How the Custom Stable Elite Rewrote the Script on Ocular Surface Disease and Corneal Irregularities
By Nicholas McColley, O.D., MBA, Hancock Eye Associates
The Patient Perspective – Bypassing the Pain
Every day, patients enter our practice with complaints about their vision or discomfort from traditional methods of vision correction and dry eye management. For individuals dealing with severe dry eye, keratoconus, or post-surgical complications, finding comfort isn't just about clear vision—it's about ocular survival. Traditional contact lenses often exacerbate these conditions by resting directly on a highly sensitive cornea.
The idea behind scleral lenses is simple yet revolutionary: quit fighting the cornea and bypass it altogether. The Custom Stable Elite Scleral Contact Lens by Valley Contax is not just a "product," but a therapeutic treatment mechanism. By vaulting over the irregular or damaged corneal surface and resting gently on the white of the eye (the sclera), it creates a continuous cushion of preservative-free tears. This "liquid bandage" constantly bathes the ocular surface, providing immediate physical relief from dry eye while delivering crisp, life-changing vision.
"I have literally had dozens of patients in my office break down and cry tears of joy the moment a diagnostic lens is applied! The immediate improvement they experience is astounding.”
If patients have struggled with comfort or vision in contact lenses, scleral lenses are a must-try – with the expertise of a practitioner adept to fitting the lenses.
The Practitioner Perspective – The Ultimate Practice Builder
For the independent practitioner, building a specialty lens baseline is a profound differentiator. How is your clinic insulating itself from outside pressures and mass-produced commodities that leave patients underwhelmed? Are you using specialty lenses to build the most loyal, happy patients that will improve your practice's Net Promoter Score (a measure of how likely patients will refer others to you)?
Specialty lens products are not a faucet you can turn on overnight; it takes time, diligence, and clinical success. It requires building trust with local corneal specialists who refer their delicate post-graft or ectasia patients to you. It requires happy patients that tell others that "my doctor was able to do something for me that no one else could, maybe they could for you too".
Fortunately, the Custom Stable Elite makes fitting incredibly efficient for the practitioner. The fitting set was developed in a highly intentional way. My set features two lenses for each prolate and oblate base curve with toric landing zones. The laser-marked meridian highlights the flat meridian, so you know exactly where the lens rotates dynamically on the eye. Because patients have two eyes, having duplicates in the fit set dramatically reduces chair time. Furthermore, because each lens in the fit set is manufactured to have the same over-refraction, moving between diagnostic lenses rarely requires a re-refraction—a massive timesaver. For presbyopes, their Aurora multifocal set allows you to easily control distance and near center-zone designs with varying optic zone diameters so you have an idea of how much near vision a patient can achieve before ordering.
When you do need to make modifications, the consultants at Valley Contax act as true extensions of your practice. Lean on them for the touch-ups. They will expertly guide you through quadrant-specific landing zones, dual-sag adjustments for centration, Limbal Lite adjustments to change the vault over the limbus, "in" and "out" movements in their algorithm to help change mid-peripheral clearance, pinguecula vaults, front-toric optics, and much more. Just tell them what you see and what you need!
There is truly no limit to what this lens can do. My "poster-child" patient is a post-graft individual with corectopia and a shunt for glaucoma following a penetrating aspergillus infection. We were able to utilize the Custom Stable Elite design to get her to 20/20 while completely avoiding landing on the bleb. But – these lenses are not just for the trainwreck corneas in your practice. My normal cornea, dry eye patients have become just as numerous as irregular cornea patients.
“My strongest advice to practitioners hesitant to dip their toes into specialty lenses is this: this lens makes it easy to start. The team makes it easy to learn. It is not as daunting as you think if you just stick with the process.”
It is quickly becoming a first or second-line dry eye therapy in our clinic, our reputation is growing, and patients are driving hours to see us. It is the ultimate practice builder and keeps patients in your chair and happy!
ABOUT THE AUTHOR
This article was contributed by Dr. Nick McColley at Hancock Eye Associates in Greenfield and McCordsville, IN. Specializing in advanced ocular surface management and custom scleral lens design, they utilize precision technology like the Custom Stable Elite to restore sight and comfort to patients in the Indianapolis Metro area.