Management of Pediatric Open Globe Injury With Fenestrated Scleral Lens: A Case Report From India

Introduction This case report describes the refractive management of the open globe injury in a pediatric case with a fenestrated scleral contact lens. Case Report A boy aged 3 years with high irregular astigmatism in the right eye presented for Prosthetic Replacement of Ocular Surface Ecosystem treatment. The ocular history included an open globe injury with a metal rod in the right eye, which was surgically managed by scleral tear repair and resulted in high irregular astigmatism. The child was initially fitted with a corneal gas-permeable lens, which showed a significant improvement in vision; however, the child was not tolerant to it. Subsequently, the child was shifted to a fenestrated scleral lens, resulting in both improved vision and enhanced comfort. Handling the fenestrated scleral lens became easier compared with the fluid-ventilated scleral lens in this pediatric case. Vision reduction due to trauma resulted in amblyopia, and the fenestrated scleral lens, combined with amblyopia therapy, improved vision in the follow-up visit. Conclusion Fenestrated scleral lens served as a refractive aid and addressed the important challenge of complexity in lens insertion and removal when fitted with the fluid-ventilated scleral lens in the pediatric population.