A 64-year-old elementary school teacher with bilateral keratoconus had been wearing scleral contact lenses since 2010. She presented to the clinic reporting that one week prior, while fixing a jam in her electric stapler, a staple sprang from the device and hit her left eye with a "force that put a hole through the hard contact." She recalled that immediately after the incident, she experienced moderate pain and conjunctival redness. She removed her left lens, and the eye remained mildly irritated for 1-2 days. When she presented to the clinic one week after the incident, her left eye was white and quiet. She was wearing a backup lens, and entering acuities were 20/25 OD, 20/20- OS. It was speculated that the staple hit the lens and ricocheted away from the eye, with some of the broken lens fragments entering the scleral lens tear chamber and surrounding ocular environment. The rigidity of a scleral contact lens, as well as the deep tear reservoir beneath, provide a strong protective barrier to the cornea and anterior segment. If this patient had not been wearing scleral lenses, the result would presumably have been traumatic. 

Many thanks to everyone who took the time to complete the SCOPE (Scleral Lenses in Current Ophthalmic Practices: An Evaluation) survey. We received over 800 responses from eye care providers in 40 countries representing over 26,000 scleral lens fits.  We are beginning to analyze the data, and look forward to sharing our results with the eye care community.