Transient corneal epithelial bullae associated with large diameter scleral lens wear: A case series

Cont Lens Anterior Eye. 2018 Oct;41(5):463-468. doi: 10.1016/j.clae.2018.05.002. Epub 2018 May 26.


With the increased fitting of scleral lenses by eye care practitioners, complications with lens wear need to be considered. Several prior studies have addressed complications specific to scleral lens wear and the incidence of hypoxia with extended wear, but few report the presence of epithelial bullae. This case series investigates three patients with differing ocular surface diseases, yet all developed transient epithelial bullae with concurrent large diameter scleral lens wear. These bullae appear to form due to weakened connections in the corneal epithelium at the level of basement membrane and Bowman's layer and flatten within minutes of lens removal. These bullae need to be further studied, as they can increase the patient's risk of epithelial defects, infections, and other complications in already compromised corneas.

Keywords: Bullae; Complications; Cornea; Hypoxia; Scleral lens.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Contact Lenses / adverse effects*
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology*
  • Epithelium, Corneal / pathology*
  • Equipment Failure
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Fitting / adverse effects*
  • Sclera
  • Tomography, Optical Coherence
  • Visual Acuity*