Introduction Pediatric posterior fossa tumors commonly result in vision-threatening ocular complications including neurotrophic keratopathy. For these young patients, scleral lenses can be a valuable noninvasive treatment as it provides effective protection of the ocular surface while optimizing vision to reduce risk of amblyopia and prevent further surgical management. Case Report A 20-month-old patient, with a history of posterior fossa mass, presented with neurotrophic and exposure keratopathy unresponsive to standard treatments. To avoid further surgical intervention for our patient, such as tarsorrhaphy, a scleral lens was fitted with the goal to rehabilitate her cornea and provide ocular surface protection. After several weeks of scleral lens wear, there was significant improvement in corneal health and stability. This case supports the safety and long-term efficacy in managing pediatric ocular surface disease. Conclusion This report adds to the limited literature of how scleral lenses offer a noninvasive and more accessible alternative to tarsorrhaphy in cases of severe ocular surface disease like neurotrophic keratopathy, especially in younger patients to reduce the risk and severity of amblyopia. It also demonstrates that scleral lenses can be well tolerated by young patients and their caregivers.
Amanda Dieu (Wed,) studied this question.