At Insight Vision Center Optometry in Orange County, we fit advanced scleral contact lenses for patients with corneal irregularities, severe dry eye, and complex vision needs that cannot be addressed with standard contacts or glasses. Our fellowship-trained optometrists use modern diagnostic technology and custom lens designs to restore clear, comfortable vision when other options have not worked.
Scleral lenses are large, custom-designed rigid gas-permeable contact lenses that vault over your entire cornea and rest gently on the white part of your eye, called the sclera. Unlike traditional contact lenses that sit directly on the cornea, scleral lenses create a fluid-filled chamber between the lens and your eye that provides exceptional comfort, protection, and vision correction.
The key feature of a scleral lens is its vault, which is the space between the back surface of the lens and the front surface of your cornea. Before you insert the lens, you fill it completely with preservative-free saline solution. This creates a smooth, liquid cushion that bathes your cornea and compensates for any irregularities in its shape, delivering clear vision even when the corneal surface is uneven or damaged.
The saline reservoir between your cornea and the scleral lens acts as a protective barrier. It keeps the corneal surface constantly hydrated and shields it from irritation caused by eyelid movement or environmental factors. For patients with severe dry eye or compromised corneal surfaces, this tear reservoir can provide relief that is not possible with other lens types.
Modern scleral lenses are made from highly oxygen-permeable materials. Even though the lens is larger and holds a fluid reservoir, adequate oxygen still reaches the cornea to maintain healthy cell function. Our optometrists carefully select lens materials with appropriate oxygen transmission based on your eye health and wearing schedule to minimize any risk of corneal swelling or complications.
Every scleral lens is customized to match the unique shape and curvature of your eye. We use advanced imaging and measurement tools to map both your cornea and sclera, then design a lens with precise parameters for diameter, vault height, edge alignment, and optical power. This level of customization is what makes scleral lenses effective for even the most challenging cases.
Scleral lenses are ideal for patients whose vision or comfort needs cannot be met by standard contact lenses or glasses. We fit scleral lenses for a wide range of corneal and ocular surface conditions, offering solutions that improve both vision quality and daily comfort.
Keratoconus is a progressive condition in which the cornea thins and bulges into a cone shape, causing distorted and blurry vision. Standard glasses and soft contact lenses often cannot correct the irregular astigmatism caused by keratoconus. Scleral lenses vault over the irregular cornea and use the saline reservoir to create a perfectly smooth optical surface, dramatically improving vision clarity and sharpness.
Patients with chronic dry eye, Sjogren syndrome, or other conditions that reduce tear production often find traditional contact lenses unbearable. The constant moisture provided by the scleral lens tear reservoir keeps the cornea hydrated and comfortable throughout the day. Many patients who have given up on contact lenses due to dryness find scleral lenses to be life-changing. If you are unsure if your symptoms suggest a chronic issue, our dry eye quiz can help you understand your condition.
Following procedures such as corneal transplants, LASIK, radial keratotomy, or other refractive surgeries, the cornea can become irregular or unstable. Scleral lenses protect the healing cornea while providing excellent vision correction. Additionally, for corneal scars from injury or conditions like Stevens-Johnson syndrome, scleral lenses smooth out optical irregularities. We also fit prosthetic scleral lenses for patients with iris atrophy or aniridia to improve both appearance and vision.
If you have severe astigmatism or an unusual prescription that is difficult to correct with glasses or standard lenses, scleral lenses may offer a better solution. The rigid lens material and custom optics provide crisp, stable vision even for highly complex refractive errors.
Some patients simply cannot tolerate soft contact lenses or traditional rigid gas-permeable lenses due to discomfort or poor fit. Because scleral lenses rest on the less sensitive sclera rather than the cornea, they often feel more comfortable and stable. If you have struggled with contact lens intolerance, scleral lenses may be the answer.
Our practice is equipped with modern diagnostic and fitting technologies that allow us to design and customize scleral lenses with exceptional precision. We offer some of the most advanced scleral lens options available, tailored to your specific eye condition and visual needs.
We use the Tomey WaveDyn Aberrometer to measure higher-order aberrations in your visual system. This technology allows us to design wavefront-guided scleral lenses that correct not only your basic prescription but also subtle distortions that affect image quality. Dr. Nathan Schramm, OD, FSLS, FBCLA, has served as principal investigator for a 200-eye study on wavefront-guided scleral lenses and is one of only 300 fellows worldwide in the Scleral Lens Education Society and one of 250 fellows in the British Contact Lens Association.
For eyes with highly irregular surfaces or unique anatomical challenges, we offer EyePrintPRO, a technology that creates a precise impression of your eye to design a truly customized scleral lens. This process captures the exact contours of your sclera and cornea, resulting in a lens that fits like no other. EyePrintPRO lenses are especially beneficial for patients with severe irregularities or those who have not achieved success with conventional fitting methods.
We fit a full range of scleral lens designs to meet diverse patient needs. Options include HERO Scleral lenses for stability and comfort, channeled scleral lenses for enhanced tear circulation, and custom tinted lenses for light sensitivity or cosmetic purposes. We also work with SpecialEyes and other advanced manufacturers to create lenses for infant aphakia, post-surgical eyes, and other rare conditions.
Accurate fitting begins with detailed imaging of your eye. We use anterior segment optical coherence tomography, or AS-OCT, to visualize the vault and fit of the lens in real time. Corneal topography maps the shape of your cornea with high precision. These tools allow our optometrists to fine-tune every aspect of your lens design for optimal comfort, vision, and eye health. Dr. Thanh Mai, OD, FSLS, FIAOMC, is also a fellow of the Scleral Lens Education Society and serves as Vice President of Clinical Innovation for Treehouse Eyes, bringing advanced expertise to every fitting.
Fitting scleral lenses is a detailed process that requires specialized training and advanced equipment. Our team takes the time to ensure your lenses fit properly, feel comfortable, and deliver the best possible vision. Most patients require multiple visits to achieve the ideal fit.
Your first visit includes a comprehensive eye exam and detailed imaging of your cornea and sclera. We use corneal topography, AS-OCT, and other diagnostic tools to measure the shape, size, and health of your eyes. We also evaluate your tear film quality and discuss your vision goals and lifestyle needs. This information allows us to select an appropriate lens design and starting parameters for your trial fitting.
During your trial fitting, you will try on diagnostic lenses while we evaluate the fit under a microscope. We check the vault over your cornea, the alignment of the lens edge on your sclera, and the way the lens moves with blinking. You will wear the trial lens for a short time so we can assess comfort and vision. Based on this evaluation, we may adjust the lens curvature, diameter, or edge design. Multiple trials are often needed to achieve the perfect fit.
Because scleral lenses are larger than standard contacts, inserting and removing them requires a different technique. We provide hands-on training using a plunger or suction tool to safely place the lens on your eye and remove it without damaging the lens or your cornea. You will practice filling the lens with preservative-free saline and checking for air bubbles before insertion. We make sure you are confident and comfortable with the process before you take your lenses home.
We recommend starting with a gradual wearing schedule to allow your eyes to adapt. You may begin with just a few hours per day and slowly increase wear time over one to two weeks. This helps minimize discomfort and allows your eyes to adjust to the sensation of the lens. We provide clear instructions on how to progress and what to expect during the adaptation period.
Your first follow-up visit is typically scheduled within one to two weeks after you receive your lenses. We check the fit, examine your cornea and eye surface, and assess your comfort and vision. Additional adjustments may be made based on how your eyes respond. Ongoing follow-up appointments every few months help us monitor your eye health and ensure long-term success with your scleral lenses.
Proper care and maintenance of your scleral lenses are essential to protect your eye health and extend the life of your lenses. A consistent cleaning routine and careful handling will help prevent infections and keep your lenses in excellent condition.
Each time you remove your lenses, clean them immediately with a recommended cleaning solution. Place a few drops of solution on the lens and gently rub both sides with your fingertip for 10 to 20 seconds. This removes protein deposits, debris, and oils that build up during wear. Rinse the lens thoroughly with fresh saline or multipurpose solution before storing or reinserting.
Store your lenses in a clean case filled with fresh disinfecting solution every night. Never reuse old solution, as this increases the risk of contamination and eye infections. Allow the lenses to soak for at least four to six hours, or as directed by your eye care provider. Replace your lens case every one to three months to reduce bacterial buildup.
Always wash and dry your hands thoroughly before touching your lenses. Avoid using lotions, oils, or soaps with moisturizers, as these can leave residue on the lenses. Work over a clean, lint-free towel to prevent damage if you drop a lens. Inspect each lens for cracks, chips, or warping before inserting it. If you notice any damage, contact our office for a replacement.
When you travel, pack your lenses in a hard protective case and bring extra cleaning solutions and preservative-free saline in your carry-on luggage. Avoid exposing lenses to tap water, which can contain harmful microorganisms. Bring a copy of your lens prescription or a note from your optometrist if you are traveling by air, as security may ask about the medical liquids in your bag.
Most patients adapt to scleral lenses within a few days to two weeks and experience significant improvements in vision and comfort. Understanding what is normal and what requires attention will help you wear your lenses safely and confidently.
During the first few days, you may notice mild lens awareness, increased tearing, or slight redness. These sensations typically improve as your eyes adjust. Gradually increasing your wearing time helps your eyes adapt more comfortably. If discomfort persists beyond the first week or worsens, contact our office for an evaluation.
It is normal to feel slight pressure or awareness of the lens, especially when you first insert it. Mild fluctuations in vision during the first hour of wear are also common as the tear reservoir settles. However, sharp pain, significant redness, sudden vision loss, discharge, or sensitivity to light are warning signs that require immediate attention. Remove your lenses and contact our office right away if you experience any of these symptoms.
Use preservative-free rewetting drops or artificial tears as needed to keep your eyes comfortable. Take regular breaks during extended screen time to reduce eye strain. If you notice fogging or clouding in the tear reservoir during the day, remove the lens, rinse it with fresh saline, refill it, and reinsert. If fogging continues, a lens surface treatment or adjustment may be needed.
Reach out to us immediately if you have persistent pain, redness, discharge, or any sudden change in vision. Also contact us if your lens becomes damaged, if you lose a lens, or if the fit feels uncomfortable after previously feeling fine. Regular checkups allow us to catch potential issues early and keep your eyes healthy during long-term lens wear.
If you are struggling with corneal irregularities, severe dry eye, or vision problems that have not been solved with standard contact lenses or glasses, scleral lenses may offer the solution you need. Our experienced optometrists at Insight Vision Center Optometry use advanced diagnostic technology and custom lens designs to fit scleral lenses for even the most challenging cases. Contact our Costa Mesa office to schedule a scleral lens evaluation and take the first step toward clearer, more comfortable vision.
Most patients adapt within one to two weeks, though some adjust in just a few days. We recommend starting with two to four hours of daily wear and gradually building up to full-day wear as your comfort improves. Following the wearing schedule we provide helps your eyes adjust more smoothly and reduces the chance of discomfort.
Fogging or clouding can occur when debris accumulates in the tear reservoir or when protein deposits on the lens surface. To fix it, remove the lens, rinse both sides with fresh saline, refill the bowl with new saline, and reinsert. If fogging happens frequently, contact our office, as a surface treatment or lens modification may help prevent it.
We strongly recommend removing your lenses before swimming, showering, or exposing them to any water. Water exposure increases the risk of serious eye infections, including those caused by microorganisms found in tap water, pools, and hot tubs. If you must swim with your lenses, wear watertight goggles and remove and disinfect the lenses as soon as possible afterward.
The main difference is the diameter. Mini-scleral lenses typically range from 14.5 to 18 millimeters and are used for less complex conditions or when a smaller lens is better tolerated. Full scleral lenses are 18 millimeters or larger and provide a higher vault, making them suitable for more severe corneal irregularities or larger eyes. Your optometrist will recommend the best size based on your condition and anatomy.
With proper care, scleral lenses typically last one to two years. Over time, deposits and wear can affect lens clarity and comfort. Regular checkups allow us to monitor the condition of your lenses and determine when replacement is needed. Replacing lenses on schedule ensures optimal vision and reduces the risk of complications.
Many insurance plans consider scleral lenses medically necessary for conditions like keratoconus, corneal transplants, and severe dry eye, and may cover part of the cost. Coverage varies by plan, so we recommend contacting your insurance provider and our office to discuss your benefits. We will work with you to understand your costs and help you explore payment options if needed.
