Speciality contact lenses: supporting complex visual rehabilitation

Speciality contact lens fitting in the community

When fitting speciality contact lenses for complex patients in the community, optometrists should look beyond the lens alone and consider the wider ocular and systemic picture.

Careful assessment of corneal shape, ocular surface health, tear film stability, previous surgery, and underlying conditions such as keratoconus or ocular surface disease is essential. Understanding the patient’s visual demands, occupation, lifestyle, and ability to manage lens handling and aftercare is equally important.

Setting realistic expectations around visual outcomes, adaptation, comfort, and ongoing care can improve satisfaction and long-term wear. Regular monitoring helps identify complications early, optimise fit and performance, and support successful long-term outcomes.

When fitting speciality contact lenses for complex patients in the community, optometrists should look beyond the lens alone and consider the wider ocular and systemic picture.

Careful assessment of corneal shape, ocular surface health, tear film stability, previous surgery, and underlying conditions such as keratoconus or ocular surface disease is essential. Understanding the patient’s visual demands, occupation, lifestyle, and ability to manage lens handling and aftercare is equally important.

Setting realistic expectations around visual outcomes, adaptation, comfort, and ongoing care can improve satisfaction and long-term wear. Regular monitoring helps identify complications early, optimise fit and performance, and support successful long-term outcomes.

An additional option for challenging contact lens cases

Our speciality contact lens service provides an additional referral option for these more complex cases. Our specialist optometry team works closely with the ophthalmic surgical and medical teams across numerous subspecialties, enabling a truly integrated approach to care.

When might a specialist referral add value?

• Referral to Moorfields Private may be worth considering when:

• Previous fitting approaches have not achieved satisfactory vision, comfort or lens tolerance

• Access to advanced technologies, such as profilometry-guided or impression-based scleral lens fitting, may be beneficial

• Significant ocular surface disease, including severe dry eye disease, requires close collaboration between contact lens and ophthalmic teams

• Complex corneal anatomy such as keratoconus or post-surgical irregularity, presents ongoing fitting challenges

• Highly customised cosmetic or prosthetic lens designs are required

• Contact lens management forms part of a broader ophthalmic treatment plan

When to advanced fitting technologies

We offer a range of speciality contact lens options, including bespoke corneal RGP, scleral, and custom soft lenses.

For particularly challenging cases, advanced fitting pathways include:

• Scan-based freeform scleral lens design, using detailed corneo-scleral profilometry to create highly customised lenses

• Impression-based scleral lenses (EyePrintPRO®), manufactured from an impression of the ocular surface and particularly valuable for patients with severe ocular irregularity or complex anatomy

These technologies can offer solutions for patients who have struggled with conventional lens fitting approaches and allow a greater degree of customisation where standard fitting techniques have not provided a satisfactory outcome.

Multidisciplinary support for complex ocular disease

For patients with severe ocular surface disease, corneal pathology or other complex ophthalmic conditions, contact lens management often forms part of a wider treatment pathway.

The close integration between our speciality contact lens service and ophthalmic subspecialty teams allows patients to access coordinated care when required.

Referring a patient

Community optometrists and GPscan refer patients directly to the Moorfields Private speciality contact lens service for assessment.

• When referring, it can be helpful to include:

• Relevant clinical history

• Current and previous contact lens details

• Corneal topography or imaging, where available

• Information on previous fitting attempts and outcomes

• Details of any co-existing ocular surface or corneal disease

Suitable patients can be signposted to the speciality contact lens webpage for more information on available lens options, conditions treated, and what to expect at their assessment and fitting appointment.

Why choose Moorfields Private for speciality contact lenses?

Moorfields Private is part of one of the world's leading eye hospitals, offering patients access to the full spectrum of ophthalmic expertise alongside specialist contact lens services. This integrated environment is particularly valuable for patients with corneal, ocular surface and other conditions, many of whom require long-term collaborative management and may benefit from surgical intervention at some stage in their treatment.