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Home > Our Services > Medically Necessary Contact Lenses
Clearer Vision Starts with Specialized Eye Care

If contact lenses are the only method that can improve your vision, then contact lenses are usually considered medically necessary. Medically necessary contacts are most often used in keratoconus treatment. An experienced optometrist in Elmhurst, New York, can evaluate your condition and determine if these lenses are right for you. Keratoconus is a disorder of the cornea that leads to progressive changes in its shape and structure. Over time, the cornea becomes increasingly thinner and steeper. These changes result in the formation of high levels of irregular astigmatism and myopia.

Conditions That May Require Medically Necessary Lenses

Here is a list of the most common conditions treated with medically necessary contacts:

  • Keratoconus
  • Pellucid marginal degeneration
  • Post-refractive surgery complications (such as LASIK and PRK)
    Eye diagram
  • 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
Eye

Scleral contact lenses are the most common medically necessary contact lens treatment used. Scleral contacts are large-diameter gas-permeable contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by keratoconus and other corneal irregularities.

Does My Insurance Cover Medically Necessary Contact Lenses?

Your medical plan will not cover the fitting of contact lenses for medically necessary conditions; however, most vision plans do offer coverage. Your medical plan will cover the diagnosis and monitoring of your condition. They will also cover surgery should that become necessary.

Want to know more about medically necessary contact lenses?

What to Expect During the Fitting Process
Fitting medically necessary contact lenses requires precision and a customized approach. The process begins with a comprehensive eye exam to assess the cornea’s shape and health. Advanced imaging techniques help in designing lenses that fit securely and comfortably. Follow-up visits are essential to ensure the lenses provide optimal vision and do not cause discomfort. The goal is to achieve the best possible correction while preserving corneal integrity.

Frequently Asked Questions
Here are common questions asked about medically necessary contact lenses and how they help support eye health and vision clarity.

What makes contact lenses medically necessary?
They are classified as medically necessary when no other form of vision correction, such as glasses, can provide adequate visual improvement for certain eye conditions.
Are these lenses covered by insurance?
In many cases, vision or health insurance policies cover medically necessary contact lenses if specific clinical criteria are met.
What types of lenses are usually prescribed for medical necessity?
Common types include scleral lenses, rigid gas permeable lenses, and hybrid lenses designed for irregular corneas.
Can these lenses halt the progression of keratoconus?
While they do not stop the condition itself, they provide improved vision and comfort, which can significantly aid daily function and reduce visual strain.
How often should medically necessary lenses be replaced?
Depending on the lens type and the patient’s eye condition, they may need replacement every 6 to 12 months to maintain fit and effectiveness.
Is the fitting process different from regular contact lenses?
Yes, these lenses require detailed corneal mapping and a more customized fitting process to address specific eye irregularities.

Your Eyes Deserve Dedicated Attention
Protect your vision with expert care—schedule your comprehensive eye exam today! Book an appointment now and see the world more clearly.