Scleral lenses offer a comfortable and effective way to correct high astigmatism. These large diameter lenses vault over the cornea and rest on the white part of your eye, creating a smooth optical surface that provides stable, clear vision throughout the day.
Astigmatism happens when the front of the eye, called the cornea, has an irregular curve. Instead of being round like a basketball, the cornea is shaped more like a football. This uneven shape causes light to focus unevenly on the retina, the light sensitive layer at the back of your eye.
High astigmatism can blur your vision for both near and far objects. Simple tasks like reading, driving, or recognizing faces become more difficult. Many people with high astigmatism find that standard soft contact lenses do not give them the sharp vision they need because soft lenses conform to the irregular corneal surface.
Regular astigmatism follows a predictable pattern and can often be corrected with glasses or standard contacts. Irregular astigmatism has an unpredictable shape that is harder to correct. Conditions like keratoconus, corneal scarring, or previous eye surgery can cause irregular astigmatism. Scleral lenses work well for both types.
Scleral lenses are larger than standard contacts. They rest on the sclera, the tough white outer wall of the eye, rather than sitting directly on the cornea. The lens arches over the entire cornea without touching it. This design creates a dome of space between the lens and the cornea.
The space between the scleral lens and your cornea fills with saline solution when you insert the lens. This fluid reservoir does two important things. First, it fills in the corneal irregularities to create a smooth surface for focusing light. Second, it keeps your cornea bathed in moisture all day long.
Scleral lenses are made from rigid gas permeable material. Unlike soft lenses, they hold their shape on your eye. This rigidity means the front surface of the lens stays smooth and regular, even when your cornea underneath is uneven. Light passes through this smooth surface and focuses correctly on the retina.
Because scleral lenses sit on the stable sclera rather than the cornea, they move very little when you blink. This stability gives you consistent vision without the blur that can happen when smaller lenses shift around. Many patients notice their vision stays clear from morning until they remove the lenses at night.
The fluid reservoir under a scleral lens acts like a cushion for your eye. It keeps the cornea hydrated and protected. Patients who have struggled with dry, irritated eyes while wearing other contact lenses often find scleral lenses much more comfortable for extended wear.
Each scleral lens is designed to match your unique eye shape. Our optometrists use detailed measurements of your cornea and sclera to order lenses made specifically for you. This personalized fit helps ensure proper fluid exchange, good vision, and comfortable wear.
Scleral lenses can correct vision in situations where other lenses fail. Whether your astigmatism comes from a naturally irregular cornea, keratoconus, a corneal transplant, or complications from previous surgery, scleral lenses can often provide the visual clarity you need.
If standard glasses or soft contacts have not given you clear vision due to significant astigmatism, scleral lenses may help. The rigid lens surface and fluid reservoir work together to correct refractive errors that other options cannot address.
Keratoconus causes the cornea to thin and bulge into a cone shape. Corneal ectasia is similar thinning that can happen after refractive surgery. Scleral lenses vault over the irregular cornea and create a new front optical surface, reducing distortion and improving clarity.
Eye surgeries such as LASIK, radial keratotomy, or corneal transplants can leave the corneal surface uneven. Eye injuries can also create irregularities. Scleral lenses avoid direct contact with sensitive or scarred areas while still providing excellent vision correction.
The fluid reservoir in a scleral lens continuously bathes the cornea in moisture. This makes scleral lenses a good option for patients with dry eye syndrome, including those with Sjogren's syndrome, graft versus host disease, or other conditions that cause severe dryness.
Your fitting begins with a thorough eye exam. We use imaging technology such as corneal topography to map the exact shape of your cornea and sclera. These detailed measurements help determine the best lens design for your eyes. At Insight Vision Center Optometry, doctors like Dr. Nathan Schramm, OD, FSLS, FBCLA and Dr. Thanh Mai, OD, FSLS, FIAOMC use the Tomey WaveDyn Aberrometer for precise measurements.
During the fitting appointment, our optometrists place trial lenses on your eyes. These diagnostic lenses help assess how well the lens vaults over your cornea, how it sits on your sclera, and how clearly you see. We check the fit with special dyes and make adjustments based on what we observe.
Once the trial lenses show acceptable results, we order your custom lenses. The final lenses are manufactured to match your eye measurements precisely. This customization ensures proper fluid reservoir depth, stable positioning, and optimal vision correction.
Learning to insert and remove scleral lenses takes practice. Our eye care team teaches you the proper technique using insertion devices and suction tools. Follow up appointments allow us to fine tune the fit and address any issues during your adjustment period.
Soft contact lenses are popular because they are easy to wear and comfortable right away. However, soft lenses conform to the shape of your cornea. If your cornea is irregular, the lens takes on that irregular shape and cannot fully correct your astigmatism.
Traditional rigid gas permeable lenses can provide sharp vision because they hold their shape. However, these smaller lenses sit directly on the cornea. Some patients find them uncomfortable, especially if their corneas are irregular or sensitive.
Hybrid lenses combine a rigid center for clear vision with a soft outer ring for comfort. They work well for some patients with astigmatism. However, they may not provide the same level of stability or moisture protection that scleral lenses offer for more complex cases.
Scleral lenses require careful cleaning and storage. You clean them with approved solutions after each use and store them in fresh solution overnight. Proper hygiene helps prevent infections and keeps your lenses working well for their expected lifespan.
Most patients fill their scleral lens with preservative free saline before inserting it. A plunger or specialized insertion device helps position the lens on the eye. Removal uses a small suction cup. With practice, the process becomes quick and easy.
Some patients adapt to scleral lenses immediately. Others need a few weeks to get used to the insertion process and wearing schedule. We may recommend building up wear time gradually. Regular follow up visits help address any comfort or vision concerns.
Many patients wear scleral lenses comfortably for 12 to 16 hours per day. We determine the appropriate wearing schedule based on your eye health and how your eyes respond to the lenses. Some patients may need to remove and refill the lenses midday.
Scleral lenses are larger than standard contacts, so the insertion technique is different. Most patients learn the process within a few training sessions. Special tools like insertion devices and removal plungers make handling easier. With practice, most people become comfortable with their daily routine.
With proper care, scleral lenses typically last one to two years. The rigid material is durable but can develop deposits or scratches over time. Regular cleaning and careful handling help extend the life of your lenses. We monitor lens condition at follow up visits.
It is best to remove scleral lenses before swimming, using a hot tub, or showering. Water can contain microorganisms that may cause serious eye infections. If water gets in your eyes while wearing lenses, remove and disinfect them before wearing again.
Many patients notice dramatically improved vision right away. However, fine tuning the fit may take a few appointments. Your brain also needs time to adjust to the new visual input. Most patients achieve their best vision within the first few weeks of wear.
Scleral lenses help many patients who have not succeeded with other options, but they are not right for everyone. If scleral lenses do not meet your needs, we can discuss alternatives such as hybrid lenses, piggyback lens systems, or custom soft lenses depending on your condition.
