Quick Reference Guide

Essential Steps for Fitting Gaudi Scleral Lenses

Choose Your Fitting Approach

Critical Documentation (Upload to EWS)

Key Design Features

Troubleshooting Quick Reference

Introduction

The Gaudi Scleral Lens system represents the next generation of custom scleral lens design, utilizing advanced profilometry data to create truly personalized lenses for even the most challenging fits. Designed with precision and unlimited customization, these lenses provide unmatched comfort and visual clarity.

The Gaudi lens family offers three distinct design platforms, each tailored to specific clinical needs:

Equipment & Requirements

Profilometry Devices

Gaudi lenses are designed using advanced profilometry data. The following devices are compatible:

• Gaudi Profilometer (Recommended - optimal integration)

• Eaglet Eye ESP

• Pentacam CSP

Gaudi Profilometer Features

EYEXY Web Services (EWS)

The EWS platform integrates lens ordering, order tracking, and electronic health data management. Key features include:

• AI-powered lens matching algorithms

• Direct integration with profilometry data

• Lens fit visualization tools

• Collaboration tools for consultants

• Complete order history and tracking

Advanced Landing Zone Design

Understanding the sophisticated landing zone design of Gaudi lenses is essential for achieving optimal fit and comfort. The dual-ring architecture provides unprecedented control over how the lens interacts with the ocular surface.

Two-Ring Landing Zone Architecture

The Gaudi scleral lens landing zone consists of two distinct rings, each serving a specific purpose in achieving an optimal fit:

Haptic Zone Angle Adjustment

All Gaudi lenses have the capability to adjust the angle with which the haptic zone lands on the sclera. This powerful feature allows practitioners to address common fitting challenges:

Addressing Heel and Toe Compression

Haptic angle adjustments are particularly effective for resolving heel or toe compression issues:

Independent Edge Taper Adjustment

A unique feature of Gaudi lenses is the ability to adjust the edge taper independently of the haptic zone angle. This provides exceptional flexibility in managing edge-related fitting challenges.

Clinical Applications of Independent Edge Control

• Localized Edge Lift

When the haptic angle is optimal but the edge stands off in specific areas, the edge taper can be adjusted independently to achieve better alignment without affecting the haptic zone performance

• Edge Blanching

If compression is isolated to the lens edge while the haptic zone shows good alignment, the edge taper can be modified to relieve pressure without altering the primary landing zone

• Contouring Around Pinguecula

The edge zone can be precisely adjusted to vault over or contour around pingueculae and other ocular surface elevations, allowing the lens to navigate obstacles while maintaining optimal haptic alignment

• Other Ocular Surface Obstacles

Surgical scars, conjunctival blebs, filtering blebs for glaucoma, or any other surface irregularities can be accommodated through precise edge zone customization

Practical Example: Combining Haptic and Edge Adjustments

Consider a patient with a pinguecula at 3 o'clock position:

Key Advantages of Dual-Ring Design:

• Surgical Precision: Navigate around glaucoma drainage devices, filtering blebs, and other surgical hardware

• Anatomical Variations: Accommodate natural variations in scleral contour without compromising primary landing zone

• Problem Solving: Address edge and haptic issues separately for more effective troubleshooting

• Patient Comfort: Eliminate pressure points and edge awareness through precise control

• Universal Capability: Available on ALL Gaudi lenses (AI, QS, and Legend)

Fitting Process

Initial Assessment

Before beginning the fitting process, conduct a thorough patient evaluation:

• Complete ocular health examination

• Corneal topography or tomography

• Tear film assessment

• Meibomian gland evaluation

• Measurement of horizontal visible iris diameter (HVID)

• Documentation of any ocular surface irregularities (pingueculae, scars, surgical implants)

Profilometry Scan

Scan Quality is Critical: The quality of your profilometry scan directly impacts the success of the initial lens fit. Follow these best practices:

• Patient Preparation

Ensure patient is thoroughly washed out of any current lenses (minimum 24 hours, preferably longer)
Educate patient on proper fixation and blinking patterns during scanning

• Scanning Technique

Take multiple scans for each eye (at least 2-3)
Verify adequate coverage (minimum 16-18mm diameter for scleral fitting)
Check scan quality score before proceeding
For challenging eyes with scarring, use fluorescein mode

• Data Review

Review scans for missing sections or artifacts
Select the highest quality scan with best coverage

Fitting Approach Selection

After obtaining quality profilometry data, determine the appropriate fitting approach. The Gaudi system offers three pathways based on practitioner preference and clinical needs:

Gaudi AI Trial Set Fitting (No profilometry)

Gaudi AI diagnostic lenses are engineered using advanced machine learning algorithms trained on diverse eye shapes. They combine the convenience of traditional trial lens fitting with the advanced customization capabilities of the Gaudi platform. This approach is ideal for practitioners who prefer hands-on diagnostic fitting while still having access to comprehensive lens modifications. You will notice that there are no prolate or oblate options, as the trial set lenses gradually transition from oblate to prolate with the increasing sagittal height.

Gaudi Trial Set Description

Gaudi AI trial sets can be customized based on practitioners’ preferences and target demographics. One of the most commonly used standard Gaudi AI trial sets is a 14-lens trial set with a 15.8-mm diameter.

Figure 1. Example of a 14-lens 15.8-mm trial set.

Key Advantages of Gaudi AI

• Immediate Diagnostic Fitting: No profilometry is needed. Trial lenses available in office for same-day evaluation.

• Patient Comfort Assessment: Patient can experience lens before final order

• Traditional Workflow: Familiar fitting process for practitioners transitioning to freeform lenses

• Full Customization: Once trial lens is finalized, all 8-sector adjustments available for final lens

• Flexible Modifications: Can add multifocal, toric, or HOA correction to final lens

Gaudi AI Fitting Process

1. Select Initial Diagnostic Lens

Choose from Gaudi AI trial set based on patient's corneal and scleral measurements.

Select the first lens from the standard toricity group: the s-lenses in the lower part of the box (Figure 1). Use the following first lens selection guide:

• Normal cornea – start with lens s3.

• Flat corneas, (i.e. transplant) - start with lens s2.

• Mild cone – start with lens s5

• Extreme cone – start with lens s6 or s7

2. Apply Diagnostic Lens

Allow appropriate settling time (20-30 minutes minimum)

3. Evaluate Fit

Assess central clearance, limbal vault, and landing zone alignment

Document with fluorescein patterns and photographs

Try different trial lenses if needed

4. Finalize Diagnostic Lens Parameters

Once optimal trial lens is identified, record all parameters

5. Perform Over-Refraction

Determine final power prescription

6. Customize Final Lens

All Gaudi QS adjustments available:

• Sector-specific limbal clearance adjustments

• Mid-periphery vault modifications

• Landing zone angle adjustments in any sector

• Central vault fine-tuning

• Front surface toric if needed

• Multifocal or HOA correction options

7. Order Through EWS

Upload trial lens images and specify any modifications needed

Consultant will review and optimize design based on trial lens findings

Landing Zone Toricity Adjustment

One of the key advantages of the Gaudi AI system is the ability to adjust landing zone toricity to accommodate the natural asymmetry of the sclera. Understanding and properly adjusting toricity is essential for optimal lens fit and comfort.

Standard Toricity Options

Gaudi AI trial lenses are available in two standard toricity levels:

• 150 µm toricity (lower toricity - for more symmetrical scleral profiles)

• 300 µm toricity (higher toricity - for more asymmetrical scleral profiles)

Meridian Orientation

IMPORTANT: The flat and steep meridians are standardized and laser marked on the lens for easy identification:

• Flat Meridian: 0-180° (horizontal)

• Steep Meridian: 90-270° (vertical)

• Laser Marking: The meridian is clearly marked on each lens for proper orientation

Figure 2. Gaudi Lens Markings

Clinical Decision Making: Adjusting Toricity

After evaluating the trial lens fit, use the following guidelines to determine if toricity adjustment is needed:

Assessment Tools for Determining Toricity Changes:

Use one or more of the following methods to accurately assess the amount of toricity adjustment needed:

1. Gaudi Profilometer Blanching Map

The blanching map provides a convenient visualization of landing zone pressure. Dark areas around the lens edge represent blood vessel blanching.

2. AS-OCT (Anterior Segment Optical Coherence Tomography)

Provides cross-sectional imaging of the lens-sclera interface

Allows precise measurement of compression or lift-off

Scan along both 0-180° and 90-270° meridians for comparison

3. Slit Lamp Observation

Direct visualization of conjunctival blanching

Assessment of fluorescein patterns in the landing zone

Observation of lens movement and stability

Evaluation of post-lens removal conjunctival imprint

Clinical Examples

Key Points to Remember:

• Toricity adjustments beyond the standard 150 µm and 300 µm options can be custom ordered

• Always allow adequate settling time (20-30 minutes) before assessing toricity

• Use multiple assessment methods for most accurate determination

• Document findings with images for consultant review

• Communicate toricity changes clearly when ordering final lens through EWS

Important Note: Transition from Trial to Final Lens

While the trial lens provides the foundation for the fit, the final Gaudi AI lens is manufactured with all the precision and customization capabilities of the Gaudi system. This means:

• The final lens can have sector-specific adjustments even if the trial lens was rotationally symmetric

• Modifications based on fluorescein patterns can be implemented in specific meridians

• The trial lens serves as a starting point, but the final lens achieves the precise customization needed

• All optical corrections (multifocal, toric, HOA) can be added to the final lens design

Gaudi AI Empirical Fitting (Without Trial Lenses)

Gaudi AI trial lenses are AI-generated lenses designed to match specific eye shapes, allowing for efficient fitting with minimal modifications.

Gaudi AI Empirical Fitting Process

1. Upload profilometry data to EYEXY Web Services

The EWS AI algorithm analyzes the eye shape and suggests the best fitting lens from your Gaudi AI diagnostic set

2. Apply the suggested Gaudi AI diagnostic lens

Allow appropriate settling time (20-30 minutes minimum)

3. Evaluate lens fit

Assess central corneal clearance (target: 200-300 µm)

Evaluate limbal clearance

Check scleral landing zone alignment

Verify edge lift and comfort

Document with fluorescein patterns and photographs

4. Perform over-refraction

Determine final power prescription

5. Order through EWS

If modifications needed, use the convenient EWS adjustment control to communicate changes to the consultant

Upload images and reports for consultant review

Custom Freeform Design Process

For complex cases requiring Gaudi QS or Gaudi Legend lenses, the custom design process leverages the full capabilities of the Gaudi Design App.

Design Workflow

1. Data Upload

Upload profilometry scan to EWS or directly to Gaudi Design App (if you have access)

2. Initial Design Parameters

Software generates initial design based on profilometry data

Point cloud alignment ensures precise fit to ocular surface

3. Customization Options

Adjust fit factor to control how closely lens follows eye shape

Modify lens diameter based on HVID and limbal anatomy

Customize optic zone diameter

Fine-tune central clearance

Adjust mid-periphery and limbal clearance in specific sectors

4. Sector-Specific Adjustments (Gaudi QS)

8-sector customization allows precise control in different meridians

Navigate around pingueculae, blebs, and other irregularities

Custom edge vaults for glaucoma shunts or other surgical hardware

Channels for tear flow optimization

Toe-heel adjustments at any meridian

5. Advanced Features (Gaudi Legend)

Decentered optic zones for visual axis alignment

Tilted optic zones for irregular corneas

Back OZ cyl, for more precise corneal alignment

6. Optical Correction

Front surface toric for astigmatism correction

Multifocal designs for presbyopia

Higher order aberration (HOA) correction with OVITZ xWave technology (requires xWave aberrometer)

7. Consultation

Work with EYEXY Inc. consultant to optimize design

Upload clinical images, OCT scans, and detailed notes about specific patient needs

8. Final Review and Order

Review complete lens design

Submit order through EWS platform

Fit Evaluation Documentation

Comprehensive documentation during fit evaluation is essential for successful lens design and optimization. The information you gather and communicate to the consultant directly impacts the quality and efficiency of the final lens design.

Critical Information: Must-Have Data

The following information is REQUIRED for all Gaudi lens orders and modifications:

Important Information: Good-to-Have Data

While not absolutely required, the following information significantly enhances the consultant's ability to optimize your lens design:

Imaging Documentation: Maximize Success

High-quality imaging is invaluable for lens design optimization. The following images dramatically improve the consultant's ability to create the optimal lens:

Gaudi Profilometer-Specific Maps

• Blood Vessel Impingement Map

Color-coded visualization showing areas of vascular compression

Identifies specific meridians requiring haptic or edge adjustments

• Centration Map

Shows lens position relative to corneal apex and pupil center

Helps determine if diameter changes or sector adjustments are needed

Clinical Photography

• Color Image of the Eye

White light slit lamp image showing lens on eye

Captures conjunctival vessels, blanching, and obstacles

Multiple views (straight ahead, lateral gaze) are helpful

• Fluorescein Image with Fluorescein in the Bowl

Shows clearance patterns across entire lens profile

Critical for assessing central, limbal, and landing zone clearance

Capture images in primary gaze and multiple meridians if asymmetric fit

AS-OCT Imaging

Anterior Segment Optical Coherence Tomography provides precise, quantitative measurements:

• Central Clearance OCT

Precise measurement of fluid reservoir thickness over corneal apex

• Limbal Region OCT

Visualization of limbal clearance and transition zone

• Edge/Landing Zone OCT

Shows haptic and edge interaction with sclera

Reveals compression, lift-off, or optimal alignment

Scan multiple meridians (0°, 90°, 180°, 270°) for complete assessment

Documentation Workflow: Best Practices

Remember:

• More information = Better lens design = Fewer remakes

• The consultant cannot see what you don't document

• High-quality images are worth thousands of words

• When in doubt, document it and include the image

Fitting Goals & Evaluation

Optimal lens fit should be evaluated after appropriate settling time (20-30 minutes minimum).

Ideal Fitting Characteristics

• Central Corneal Clearance

200-300 µm of clearance over corneal apex (approximately 150-250 µm when measured in comparison to the center thickness of the lens which is typically 300 µm)

• Limbal Clearance

Adequate clearance throughout limbal area ~50 µm with vaulting at limbus to prevent impingement

• Scleral Landing Zone

Even alignment on sclera without compression

No blanching of conjunctival blood vessels

• Lens Edge

Edge does not impinge on bulbar conjunctiva

Minimal to no imprint on conjunctiva upon lens removal

• Lens Movement

Lens centers well and remains virtually motionless on blinking

Minimal lag on lateral gaze

• Fluid Reservoir

No air bubbles trapped under optic zone or haptic after lens settlement

Troubleshooting Common Fit Issues

Materials & Advanced Options

Lens Materials

Gaudi lenses are manufactured using high Dk gas permeable materials optimized for scleral lens wear:

• Hyper Dk materials ensure optimal oxygen transmission

• Superior wettability for all-day comfort

• Gaudi Lenses are manufactured in California, USA by Hedgefog Research Inc.

Optical Enhancements

Front Surface Toric

Available for residual astigmatism correction after spherical lens over-refraction

Multifocal Designs

Progressive addition lenses for presbyopic patients, eliminating the need for reading glasses

OVITZ xWave HOA Correction

Higher order aberration correction technology for patients with complex optical needs

Reduces visual symptoms such as ghosting, double vision, glare, and halos

Requires xWave aberrometer measurement

Design Profiles

The Gaudi Design App allows practitioners to create and save personalized design profiles:

• Custom fit factor preferences

• Preferred clearance settings

• Default landing zone parameters

• Settings can be saved and applied to all your future orders

Patient Care & Education Checklist

Insertion and Removal

Provide comprehensive training on proper lens handling:

• Demonstrate insertion using DMV plunger or tripod method

• Proper filling technique to avoid air bubbles

• Safe removal using DMV removal plunger

• Importance of washing hands before handling lenses

Lens Care

• Clean lenses daily with approved GP cleaner

• Store in approved GP conditioning solution overnight

• Replace solution daily - never top off

• Use preservative-free saline for lens filling

• Replace lens case every 3 months

Wearing Schedule

• Begin with 4-6 hours of wear

• Gradually increase by 2 hours daily as tolerated

• Target full-day wear (12-16 hours)

• Remove lenses before sleeping unless approved for extended wear

Follow-up Schedule

• 1-2 weeks after initial dispensing

• 1 month follow-up

• 3 months

• Then every 6 months or as needed

Patient Care & Education Checklist

How to Order

All Gaudi lenses are ordered through the EYEXY Web Services (EWS) platform:

1. Log into your EWS account. Gaudi Profilometer users can log in directly in the desktop software.

2. Upload profilometry data and clinical images

3. Select lens type (Gaudi AI Empirical, Gaudi AI Trial Set, Gaudi QS, or Gaudi Legend)

4. Review and adjust parameters as needed

5. Add notes for consultant review

6. Submit order

Manufacturer

Hedgefog Research Inc

1891 N Gaffey St Ste 224

San Pedro, CA 90731

EYEXY Inc.

EYEXY Inc. is the developer of Gaudi ecosystem products and the exclusive US distributor of Gaudi Scleral Lenses

Website: www.eyexy.com

Email: info@eyexy.com

Support

For technical support, design consultation, or questions about the fitting process:

• Phone consultation: 424-505-0520

• Email detailed questions with images for comprehensive consultant review