A scleral lens is a large diameter gas-permeable lens ranging from 14mm to 20mm that completely vaults the cornea and rests on the sclera (white part of the eye), distributing its weight over a larger area. A scleral lens will usually extend only a couple of millimeters beyond the colored part of the eye.
If your cornea has an irregular shape due to eye disease (keratoconus), surgery (e.g., corneal transplant), or injury, your vision will not be clear, even with glasses. Hard contact lenses provide a smooth and regular surface so your eyes can see clearly, but they are not always well-tolerated.
Scleral contact lenses are much larger than other hard lenses (RGPs). The hard surface creates a stable, regular ocular surface, which means crisp vision. They are used to provide comfortable, functional vision for corneal disease and patients with dry eyes. An eye doctor in Ridgewood, New York, may recommend scleral lenses when conventional options are ineffective.
What conditions are treated with Scleral Contact Lenses?
Anyone can wear a scleral lens; however, because there are not many eye care providers who fit scleral lenses, they are usually reserved for more complicated cases. Keratoconus is the most common use for fitting scleral contacts, and refractive surgery complications are the second. Here is a list of the common uses for scleral contact lenses.
- Keratoconus
- Pellucid marginal degeneration
- Post-refractive surgery complications (such as LASIK and PRK)
- Corneal transplants (penetrating keratoplasty)
- Severe dry eye syndrome
- High refractive error
- Irregular astigmatism
- Corneal ectasia
- Recurrent Corneal Erosions
- Corneal Dystrophies
- Stevens-Johnson Syndrome
- Sjogren’s Syndrome
- Exposure Keratopathy
- Non-Healing Corneal Epithelial Defects
- Neuropathic Corneas
- Corneal scars
- Bullous keratopathy
Both rigid gas permeable lenses and scleral lenses are used for keratoconus treatment. However, scleral contact lenses provide improved comfort and better, more stable vision than traditional gas-permeable lenses. Scleral contact lenses also provide better visual acuity, durability, and comfort. Keratoconus experts now agree that scleral contact lenses are the treatment of choice for patients with keratoconus and irregular corneas.
Most medical insurance plans do not cover scleral contact lenses; however, numerous vision plans do consider scleral lenses as medically necessary (or visually necessary) devices and do offer partial or complete coverage.
How Scleral Lenses Improve Vision and Eye Comfort
By covering the cornea entirely, scleral lenses create a tear-filled space that promotes hydration and reduces irritation. This feature is especially helpful for patients with chronic dry eye or ocular surface disease. The smooth, stable lens surface improves visual sharpness even in cases of distorted or scarred corneas. These lenses are also effective for post-surgical eyes and those who have experienced trauma or infection. Overall, scleral lenses combine comfort with advanced vision correction.
Why This Lens Type Requires Professional Fitting
Scleral lenses are custom-made for each eye, requiring detailed measurements and fittings by an experienced eye care provider. Their size and unique resting position mean that a precise fit is essential to ensure both comfort and effectiveness. A poor fit can cause discomfort, vision issues, or reduced oxygen flow to the eye. Fitting sessions may include trial lenses, corneal mapping, and adjustments over time. With professional guidance, patients can expect optimal results and long-term comfort.
Frequently Asked Questions
Scleral lenses come with unique benefits and care requirements. Here are answers to common questions people ask about this specialty lens type.
What conditions are treated with scleral lenses?
How are scleral lenses different from regular contacts?
Do scleral lenses improve dry eye symptoms?
How long do scleral lenses last?
Is it hard to insert and remove scleral lenses?
Are scleral lenses covered by insurance?
Can anyone wear scleral lenses?
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