We describe a case of fitting a scleral contact lens for keratoconus management. A 37-year-old female has came for the keratoconus management opinion. She was using glasses for the last 20 years. She was presented with bilateral severe keratoconus with corneal hydrops, and it show high myopic. A standardized eye examination was thoroughly done in the hospital visual acuity, corneal oculyzer and slit lamp examination with IOP measurement. . The best spectacle corrected visual acuity was Right eye 6/60 with pinhole no improvement with the correction of -13.75/-2.00 x 35 and Left eye having best spectacle corrected visual acuity of counting finger- finger counting with pinhole no improvement with the correction of -14.00 dsph. Optimal fitting characteristics were found in terms of vault, centration and landing and coverage the final parameter that we selected base curve, diameter, power and sag value RE 7.34, 16.40 mm, -15.25/-1.00 X 40, 5.41; LE 6.75, 16.40, -19.25/-1.50 X 110, 5.68 respectively. With over refraction of this power visual acuity was 6/6p and 6/9 in right eye and left eye respectively. In this case we were fit the patient with miniscleral lens which are more comfortable, and the visual acuity was also improved and in the follow up of 3 months no ocular adverse effects were seen. This case report shows that in this patient a Maxim Scleral Lens could be fitted successfully for keratoconus management, providing good visual quality.
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