Scleral lenses were the first type of contact lens, developed in the late nineteenth century to restore vision and protect the ocular surface. With the advent of rigid corneal lenses in the middle of the twentieth century and soft lenses in the 1970’s, the use of scleral lenses diminished; in recent times there has been a resurgence in their use driven by advances in manufacturing and ocular imaging technology. Scleral lenses are often the only viable form of contact lens wear across a range of clinical indications and can potentially delay the need for corneal surgery. This report provides a brief historical review of scleral lenses and a detailed account of contemporary scleral lens practice including common indications and recommended terminology. Recent research on ocular surface shape is presented, in addition to a comprehensive account of modern scleral lens fitting and on-eye evaluation. A range of optical and physiological challenges associated with scleral lenses are presented, including options for the clinical management of a range of ocular conditions. Future applications which take advantage of the stability of scleral lenses are also discussed. In summary, this report presents evidence-based recommendations to optimise patient outcomes in modern scleral lens practice.

巩膜镜片是第一种隐形眼镜，开发于 19 世纪后期，用于恢复视力和保护眼表。随着 20 世纪中叶硬性角膜镜片和 1970 年代软性镜片的出现，巩膜镜片的使用减少了。最近，由于制造和眼部成像技术的进步，它们的使用重新兴起。巩膜镜片通常是在一系列临床适应症中唯一可行的隐形眼镜佩戴形式，并且可能会延迟角膜手术的需要。本报告提供了巩膜镜片的简要历史回顾和当代巩膜镜片实践的详细说明，包括常见的适应症和推荐的术语。介绍了眼表形状的最新研究，除了对现代巩膜镜片验配和眼部评估的全面介绍。介绍了与巩膜镜片相关的一系列光学和生理挑战，包括一系列眼部疾病的临床管理选项。还讨论了利用巩膜镜片稳定性的未来应用。总之，本报告提出了以证据为基础的建议，以优化现代巩膜镜片实践中的患者结果。