Scleral lenses are large, gas-permeable contact lenses that vault over the cornea and rest on the sclera, the white part of the eye. They provide continuous hydration and protection for patients with severe dry eye conditions that do not respond well to other treatments.
Scleral lenses create a space between the lens and the cornea that holds a reservoir of sterile saline. This fluid layer acts like an extended tear film, keeping the cornea continuously bathed in moisture throughout the day. The reservoir helps reduce common dry eye symptoms such as burning, stinging, and the feeling of grit in the eye.
By covering the entire cornea, scleral lenses shield the eye from environmental irritants. Wind, dust, and pollutants cannot reach the sensitive corneal surface. This protection helps prevent further damage to eyes already compromised by severe dryness.
The fluid reservoir creates a smooth optical surface that compensates for irregularities caused by corneal scarring or damage. Many patients experience clearer, more stable vision compared to glasses or standard contact lenses. This improved clarity can make a meaningful difference in daily activities like reading and driving.
Patients with severe dry eye often apply artificial tears many times each day. With scleral lenses providing continuous moisture, many people find they need eye drops far less frequently. This can simplify daily routines and reduce the overall burden of managing dry eye symptoms.
This autoimmune condition causes the body to attack moisture-producing glands, leading to chronic dryness in the eyes and mouth. Scleral lenses help compensate for reduced tear production by providing a consistent layer of hydration that standard treatments may not achieve.
Patients who develop ocular complications after bone marrow or stem cell transplants often experience severe dry eye symptoms. Scleral lenses can provide significant relief by maintaining moisture and protecting the damaged ocular surface.
Some patients experience chronic dryness after LASIK surgery. Scleral lenses can help by smoothing corneal irregularities and providing continuous moisture that supports comfort and healing.
When corneal nerves are damaged, the eye may not sense irritation or injury properly. This makes the cornea vulnerable to damage. Scleral lenses create a protective environment that helps prevent complications in patients with reduced corneal sensation.
Eyelid abnormalities or incomplete blinking can leave parts of the cornea exposed and unprotected. Scleral lenses cover the entire cornea, maintaining moisture even when normal blinking patterns are disrupted.
When the eyes cannot produce enough of the watery component of tears, traditional treatments may fall short. The fluid reservoir in scleral lenses provides hydration that helps compensate for insufficient natural tear production.
A thorough examination determines the severity of dry eye and whether scleral lenses are appropriate. We will assess your overall eye health, tear production, and the condition of your cornea and ocular surface. You can also take our dry eye quiz to help us understand your specific symptoms before your visit.
Technologies such as anterior segment optical coherence tomography (AS-OCT) and SMap scleral profilometry map the unique shape of each eye. These detailed measurements guide the design of a lens that fits precisely. At Insight Vision Center Optometry, Dr. Nathan Schramm, OD, FSLS, FBCLA and Dr. Thanh Mai, OD, FSLS, FIAOMC have advanced training in scleral lens fitting for complex cases.
Each scleral lens is designed based on your individual eye measurements. The lens must vault appropriately over the cornea while resting comfortably on the sclera. The goal is to maintain an adequate fluid reservoir without excessive pressure on the eye.
During fitting appointments, we evaluate how the lens sits on your eye and make adjustments as needed. Proper fit ensures good oxygen flow to the cornea, adequate tear exchange, and comfortable all-day wear.
The Pentacam imaging system creates detailed three-dimensional maps of the cornea's front and back surfaces. This information helps identify subtle irregularities that affect how a scleral lens should be designed. Accurate corneal mapping is especially important for patients with corneal scarring or previous eye surgery.
The sclera is not perfectly round, and its shape varies from person to person. Advanced profilometry captures the unique contours of the white part of the eye where the lens will rest. This data allows for custom lens designs that distribute weight evenly and minimize discomfort.
Some patients benefit from wavefront-guided scleral lenses that correct higher-order visual aberrations. The Tomey WaveDyn Aberrometer measures how light travels through the eye, identifying optical imperfections beyond basic nearsightedness or farsightedness. This technology can help achieve sharper vision for patients with complex visual needs.
Scleral lenses are filled with preservative-free saline before insertion. Learning proper technique takes practice, but most patients become comfortable with the process within a few weeks. We will provide hands-on training during your fitting appointments.
Proper hygiene is essential for safe scleral lens wear. Lenses must be cleaned and disinfected daily using solutions recommended by our optometrists. Following a consistent cleaning routine helps prevent complications and extends the life of your lenses.
Many patients wear scleral lenses throughout their waking hours. We will recommend a wearing schedule based on your individual needs and how your eyes respond to the lenses. Some patients build up to full-day wear gradually.
While scleral lenses are generally safe when properly fitted, it is important to recognize signs that something may be wrong. Increased redness, pain, blurred vision, or unusual discharge should prompt you to remove your lenses and contact us.
Unlike treatments that provide temporary relief, scleral lenses maintain a stable environment throughout the day. Many patients describe a significant improvement in daily comfort compared to their previous dry eye management routine.
By shielding the cornea from environmental exposure and friction, scleral lenses may help prevent progressive damage to the ocular surface. This protective effect can be particularly valuable for patients with conditions that put them at risk for corneal complications.
Clear, stable vision and reduced discomfort allow many patients to return to activities they had limited due to dry eye symptoms. Work, hobbies, and social interactions often become easier when eye symptoms are well managed.
Scheduled follow-up appointments allow us to assess how well your lenses are working. We will check the lens fit, evaluate corneal health, and ensure the fluid reservoir is being maintained properly throughout the day.
Your eyes may change over time, and your scleral lenses may need modifications. Regular check-ups help identify when adjustments are needed so your lenses continue to provide optimal comfort and vision.
Scleral lenses are often part of a broader dry eye management plan. We may recommend additional treatments such as lid hygiene, anti-inflammatory drops, or in-office procedures to address underlying causes of your dry eye condition. At Insight Vision Center Optometry, treatments like IPL therapy, TearCare, and BlephEx may complement scleral lens wear for comprehensive dry eye care.
Most patients adapt to scleral lenses within two to four weeks. The insertion and removal process typically takes the longest to master. We will work with you during this adjustment period to address any challenges.
Many patients with previous eye surgery, including LASIK, corneal transplants, or cataract surgery, successfully wear scleral lenses. A thorough evaluation will determine whether scleral lenses are appropriate for your specific situation.
Scleral lenses typically last one to two years with proper care. However, replacement timing varies based on how well the lenses are maintained and whether your prescription or eye shape changes.
Some patients experience dryness toward the end of the day as the fluid reservoir decreases. Removing the lenses, refilling with fresh saline, and reinserting can help. We may also adjust the lens design to improve fluid retention or recommend complementary treatments.
Scleral lenses are often recommended when standard dry eye treatments provide insufficient relief. Because they work differently than drops or medications, many patients who have not responded well to other approaches find meaningful improvement with scleral lenses.
Good candidates typically have moderate to severe dry eye symptoms that interfere with daily life and have not responded adequately to other treatments. A comprehensive evaluation with an optometrist experienced in scleral lens fitting will determine whether this option is right for you.
