Scleral Contact Lenses

Scleral lenses are a unique type of lens designed to treat a variety of eye conditions which do not respond to any other type of therapy.  The new generation of scleral lenses is made from a highly oxygen permeable polymer and are unique in that they fit over the compromised corneal tissue and are supported by the white portion of the eye (sclera).

Since the lens vaults over the compromised cornea and fit under the eyelids, they are extremely comfortable and are almost never dislodged accidentally.   The space between the front of the cornea and the back surface of the scleral lens is filled with contact lens solution.  The liquid reservoir fills in the surface irregularities of the cornea, allowing vision to be restored in a comfortable manner.  This fluid cushion beneath the lens also provides oxygen to the cornea, allowing the eye to heal.  This effect creates a smooth optical surface over the diseased cornea that replaces the distorted corneal surface to improve vision.

Many conditions can be treated with scleral lenses when other lenses have failed.  They can be used for keratoconus, pellucid marginal degeneration, corneal ectasia resulting from lasik surgery, distorted corneal transplants, and Stevens-Johnson syndrome.

Frequent asked questions about Scleral lenses

Why do scleral lenses work well with keratoconus?

Scleral lenses do not touch or rest on the irritated corneal tissue. Instead these lenses vault over the cornea and are supported by the white portion (the sclera) of the eye. A special fluid fills the space between the back portion of the lens and the front of the cornea. There is very little lens movement and the edges of the lens are beneath the eyelids. Due to the increased stability of these lenses over conventional gas permeable lenses, comfort and vision is usually excellent. In addition, the fluid environment between the back of the lens and the front of the cornea tends to promote healing of the irritated corneal tissue.

My doctor says that my keratoconus is mild yet I can’t seem to tolerate my contact lenses and the vision with my glasses is getting worse. My doctor has tried everything. Will scleral lenses work for me?

The use of scleral lenses in keratoconus is not related to the severity of the disease. Patients with mild keratoconus can be fitted with gas permeable scleral lenses.

My keratoconus is very advanced. I see well with my contact lenses but one lens pops out 6 or more times a day and I can only wear the other lens for a few hours because it hurts. My doctor says that this is the best fit that I can get. Can scleral lenses help me?

Your doctor’s response is not unusual. Doctors often associate scleral contact lenses with the poorly tolerated scleral lenses that were used 50 or 60 years ago. The gas permeable scleral lenses of today are made of highly oxygen permeable materials that provide excellent comfort and vision. In fact, patients with a number of corneal diseases actually undergo a healing affect after scleral lens wear. The scleral lenses create a reservoir of fluid that bathes the corneal surface while the lenses are worn. This often reduces the pain and light sensitivity that can be debilitating to patients with corneal diseases such as Stevens-Johnson Syndrome, post-lasik surgery, post-corneal transplants, corneal ectasia, keratoconus and so on.