Scleral lenses offer stable, clear vision for patients with high astigmatism and irregular corneal conditions. These large-diameter lenses vault over the cornea and rest gently on the sclera, the white part of your eye. This creates a smooth optical surface for comfortable, reliable vision correction.
Astigmatism occurs when the natural curvature of the eye is irregular. This causes light to focus unevenly on the retina. High astigmatism can blur vision for both near and distant objects, making everyday activities like driving, reading, or recognizing faces more difficult.
When the cornea or lens surface lacks a uniform curve, it disrupts how light is focused. Traditional soft contact lenses conform too readily to the irregular surface, which can leave vision blurry or unstable. Scleral lenses create a new, regular optical surface that directs light precisely onto the retina, helping achieve stable and clear vision.
Regular astigmatism results from a naturally oval-shaped cornea. Irregular astigmatism involves more complex surface distortions, often caused by conditions like keratoconus or previous eye surgery. Scleral lenses can correct both types by creating a uniform refractive surface over the cornea.
Scleral lenses are large-diameter rigid gas permeable lenses that rest on the sclera rather than directly on the cornea. By vaulting over the cornea, these lenses create a fluid-filled reservoir that fills in surface irregularities. This provides a smooth surface for light focusing while keeping the eyes comfortably hydrated.
Unlike soft lenses, scleral lenses maintain their rigid shape regardless of the underlying corneal contour. This rigidity is key to their effectiveness. The lens does not flex or conform to irregular surfaces, so it can provide consistent optical correction even for challenging cases.
The tear fluid trapped between the lens and the cornea creates a protective cushion. This reservoir corrects surface imperfections by forming an even refractive layer. It also keeps the cornea bathed in moisture throughout the day, which is especially helpful for patients who experience dry eye symptoms.
Because scleral lenses vault over the cornea and sit firmly on the sclera, they do not shift as much as other lens types. This provides consistent, blur-free vision throughout the day. Patients often notice less visual fluctuation compared to soft lenses.
Each lens is designed to match your unique eye shape. This customization is critical for patients with irregular or high astigmatism. The tailored fit provides clear vision and comfort that standard contact lenses often cannot match.
The protective tear reservoir reduces irritation and provides continuous lubrication. This is especially helpful for individuals who experience dry eye symptoms or discomfort with other lens types. Many patients can wear scleral lenses comfortably for extended periods.
Scleral lenses can correct both regular and irregular astigmatism. They are also effective for patients with keratoconus, post-surgical corneal changes, and other conditions that create irregular corneal surfaces.
When traditional lenses fail to adequately correct the refractive error due to significant corneal irregularities, scleral lenses provide a stable alternative. They are often the preferred option when other lens types have not delivered satisfactory vision.
Keratoconus causes the cornea to thin and bulge into a cone shape. Corneal ectasia involves similar progressive thinning. Scleral lenses create a new front optical surface over these irregular corneas, minimizing distortion and improving visual clarity.
After procedures such as LASIK, radial keratotomy, corneal transplants, or eye injuries, the corneal surface can become irregular. Standard lenses may be difficult to fit or uncomfortable. Scleral lenses avoid direct contact with these sensitive areas while providing effective vision correction.
The fluid reservoir of scleral lenses continuously bathes the cornea with moisture. This helps alleviate discomfort associated with dry eyes and can enhance overall eye health. Many dry eye patients find scleral lenses more comfortable than other contact lens options.
The fitting process begins with a thorough consultation and eye examination. Advanced imaging techniques like corneal topography and scleral profilometry create detailed maps of your eye's unique contours. This evaluation ensures the lens fits perfectly and functions ideally.
During the fitting session, a series of trial lenses are placed on your eye to assess initial comfort and visual acuity. This trial period helps determine the best lens parameters for your eyes. Our eye doctors evaluate the fit and make notes for any needed adjustments.
Once the trial lenses provide acceptable performance, the final lenses are customized to match your eye's shape precisely. This ensures optimal fluid reservoir formation and stability throughout the day. The custom design addresses your specific corneal irregularities and refractive needs.
Regular follow-up appointments help fine-tune the lenses for maximum comfort and clear vision. Many patients experience a brief adjustment period when first wearing scleral lenses. With follow-up care, any minor discomfort can be quickly addressed.
Soft lenses are popular for their ease of use. However, they conform to the cornea's shape. For individuals with irregular or severe astigmatism, this conformity means the underlying irregularities are not corrected, which can result in blurred or unstable vision.
Soft toric lenses correct for astigmatism and work well for mild cases. However, for patients with high or irregular astigmatism, the soft lens design may not provide optimal correction. Soft toric lenses can also rotate during wear, causing fluctuating vision throughout the day.
Rigid gas permeable lenses can provide excellent vision by maintaining their shape. However, they are smaller than scleral lenses and rest directly on the cornea. This can lead to discomfort and a longer adaptation period, especially for those used to soft contacts.
Hybrid lenses combine a rigid center with a soft outer skirt. While they may work well for some patients, they may not deliver the same level of stability or hydration provided by scleral lenses, particularly for high astigmatism cases.
Clear, stable vision enhances your overall quality of life. With scleral lenses, everyday activities become more enjoyable and less stressful. Patients often report being able to see details they previously missed, from street signs to facial expressions.
The consistent refractive surface provided by scleral lenses helps minimize distortions that can lead to eye strain and headaches. Many patients find they can work, read, and use digital devices more comfortably with scleral lenses.
The continuous presence of tear fluid keeps the cornea well hydrated throughout the day. Blinking no longer results in harsh contact between the lens and your cornea. Even extended hours of lens wear can remain comfortable for most patients.
At Insight Vision Center Optometry, our eye doctors use advanced technology including corneal topography, the Pentacam, and the Tomey WaveDyn Aberrometer to create detailed maps of your eyes. This technology helps identify the precise dimensions and curvatures that need correction for optimal lens performance.
Dr. Nathan Schramm, OD, FSLS, FBCLA holds fellowships in scleral lenses and is one of approximately 300 FSLS fellows worldwide. He co-founded the International Congress of Scleral Contacts and serves as a principal investigator for wavefront-guided scleral lens studies. Dr. Thanh Mai, OD, FSLS also holds an FSLS fellowship and uses Pentacam corneal tomography for precise fitting.
Our team takes a personalized approach to scleral lens fitting. We work with patients who have challenging cases including keratoconus, post-surgical irregularities, and severe dry eye. Follow-up appointments ensure your lenses continue to provide clear, comfortable vision.
Most patients adapt to scleral lenses within one to two weeks. The initial days may involve some awareness of the lens on your eye, but this typically fades as you become accustomed to insertion, removal, and wearing the lenses throughout the day.
Scleral lenses are not designed for overnight wear. You should remove, clean, and store your lenses each night. Sleeping in scleral lenses can reduce oxygen flow to the cornea and increase the risk of eye health issues.
Scleral lenses require filling with preservative-free saline solution before insertion. You place the lens on a special plunger or your fingertips, then carefully position it on your eye. For removal, a small suction device gently lifts the lens from your eye. Our team provides thorough training during your fitting appointments.
With proper care, scleral lenses typically last one to three years. Regular cleaning and safe storage extend their lifespan. Your eye doctor will monitor lens condition at follow-up visits and recommend replacement when needed.
Coverage varies by insurance plan. Some vision and medical insurance plans provide partial coverage for medically necessary contact lenses, which may include scleral lenses prescribed for keratoconus or other qualifying conditions. Our staff can help you understand your coverage options.
Some discomfort during the adjustment period is normal. If discomfort persists, contact your eye doctor. The lens fit may need adjustment, or there could be debris under the lens. Do not continue wearing a lens that causes significant pain, redness, or vision changes.
