Scleral lenses are specialized contact lenses designed for eyes that cannot tolerate regular contacts or need advanced vision correction. These larger lenses vault over your cornea and rest gently on the white part of your eye, creating a smooth optical surface with a protective fluid reservoir between the lens and your cornea. Our eye doctors in Orange County may recommend scleral lenses if you have an irregular cornea, severe dry eyes, or other conditions where standard contacts fall short.
Scleral lenses represent a significant advancement in contact lens technology, offering solutions for complex eye conditions that other lenses cannot address effectively. Unlike conventional contacts, these specialty lenses create a healing environment while delivering exceptional visual clarity.
Scleral lenses are considerably larger than standard soft or rigid gas permeable contacts. Instead of resting directly on your cornea, they vault over it completely and rest on the conjunctiva, which is the clear tissue covering the white part (sclera) of your eye.
Before inserting the lens, you fill the space between the lens and your cornea with sterile, preservative-free saline solution. This liquid cushion protects your cornea and maintains moisture on your eye surface, which can be especially helpful if you struggle with dry eyes or have a damaged cornea. During wear, this fluid layer can mix with your natural tears and may accumulate debris over time.
We may recommend scleral lenses for a wide range of eye conditions where conventional lenses fail to provide adequate comfort or vision. People with keratoconus, where the cornea develops a cone-like shape, often achieve dramatically better vision with these lenses than with glasses or regular contacts.
You may benefit from scleral lenses if you have tried other contact lenses and experienced discomfort, instability, or blurry vision. Common signs include lenses that move excessively with each blink, persistent dryness, or vision that fluctuates throughout the day.
If your cornea has an irregular shape that glasses cannot fully correct, or if you have undergone corneal surgery that left you with vision problems, we may recommend a scleral lens evaluation. These lenses often provide sharper, more stable vision than other available options.
Our eye doctors will recommend scleral lenses when we believe they offer the best combination of comfort, vision quality, and eye health for your specific situation. For many patients with complex corneal conditions, scleral lenses represent one of the most effective options available.
We may also suggest sclerals if you have tried specialty soft lenses or smaller rigid lenses without success. Because scleral lenses vault the cornea completely, they can succeed where other lens designs fail, particularly when your cornea is very sensitive or irregularly shaped. We use advanced imaging technology including AS-OCT and corneal topography to determine the best approach for your individual needs.
Before recommending scleral lenses, or if sclerals are not appropriate for your situation, we will discuss other vision correction options. The right choice depends on your specific eye condition, lifestyle, and vision goals.
Fitting scleral lenses requires precision, advanced technology, and careful customization. Each lens must be designed to match the unique contours of your eye, which is why the process involves multiple visits and detailed measurements. Our eye doctors have advanced fellowship training in scleral lens fitting, ensuring you receive care at the highest level.
Your first visit will include a comprehensive eye examination and an in-depth discussion of your vision challenges and goals. We will review your medical and eye history, including any previous contact lens experience and current eye conditions.
Our eye doctors will carefully examine the shape and health of your cornea and the entire front surface of your eye. This thorough evaluation helps us determine whether scleral lenses are right for you and which design will work best for your specific needs.
We use state-of-the-art imaging technology to create a detailed map of your unique eye shape. This includes corneal topography, which creates a precise contour map showing every curve and irregularity of your cornea, as well as AS-OCT for detailed analysis of corneal structure.
We will place diagnostic trial lenses on your eyes to assess the fit and vision. Using a slit lamp microscope, our eye doctors will check how the lens vaults over your cornea and how it lands on your sclera.
We look for appropriate clearance over the cornea, proper edge alignment, and good lens centration. You will wear the trial lens for a period of time so we can evaluate comfort and vision stability. Based on what we observe, we may try different trial lenses until we achieve the optimal fit. For particularly complex cases, we can utilize EyePrintPRO technology, which creates a precise impression of your eye for truly custom lens design.
Fitting scleral lenses typically requires multiple appointments over several weeks or even months. The initial visit usually takes one to two hours for measurements and trial fitting.
Once we order your custom lenses, it may take two to four weeks for the lab to manufacture them. After you receive your lenses, we will schedule follow-up visits to assess the fit and make any needed adjustments. Some patients need only minor modifications, while others may require one or more remakes to achieve the ideal fit.
We will see you within the first week or two of receiving your custom lenses. During this visit, we check how the lenses fit after you have worn them at home and assess your comfort and vision quality.
Additional follow-up appointments are scheduled at regular intervals, typically at one month, three months, six months, and then annually. These visits allow us to monitor your eye health, ensure the lenses continue to fit properly, and update your prescription if needed.
Mastering the insertion and removal of scleral lenses takes practice, but most patients become confident with the process within a week or two. We provide thorough hands-on training and remain available to answer questions as you develop your technique.
Inserting scleral lenses becomes easier with practice and patience. You will fill the bowl of the lens with preservative-free sterile saline, then lean over a mirror and use both hands to hold your eyelids open wide.
Removing scleral lenses requires a different technique than removing soft lenses. Most people use a small removal plunger designed specifically for scleral lenses.
You will look down, hold your upper eyelid, and gently press the plunger onto the lower edge of the lens to break the seal. The lens will then lift off your eye attached to the plunger. Some people learn to remove the lenses using their fingers, but we recommend starting with a plunger for safety and ease.
Your eyes and brain need time to adjust to scleral lenses. You may notice the lenses feel large at first, and your eyelids may be aware of the lens edges for the first few days.
Most patients adapt within one to two weeks as their eyelids become accustomed to the lens diameter. Vision may seem extremely sharp and clear right away, or it may take a few days to stabilize. If you experience significant discomfort beyond the first week, contact our office so we can evaluate the fit.
We typically recommend building up your wearing time gradually, starting with four to six hours on the first day and adding an hour or two each day. Most patients can comfortably wear scleral lenses for twelve to sixteen hours daily.
Wearing time should be individualized based on your eye health and comfort level. Some patients, especially those with active ocular surface disease, may need to remove their lenses midday to refresh the fluid reservoir. Always follow the wearing schedule our eye doctors recommend for your specific situation.
Proper care of your scleral lenses is essential for maintaining healthy eyes and extending the life of your lenses. We will provide detailed instructions on cleaning and storage, tailored to your specific lens material and individual needs. Consistent daily care prevents complications and ensures optimal lens performance.
We will recommend specific cleaning solutions based on your lens material and your individual needs. Rigid gas permeable lens cleaners are typically used for scleral lenses, along with hydrogen peroxide or multipurpose disinfecting systems.
If you use a hydrogen peroxide disinfection system, it is critical that the peroxide fully neutralizes before you insert your lenses. Never use hydrogen peroxide directly as a rinse or to fill the lens bowl, as peroxide that contacts your eye can cause serious chemical injury. Always follow the manufacturer instructions for neutralization time.
Clean your lenses every time you remove them from your eyes. Place a few drops of daily cleaner on each side of the lens and gently rub with your fingertip for about twenty seconds.
Rinse the lenses thoroughly with preservative-free saline or the rinsing solution recommended by our eye doctors. Then place the lenses in your storage case filled with fresh disinfecting solution. Never reuse solution from a previous day, as this can lead to contamination and eye infections.
Always store your scleral lenses in a clean case filled with the appropriate disinfecting solution. The lenses must stay submerged in solution for the minimum disinfection time specified by the solution manufacturer, usually at least four to six hours.
Replace your lens case every one to three months to prevent bacterial buildup. Keep the case open and air drying when your lenses are in your eyes, and never let water from the tap, shower, or pool contact your lenses or case.
We will examine your lenses at each follow-up visit for signs of wear, deposits, or warping. You will need new lenses if they become damaged, if protein or lipid deposits build up and cannot be cleaned away, or if your prescription changes.
The timing for routine replacement depends on the lens material, your tear chemistry, and how well you maintain them. We will let you know when it is time to order replacement lenses based on the condition of your current pair.
If you crack, chip, or scratch a scleral lens, stop wearing it immediately and contact our office. Damaged lenses can injure your eye or cause serious discomfort.
We will examine the lens and determine whether it needs to be replaced. This is why we often recommend ordering a backup pair of lenses, especially if you depend on sclerals for your daily activities and work.
While scleral lenses are designed for maximum comfort and visual clarity, you may occasionally experience minor issues. Understanding common problems and their solutions helps you maintain comfortable wear and know when to seek professional guidance. Most issues can be resolved quickly with simple adjustments or technique modifications.
Many patients find scleral lenses more comfortable than smaller contacts because they do not move with each blink. The lens edges rest on the less sensitive conjunctiva overlying the sclera rather than rubbing against the sensitive cornea.
The layer of saline between the lens and your cornea also provides cushioning and helps keep your cornea moist. People with dry eyes often experience relief they never achieved with other lens types, although the quality of the fluid reservoir can change during the day.
Small air bubbles can sometimes become trapped under a scleral lens during insertion. Tiny bubbles may not cause problems, but larger bubbles can create blurry spots in your vision or cause discomfort.
If your vision becomes cloudy or foggy after several hours of wear, debris may be building up in the fluid layer between the lens and your cornea. This is more common in people who produce excess mucus or have inflammation of the ocular surface.
Removing the lens, cleaning it, and reinserting it with fresh saline usually clears the problem. If clouding happens frequently or early in the day, let us know so we can evaluate your tear film and ocular surface health.
Some initial awareness of the lens is normal, but significant pain, redness, or light sensitivity is not. These symptoms may indicate that the lens fit is too tight, the edge is causing irritation, or you have developed an infection or corneal abrasion.
Remove your lenses immediately if you experience sharp pain, sudden vision loss, intense redness, discharge, or extreme light sensitivity. Contact our office the same day, as these can be signs of a serious problem that needs prompt attention.
Reach out to us if you have persistent discomfort that does not improve after the first week, if you cannot achieve clear vision, or if you struggle with insertion or removal after several practice sessions. We are here to help you succeed with your lenses.
You should also contact us if you notice any changes in how the lens feels or performs, if you see deposits or damage on the lens, or if you develop any eye redness, discharge, or pain. Quick communication helps us address small issues before they become larger problems.
Scleral lenses are safe when fitted properly and cared for correctly, but like all contact lenses they carry some risks. Understanding potential complications helps you recognize warning signs early and seek prompt care when needed. Most complications can be prevented with good hygiene, proper lens handling, and regular follow-up care.
Being aware of potential risks associated with scleral lens wear helps you take appropriate precautions and respond quickly if problems arise. While serious complications are uncommon with proper care, they can occur.
Scleral lenses require good manual dexterity, careful hygiene, and commitment to follow-up care. Our eye doctors will evaluate whether these lenses are appropriate for your situation.
Certain symptoms require immediate attention. If you experience any of the following, remove your lenses right away and contact our office. If we are closed or unreachable and symptoms are severe, seek urgent care or go to an emergency department.
Understanding the financial aspects of scleral lens wear helps you plan and budget appropriately. While scleral lenses represent a significant investment, they often provide vision and comfort that cannot be achieved through other means. We work with patients to explore insurance coverage and payment options whenever possible.
Scleral lenses cost more than standard contact lenses because they are custom-designed for your unique eye shape and require specialized fitting expertise. The total cost usually includes professional fitting fees, advanced imaging, trial lenses, and the final custom lenses.
Prices vary depending on the complexity of your condition, the type of lens design needed, and the number of visits and lens modifications required. Our team can provide you with a detailed cost estimate during your initial evaluation so you can plan accordingly.
Many vision insurance plans cover scleral lenses when they are medically necessary, such as for keratoconus, corneal scarring, or severe dry eye. Medical insurance may also provide coverage in certain situations.
We will work with you to determine your coverage and provide the documentation your insurance company needs. Even if your insurance does not cover the full cost, partial reimbursement or contributions toward the fitting may be available.
With proper care and handling, scleral lenses generally last one to three years. The exact lifespan depends on the lens material, how often you wear them, your tear chemistry, and environmental factors that can affect lens deposits and surface quality.
We will monitor the condition of your lenses at regular checkups and advise you when replacement is needed. Replacing lenses on schedule helps ensure optimal vision, comfort, and eye health. Planning for periodic replacement costs is an important part of budgeting for scleral lens wear.
We strongly recommend having a backup pair of scleral lenses, especially if you rely on them for work or driving. If you lose or damage a lens, having a spare means you will not be without vision correction while waiting for a replacement.
You should also keep an updated pair of eyeglasses, even though they may not provide the same quality of vision as your scleral lenses. Glasses give your eyes a rest and serve as a backup option when you cannot wear your contacts.
We do not recommend sleeping in scleral lenses. Your cornea needs direct access to oxygen from the air, and wearing lenses overnight significantly increases the risk of infections and other complications, even with highly breathable lens materials. Removing your lenses before sleep is an important safety measure that protects your eye health.
You should remove your scleral lenses before swimming, showering, or using a hot tub. Water from any source can introduce bacteria, parasites, or other microorganisms that can cause serious eye infections. If you must swim with your lenses, wear tight-fitting goggles and discuss the risks with our eye doctors, but removal before water exposure is always the safest approach.
Scleral lenses do not permanently change the shape of your cornea, but they do create a new, smooth refractive surface that corrects irregular astigmatism and other optical imperfections. As long as you wear the lenses, you should enjoy clear, stable vision that glasses and soft contacts often cannot provide. For patients requiring highly customized optics, we can design wavefront-guided scleral lenses that address even complex visual aberrations.
Yes, scleral lenses are safe for daily use when fitted properly, worn as directed, and cared for correctly. We monitor your eye health at regular follow-up visits to ensure the lenses are not causing any problems. Many people around the world wear scleral lenses successfully every day, achieving vision and comfort they could not obtain through other means.
Learning to insert and remove scleral lenses takes practice, and some people need more coaching than others. If you are struggling after your initial training, contact our office to schedule additional hands-on instruction. We can troubleshoot your technique and offer personalized tips that make the process easier. Most patients become proficient within the first week or two with proper guidance and practice.
If you think scleral lenses might be right for you, or if you have questions about your current lenses, we encourage you to reach out to Insight Vision Center Optometry. Our eye doctors hold advanced fellowship credentials in scleral lens fitting, with Dr. Nathan Schramm, OD, FSLS, FBCLA and Dr. Thanh Mai, OD, FSLS, FIAOMC both holding Fellowships in the Scleral Lens Education Society, a distinction held by only 300 practitioners worldwide. We utilize advanced technology including wavefront-guided lens design, EyePrintPRO custom impression lenses, and advanced imaging to provide you with the highest level of care. We are here to support you at every step of your journey to better vision and comfort.
