Intraocular pressure (IOP) is maintained through complex and interrelated systems which control aqueous production and drainage, and it has been suggested that scleral lens (SL) wear may disrupt these vital homeostatic processes. This review provides an overview of anatomical and physiological processes that control IOP, identifies potential effects of SLs on these regulatory mechanisms, and examines studies that have attempted to quantify the effect of SLs on IOP. Lack of access to the cornea during SL wear makes accurate assessment of IOP challenging; therefore, a range of different assessment techniques and instruments have been employed to quantify IOP during and following SL wear. Some studies have evaluated IOP using standard techniques prior to lens application and following lens removal, or through a large central fenestration. Other studies have utilised instruments that facilitate assessment of IOP on the peripheral cornea or conjunctiva overlying the sclera (e.g. Schiotz, transpalpebral, and pneumatonometry). Two studies have recently evaluated changes in optic nerve structure during SL wear. Conflicting results have been reported on this topic, much of which examines changes in IOP in healthy subjects over limited periods of time. Currently, only a few studies have reported on long-term effects of SL wear on IOP in habitual SL wearers (after lens removal). Future research in this area must not only consider the fact that ocular conditions treated with SLs may potentially alter corneal biomechanical properties which can influence IOP, but also that these properties may be further altered by SL wear. Monitoring other risk factors for glaucoma (permanent alterations in optic nerve physiology, visual field defects) could provide a more comprehensive assessment of potentially increased risk of glaucomatous optic neuropathy due to SL wear. Ongoing clinical assessment of optic nerve structure and function is advisable in patients at risk for glaucoma who require SLs.

眼内压(IOP) 是通过控制房水产生和排出的复杂且相互关联的系统来维持的，有人建议使用巩膜镜(SL) 磨损可能会破坏这些重要的稳态过程。本综述概述了控制 IOP 的解剖和生理过程，确定了 SL 对这些调节机制的潜在影响，并检查了试图量化 SL 对 IOP 影响的研究。在 SL 佩戴期间无法接触角膜使得准确评估 IOP 具有挑战性；因此，已采用一系列不同的评估技术和仪器来量化 SL 佩戴期间和之后的 IOP。一些研究已经使用标准技术在镜片应用之前和镜片移除之后或通过大的中央开窗来评估 IOP。其他研究使用了有助于评估周边角膜或结膜覆盖巩膜（例如 Schiotz、经眼睑和呼吸测量法）。最近有两项研究评估了 SL 佩戴期间视神经结构的变化。关于这个主题，已经报道了相互矛盾的结果，其中大部分检查了健康受试者在有限时间内 IOP 的变化。目前，只有少数研究报告了 SL 佩戴对习惯性 SL 佩戴者（摘除镜片后）IOP 的长期影响。该领域的未来研究不仅必须考虑这样一个事实，即用 SL 治疗的眼部疾病可能会改变角膜生物力学特性，从而影响 IOP，而且这些特性可能会因 SL 磨损而进一步改变。监测青光眼的其他危险因素（视神经生理学的永久性改变，SL 磨损导致的青光眼性视神经病变。对于需要 SL 的有青光眼风险的患者，建议对视神经结构和功能进行持续的临床评估。