Scleral lenses are a type of contact lens designed for patients whose needs are not met by traditional contact lenses. They are especially helpful for people with irregular corneas, such as those with keratoconus, or those with severe dry eye.
Scleral lenses are custom-made to match the precise shape of your eye. Using advanced imaging and mapping, the lens is crafted to fit the unique contours of your cornea and sclera. This tailored fit ensures optimal lens alignment, comfort, and clarity of vision.
In practice, this means fewer issues with lenses shifting or causing pressure points. The lens conforms closely to your eye's anatomy. The precise customization helps deliver sharper vision than standard contacts, which is particularly important for complex prescriptions or corneal irregularities.
Unlike regular contacts that sit on the cornea, scleral lenses vault over the cornea entirely and rest on the less sensitive sclera (the white part of the eye). Because the lens does not touch the corneal surface, it avoids aggravating any irregular or sensitive areas.
This greatly reduces irritation and light sensitivity that some people experience with standard lenses. The vaulting design also creates a consistent optical surface, contributing to more stable and clear vision since the uneven corneal shape is effectively bypassed.
One of the hallmark benefits of scleral lenses is the liquid reservoir that sits between the back of the lens and the cornea. Before inserting a scleral lens, it is filled with sterile saline solution. When the lens is on the eye, this fluid layer forms a continuous cushion of moisture over the cornea.
The result is that your eye's surface stays hydrated throughout the day. This protects against dryness and discomfort. This is especially helpful for individuals with severe dry eye syndrome, patients with conditions such as Sjogren's syndrome and lupus, and those with damaged corneas.
Scleral lenses are noticeably larger than standard soft or gas-permeable contacts, often spanning 15 to 20 or more millimeters in diameter compared to about 9 to 14 millimeters for regular lenses. This larger size anchors the lens more securely on the eye.
The broad diameter distributes pressure evenly and prevents the lens from moving around or popping out easily. For patients with irregular corneas, this stability helps maintain a consistently clear optical pathway, reducing visual distortions. Many users can comfortably wear scleral lenses for extended periods throughout the day.
Keratoconus is a condition that causes the cornea to thin and become irregularly shaped. The vaulting design of scleral lenses helps create a smooth optical surface over the irregular cornea, improving vision noticeably.
For individuals who struggle with chronic dryness, the tear reservoir provided by scleral lenses not only hydrates the eyes but also ensures that vision remains clear and comfortable over a long period of wear. This includes patients with Sjogren's syndrome and other autoimmune conditions.
The inherent stability of scleral lenses means they can correct residual astigmatism more effectively compared to other types of lenses that shift on the eye. This reduces the need for additional vision correction like prescription eyeglasses worn over contact lenses.
Whether due to trauma, surgery, or conditions such as corneal dystrophy, patients with irregular corneas often benefit significantly from the custom fit of scleral lenses. Post-surgical patients, including those who have had radial keratotomy or other refractive procedures, may find scleral lenses restore comfortable, clear vision.
Because of their secure fit and resistance to dislodgement, scleral lenses are excellent for those who regularly participate in sports or physically demanding activities. Athletes, first responders, pilots, and others who need reliable vision correction throughout their day often find scleral lenses meet their needs well.
Scleral lenses provide an improved level of comfort because they bypass the sensitive cornea. Unlike gas-permeable lenses that rest directly on the cornea, scleral lenses rest on the sclera, reducing friction and minimizing discomfort.
Soft lenses, while comfortable upon insertion, may not provide optimal correction for patients with severe corneal irregularity or dry eye issues. Many patients find that scleral lenses offer a refreshing alternative when traditional lenses prove too abrasive or unstable.
One of the standout features of scleral lenses is their ability to deliver consistently clear vision. Because they maintain a stable fluid reservoir between the lens and the cornea, they help smooth out irregularities and offer steady visual acuity.
For patients with conditions like keratoconus or high astigmatism, this feature can mean the difference between a frustrating experience with moving lenses and stable, reliable correction throughout the day. Standard rigid gas-permeable lenses may shift with each blink, potentially causing blurred vision.
The design of scleral lenses helps shield the cornea from dust, smoke, and other environmental irritants. Because they create a seal over the eye and provide a protective layer of moisture, they serve as a barrier against debris that might otherwise irritate the eye.
This feature is especially beneficial for individuals who work in environments with high levels of airborne particles or who experience irritation from everyday exposure to dust and pollutants.
Scleral lenses vault above the cornea, landing on the sclera. Gas-permeable lenses sit directly on the corneal surface. This difference is key for patients with corneal sensitivities or irregularities, as scleral lenses reduce direct contact with the sensitive corneal tissue.
Determining whether you are a good candidate for scleral lenses starts with a detailed map of your cornea and precise measurements of your eyes. Our eye doctors use advanced technology such as the Pentacam for corneal tomography and the Tomey WaveDyn Aberrometer to choose the ideal lens design and size for your unique eye shape.
During the exam, several factors are taken into account:
Follow-up appointments help fine-tune the lenses to ensure maximum comfort and clear vision. This personalized evaluation sets scleral lenses apart from other options, offering a solution tailored to your specific visual and comfort needs.
While scleral lenses might require an adjustment period due to their larger size, patients who overcome this early phase frequently report significantly enhanced comfort and stability. Many patients describe them as feeling as comfortable as soft lenses while providing superior vision stability.
HERO Scleral lenses offer precision fit with wavefront optics for clear vision. These lenses are designed for patients who need advanced correction for conditions like keratoconus or post-surgical irregularities.
Using the Tomey WaveDyn Aberrometer, our eye doctors can create wavefront-guided custom scleral lenses. Dr. Nathan Schramm, OD, FSLS, FBCLA has served as the principal investigator for the WaveDyn wavefront-guided scleral study. These lenses use detailed measurements of your eye's optical system to reduce visual disturbances like halos.
For patients with highly irregular eyes that are difficult to fit with standard scleral designs, EyePrintPRO technology creates a precise impression of your eye's surface for a truly custom lens.
Insight Vision Center Optometry has multiple fellowship-trained optometrists with advanced credentials in scleral lens fitting. Dr. Nathan Schramm, OD, FSLS, FBCLA holds both the FSLS and FBCLA fellowships. He co-founded the International Congress of Scleral Contacts. Dr. Thanh Mai, OD, FSLS, FIAOMC also holds the FSLS fellowship and has training in Pentacam corneal tomography.
Our practice uses advanced equipment including AS-OCT imaging, the Pentacam for corneal mapping, and the Tomey WaveDyn Aberrometer. This technology helps our eye doctors design lenses that fit your eyes precisely.
Most patients can comfortably wear scleral lenses throughout their waking hours. Your eye doctor will provide specific guidance based on your eye health and the fit of your lenses. Some patients wear them for 12 to 16 hours daily without discomfort.
Scleral lenses require a different technique than standard contact lenses because of their larger size. You will be trained on proper insertion and removal during your fitting appointments. Most patients become comfortable with the process within a few days of practice.
Scleral lenses require daily cleaning with approved solutions. You will fill the lens with preservative-free saline before each insertion. Your eye doctor will provide specific care instructions and recommend appropriate products for your lenses.
Coverage varies depending on your insurance plan and the medical necessity of the lenses. Our staff can help you understand your benefits. Some plans cover medically necessary contact lenses for conditions like keratoconus.
