SCLERAL LENS COMPRESSION

The patient in the photo below presented with the complaint of red eyes while wearing his scleral contact lens. A scleral contact lens is a rigid gas permeable lens that vaults the cornea and is supposed to land softly on the conjunctiva.  If it lands too steep it will compress blood vessels causing congestion and inflammation.  This patient was refit successfully into a scleral lens that had a much softer landing and the redness subsided. 

VITREORETINAL TRACTION

The above picture is an optical coherence tomography of the macular area of a patient with vitreomacular traction.  You can see the clear vitreous membrane detached from most of the macular area but tightly adherent to the inner limiting membrane at the fovea.  It pulls ont he membrane causing a small underlying cystic space.