Visual Rehabilitation With Mini-Scleral Lenses in Children With Post-Traumatic Corneal Irregularity After Open Globe Injury

Abstract

The aim of this study was to evaluate the visual and refractive outcomes of mini-scleral lens rehabilitation in pediatric patients with post-traumatic corneal irregularity after open globe injury. This single-center retrospective case series included patients aged 18 years or younger who underwent mini-scleral lens rehabilitation after open globe injury between January 2023 and April 2026. Of 80 pediatric open globe injury cases screened, 13 eyes were considered suitable for contact lens rehabilitation; two eyes rehabilitated with soft contact lenses were excluded, leaving 11 eyes of 11 patients for analysis. Demographic, trauma-related, visual, refractive, topographic, keratometric, lens-fitting, and clinical outcome data were reviewed. Visual acuity was converted to logarithm of the minimum angle of resolution units, and pre-fitting and post-fitting values were compared using the Wilcoxon signed-rank test. Median age at fitting was 9 years. Median corrected visual acuity improved from 1.30 logMAR before fitting to 0.40 logMAR with mini-scleral lens wear (p = 0.002), with improvement in 10 eyes. Median pre-fitting refractive cylinder was -3.75 D, and median topographic astigmatism was 4.57 D. No patient required corneal rigid gas-permeable lens wear, underwent keratoplasty, or discontinued lens wear because of a severe lens-related complication. Mini-scleral lenses provided significant visual improvement and may be a useful non-surgical rehabilitation option in selected pediatric eyes with post-traumatic corneal irregularity.