services Manager at Menicon, is joined by Jonathan Jackson, Head of Optometry at the Belfast Health and Social Care Trust, to discuss keratoconus and some of the aspects of managing this eye condition. Josie and Jonathan touch on the treatments available, the importance of teamwork, and a few tips on how to manage keratoconus effectively. The podcast serves as a taster for the webinar where Jonathan and his team will discuss further details about how they manage treatment at his busy hospital. Thanks to Menicon for sponsoring the associated webinar which is available to BCLA members.

Ahead of their upcoming webinar, 'The “case” for water avoidance in contact lens wear', Dr Nicole Carnt and Irenie Ekkeshis discuss their work that led to a greater public awareness of water-related infection associated with contact lens wear - specifically acanthamoeba keratitis. Nicole and Irenie were both pivotal in making clearer patient information available as well as campaigning for no water stickers on contact lens cases. 

Dr Carnt is currently a Scientia Fellow at UNSW, Sydney, and Chair of the Australian Standards Contact Lens Committee and Expert to International Standards Organization. Irenie is an acanthamoeba keratitis patient leader and her efforts to raise awareness of this infection and the 'no water' campaign have been recognised through the award of campaign of the year at the RNIB vision pioneer awards in 2016.

In 2020 Johnson and Johnson Vision launched their Prioritise Your Eyes campaign. This initiative was aimed at raising awareness of the importance of having regular eye tests. They carried out research that canvassed opinions from the public in many different countries to understand their perceptions of eye health. In this episode Rachel Hiscox, Professional Education and Development Manager at Johnson and Johnson Vision, provides insights into some of the key findings of the research. We are also joined by Gary, a patient and advocate for eye tests. Gary shares his own tale about having an eye examination that revealed a deeper underlying issue. 

This podcast explores how clinical care services have had to adapt during the Covid-19 pandemic in optometric and hospital practice. It serves as a prelude to our forthcoming webinar, 'A Brave New World of Eye Care – Delivering a service during a Pandemic'. Our presenters discuss the adjustments that have been made to ensure that practitioners continue to deliver a credible service.

Ankur Barua is a consultant ophthalmologist specialising in complex corneal, refractive and cataract surgery based in Birmingham Midland Eye Centre (BMEC).

Rakesh Kapoor is a qualified Optometrist with just under 30 years' experience within the Optical Industry. Shortly after qualifying he opened Specsavers Opticians Wembley in 1994. Subsequently he now runs 3 stores in North West London.

Both Ankur and Rakesh are both BCLA Council members.