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Hero Ultimate Scleral Lens

How the Hero Ultimate Scleral Lens Works

How the Hero Ultimate Scleral Lens Works

The Hero Ultimate Scleral Lens is a custom-fabricated contact lens engineered for patients with irregular corneas, severe dry eye, or complex ocular surface conditions that make standard contact lenses ineffective or uncomfortable. Unlike conventional lenses that sit directly on the cornea, this scleral lens vaults over the entire corneal surface and rests securely on the sclera, the white outer wall of the eye. At Insight Vision Center Optometry, Dr. Nathan Schramm, OD, FSLS, FBCLA and Dr. Thanh Mai, OD, FSLS, FIAOMC use advanced corneal and scleral topography to design each Hero lens to match the precise contours of your eye. Because the lens arches completely over the cornea without making contact, it eliminates the friction, pressure, and discomfort that corneal lenses often cause in patients with sensitive or misshapen corneas. The result is a lens that delivers both therapeutic protection and high-definition vision correction in a single device.

The space between the Hero Ultimate Scleral Lens and the corneal surface holds a layer of preservative-free sterile saline solution, creating a fluid reservoir that remains in contact with the eye throughout the entire wearing period. This reservoir continuously bathes the cornea in moisture, protecting the ocular surface from environmental irritants such as dust, pollen, wind, and dry air. For patients with severe dry eye, Sjogren's syndrome, or graft versus host disease, this constant hydration provides sustained relief that artificial tears alone cannot match. The fluid layer also serves an optical purpose: it fills in the valleys and peaks of an irregular cornea, creating a smooth refracting surface that sharpens vision well beyond what glasses or soft lenses can achieve.

The Hero Ultimate Scleral Lens is manufactured from high Dk gas-permeable materials specifically selected to allow adequate oxygen transmission to the cornea. Dk measures how efficiently a lens material transports oxygen, and maintaining healthy oxygen flow is critical for preventing corneal swelling, neovascularization, and long-term tissue damage during extended lens wear. At Insight Vision Center Optometry, the doctors use anterior segment OCT (AS-OCT) imaging to monitor the clearance between the back of the lens and the cornea, ensuring the lens maintains proper vault height for optimal oxygen exchange. This level of precision helps protect corneal health over months and years of daily wear.

For patients who experience midday fogging, reduced visual clarity after several hours of wear, or tear film stagnation beneath the lens, the Hero Ultimate Scleral Lens can be designed with optional micro-channels that promote tear exchange under the lens surface. These channels allow fresh tears to flow beneath the lens while stale fluid exits, reducing debris buildup and maintaining clearer, more consistent vision throughout the day. Dr. Schramm, who co-founded the International Congress of Scleral Contacts and serves as a principal investigator for scleral lens research, evaluates each patient individually using diagnostic imaging from the Pentacam and AS-OCT to determine whether channel or venting modifications would improve comfort and performance for your specific fitting.

Conditions Treated with Scleral Lenses

Conditions Treated with The HERO Scleral Lens

Keratoconus is a progressive condition in which the cornea thins, weakens, and bulges outward into a cone-like shape, creating severe visual distortion that worsens over time. Pellucid marginal degeneration produces a similar pattern of corneal thinning concentrated along the inferior corneal margin, resulting in irregular astigmatism and blurred vision. Both conditions create an unpredictable corneal surface that glasses and soft contact lenses cannot adequately correct. The Hero Ultimate Scleral Lens vaults entirely over the distorted cornea, and the fluid reservoir fills in the surface irregularities to create a smooth, stable optical front. At Insight Vision Center Optometry, Dr. Schramm and Dr. Mai use the Pentacam, Tomey WaveDyn Aberrometer, and AS-OCT to map the exact shape and elevation profile of the cornea and design a lens that delivers sharp, consistent vision even in advanced cases.

Patients who have undergone LASIK, PRK, radial keratotomy (RK), or corneal transplant surgery sometimes develop residual corneal irregularities that cause persistent blurriness, ghosting, glare, or fluctuating vision. These irregularities can result from uneven tissue removal, graft healing patterns, or changes in corneal biomechanics that alter the surface over time. Standard glasses and soft lenses cannot conform to these complex surface profiles, leaving patients without a reliable way to see clearly. The Hero Ultimate Scleral Lens bypasses the irregular corneal surface entirely, creating a new optical front through the combination of its rigid lens surface and the saline fluid reservoir. The doctors at Insight Vision Center Optometry have extensive experience fitting post-surgical corneas and use wavefront aberrometry to identify and correct the specific higher-order aberrations responsible for visual disturbances after surgery.

When the cornea has an asymmetric or unpredictable shape that standard toric lenses cannot address, the Hero Ultimate Scleral Lens provides an effective solution. Irregular astigmatism can develop from corneal scarring, trauma, ectatic conditions, or surgical complications, and it produces visual distortions that vary across different areas of the visual field. The fluid reservoir between the lens and the cornea neutralizes these surface imperfections by creating a uniform refractive interface, while the rigid lens surface provides consistent optical correction across the entire pupil. Using data from the Tomey WaveDyn Aberrometer, the doctors at Insight Vision Center Optometry can incorporate wavefront-guided corrections into each Hero lens to address even the most complex patterns of irregular astigmatism with exceptional clarity.

For patients living with chronic dry eye, Sjogren's syndrome, graft versus host disease (GVHD), or Stevens-Johnson syndrome, the Hero Ultimate Scleral Lens serves as both a vision correction device and a therapeutic shield. The fluid reservoir bathes the cornea in continuous moisture throughout the day, providing sustained hydration that goes well beyond what artificial tears, punctal plugs, or prescription eye drops can achieve on their own. The lens also creates a physical barrier that protects the fragile corneal surface from air currents, low humidity environments, and particulate irritants that trigger inflammation and discomfort. Dr. Nhi Nguyen, OD brings focused experience fitting scleral lenses for dry eye and ocular surface disease, working closely with patients to optimize both comfort and corneal health over the course of treatment.

Neurotrophic keratitis occurs when reduced corneal nerve function impairs the eye's ability to sense damage and trigger its natural healing response, leaving the corneal surface vulnerable to persistent epithelial defects and ulceration. Exposure keratopathy results from incomplete eyelid closure during sleep or blinking, which allows the cornea to dry out and develop surface breakdown. Both conditions can lead to chronic discomfort, recurring erosions, and progressive vision loss if the corneal surface is not adequately protected. The Hero Ultimate Scleral Lens creates a sealed, hydrated environment over the cornea, acting as a therapeutic bandage that promotes healing while shielding the damaged tissue from mechanical trauma and environmental exposure. The doctors at Insight Vision Center Optometry monitor these cases closely with AS-OCT imaging to track corneal healing and adjust the lens fit as the ocular surface improves over time.

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Vision and Comfort Benefits

Vision and Comfort Benefits

The fluid reservoir beneath the Hero Ultimate Scleral Lens fills in the corneal surface irregularities that cause blurred, distorted, or fluctuating vision, creating a smooth optical front that corrects light as it enters the eye. For patients with keratoconus, post-surgical complications, or irregular astigmatism, the improvement in visual clarity over glasses or soft lenses can be dramatic. At Insight Vision Center Optometry, the doctors take this a step further by incorporating wavefront-guided corrections using data from the Tomey WaveDyn Aberrometer, which measures higher-order aberrations such as coma, trefoil, and spherical aberration. This allows each Hero lens to reduce glare, halos, ghosting, and starbursts that standard prescriptions cannot address, delivering high-definition vision tailored to the unique optical profile of your eye.

Unlike soft contact lenses that may rotate, shift, or decentrate during blinking, eye movement, or physical activity, the Hero Ultimate Scleral Lens seats firmly on the sclera and maintains a consistent, centered position over the cornea throughout the day. This positional stability is critical for maintaining accurate optical correction, especially in lenses with wavefront-guided or toric designs where even small amounts of rotation can degrade visual quality. Whether you are working at a computer, driving at night, playing sports, or moving through a busy day, the lens stays in place and delivers consistent, uninterrupted vision from morning to evening.

Each Hero Ultimate Scleral Lens is custom-designed based on detailed scleral and corneal mapping to distribute its weight evenly across the scleral landing zone, avoiding localized pressure points that can cause discomfort over time. The continuous hydration from the fluid reservoir eliminates the dryness and friction that make conventional contact lenses intolerable for many patients, especially those with ocular surface disease or corneal sensitivity. Patients who have previously given up on contact lenses often find that they can wear scleral lenses comfortably for 12 to 16 hours per day. Many report that they forget the lens is on their eye within the first few minutes of insertion.

The Hero Ultimate Scleral Lens creates a sealed barrier between the cornea and the outside environment, shielding the eye from dust, pollen, wind, air conditioning, and other airborne irritants that trigger discomfort and inflammation. This protective function is especially valuable for patients who work in dry office environments, spend time outdoors in windy or dusty conditions, or have occupations that expose them to particulate matter. For patients with ocular surface disease or recurrent corneal erosions, this barrier also reduces the mechanical irritation from blinking, allowing the corneal surface to heal in a protected, continuously hydrated environment.

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The Fitting Process

The fitting process begins with a detailed assessment of your eyes. Your eye doctor will evaluate your corneal shape, ocular surface health, and vision needs to determine if scleral lenses are appropriate for you. This examination helps identify any underlying conditions that may affect lens selection.

Advanced imaging technology captures the precise contours of your cornea and sclera. At Insight Vision Center Optometry, tools such as the Pentacam and corneal topography help create a detailed map of your eye's surface. This data ensures that your lens will fit properly and comfortably.

Using the imaging data, a lens is designed to match your eye's unique shape. The vault height, diameter, and curvature are all customized. This level of personalization is what makes scleral lenses different from standard contact lenses. Each lens is made specifically for one patient's eye.

Once your lens arrives, you will have a fitting appointment to assess how the lens performs on your eye. Your eye doctor checks for proper centration, adequate clearance over the cornea, and overall comfort. Adjustments may be needed to achieve the best results. Some patients require multiple visits to fine-tune their fit.

Scleral lenses require a specific technique for insertion and removal. Your eye doctor and clinical staff will teach you how to handle, fill, insert, and remove your lenses safely. Most patients become comfortable with the process after a few practice sessions. Special tools such as plungers can make the process easier.

Long-Term Care and Follow-Up

Long-Term Care and Follow-Up

Proper cleaning and storage are essential for scleral lens health and longevity. Your eye doctor will provide specific instructions for daily care, including which solutions to use and how to store your lenses when not in use. Following these instructions helps prevent infections and keeps your lenses in good condition.

Follow-up appointments allow your eye doctor to monitor your corneal health and ensure the lens continues to fit properly. Over time, adjustments or replacement lenses may be needed as your eyes change. These visits also help catch any problems early before they become serious.

Contact your eye doctor if you experience redness, pain, decreased vision, or increased discharge while wearing your lenses. These symptoms may indicate a problem that needs prompt attention. Do not continue wearing a lens that causes discomfort or vision changes.

Scleral Lens Care at Insight Vision Center Optometry

The HERO Scleral Lens at Insight Vision Center Optometry

Dr. Nathan Schramm, OD, FSLS, FBCLA and Dr. Thanh Mai, OD, FSLS, FIAOMC both hold the FSLS (Fellow of the Scleral Lens Society) credential, a distinction earned by a limited number of eye doctors worldwide who have demonstrated advanced proficiency in scleral lens fitting. Dr. Schramm co-founded the International Congress of Scleral Contacts and serves as a principal investigator for scleral lens research, contributing directly to the development of new fitting techniques and lens designs used across the field. Dr. Mai serves on the EssilorLuxottica advisory board and leads clinical innovation for Treehouse Eyes, bringing additional expertise in complex contact lens fitting and myopia management. Dr. Nhi Nguyen, OD has focused experience fitting scleral lenses for dry eye management and prosthetic lens applications. Together, this team brings a depth of training and clinical research experience that draws patients from throughout Orange County and across Southern California.

Insight Vision Center Optometry uses a comprehensive suite of diagnostic instruments to ensure every scleral lens is precisely designed and properly fitted. The Pentacam captures detailed corneal elevation and pachymetry maps that reveal the exact shape and thickness of the cornea. The anterior segment OCT (AS-OCT) provides cross-sectional imaging of the lens on the eye, allowing the doctors to measure vault clearance, assess tear film dynamics, and verify that the lens is performing as intended. The Tomey WaveDyn Aberrometer maps the eye's total optical system, identifying higher-order aberrations that standard autorefractors miss, and this data is used to build wavefront-guided corrections directly into the Hero lens design. Each of these technologies contributes to a fitting process built on objective measurements rather than estimation.

The doctors at Insight Vision Center Optometry regularly fit scleral lenses for conditions that many practices are not equipped to manage. These include advanced keratoconus, post-LASIK and post-RK complications, corneal transplant irregularities, severe dry eye from Sjogren's syndrome and graft versus host disease, Stevens-Johnson syndrome, neurotrophic keratitis, exposure keratopathy, and infant aphakia. This breadth of clinical experience means the team has encountered and solved a wide range of fitting challenges, from highly irregular corneal profiles to eyes with extreme scleral asymmetry. Patients travel from throughout Orange County, across Southern California, and from out of state to access this level of care.

Scleral lenses can be successfully fitted for children when the clinical situation calls for it. Dr. Valerie Lam, OD, FAAO, FOVDR brings focused experience in pediatric contact lens fitting and works with young patients who have conditions such as infant aphakia, pediatric keratoconus, and high refractive error that require more than standard glasses or soft lenses. Fitting a child with a scleral lens involves careful collaboration with parents on insertion, removal, and daily lens care routines, along with a follow-up schedule designed to monitor the fit as the child's eyes continue to grow. The goal is to provide the clearest possible vision during the critical years of visual development while keeping the child comfortable and confident in their lenses.

Frequently Asked Questions

Frequently Asked Questions

Many patients wear scleral lenses comfortably for 12 to 16 hours per day. Your eye doctor will recommend a wearing schedule based on your individual needs and corneal health. Some patients may need to start with shorter wearing times and gradually increase.

Scleral lenses require a different technique than soft contact lenses, but most patients learn the process within a few practice sessions. You will fill the lens with saline solution before inserting it. Specialized tools such as plungers can make insertion and removal easier.

The fluid reservoir provides continuous hydration, so many patients with dry eye find they need fewer drops throughout the day. However, some patients still benefit from preservative-free drops as needed. Your eye doctor can recommend appropriate drops if necessary.

With proper care, scleral lenses can last one to two years or longer. Your eye doctor will monitor the lens condition at follow-up visits and recommend replacement when needed. Scratches or deposits on the lens may require earlier replacement.

It is generally recommended to remove scleral lenses before swimming or showering. Water can introduce bacteria or other microorganisms that may cause eye infections. If you must wear lenses in water, discuss protective options with your eye doctor.

If your vision changes, your eye doctor can evaluate whether a lens adjustment or new prescription is needed. Regular follow-up appointments help catch changes early. In some cases, a new lens with updated parameters may be required.

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