Case report: Utilization of a scleral lens to mitigate exposure keratopathy and associated mental health decline

• Published in: Contact lens & anterior eye Vol. 46; no. 4; p. 101871
• Main Authors: Whang, Ken, Brocks, Daniel
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2023
• Subjects: Aged; Blepharoplasty; Cornea - pathology; Depression; Dry eye; Eyelids - pathology; Humans; Keratitis; Male; Mental Health; PROSE; Quality of Life; Depression; PROSE; Blepharoplasty; Dry eye
• ISSN: 1367-0484; 1476-5411
• DOI: 10.1016/j.clae.2023.101871

To report a case of acute exposure keratopathy with comorbid depression and improvement of both conditions with the use of a scleral lens (SL).
A 72-year-old male with a past ocular history significant for extensive basal cell carcinoma (BCC) excision of the right upper and lower eyelids presented for evaluation of exposure keratitis and consideration of a SL for the right eye. Examination was notable for post-surgical irregular lid margins with lagophthalmos, trichiasis and an Oxford Grade I staining of the central exposed cornea. Medical history was notable for chronic severe depression and anxiety with suicidal ideation. Upon treatment with a SL, the patient noted ocular comfort, and reported significantly improved affect.
Currently, there is no peer reviewed literature reporting on the management of exposure keratopathy in the setting of comorbid affective disorders. This case highlights the improvement in quality of life for a patient with exposure keratitis and severe depression with suicidal ideation and points to the potential utilization of a SL to mitigate the risk of mental health decompensation.