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Everything You Need to Know About Scleral Contact Lenses

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Person inserting a scleral contact lens into their eye.

Many people have had bad experiences with contact lenses in the past. Whether it’s been an issue with stability, discomfort, or even being told their eyes are “the wrong shape” for contact lenses, there is a whole subset of individuals who think contact lenses just aren’t an option for them.

But that’s not necessarily true. Contact lens technology has evolved significantly over the years. Today, there are specialty lens options for nearly everyone. Perhaps the most versatile type of specialty contact is the scleral contact lens.

What Are Scleral Lenses?

Scleral lenses are large-diameter gas permeable contact lenses that vault over the cornea (the clear front of the eye) and rest over the sclera (the white of the eye). The scleral lens provides a smooth optical surface that works to correct vision problems caused by keratoconus and other irregular cornea problems.

They are fitted to leave space between the lens and the cornea, unlike conventional lenses that rest on the cornea. Scleral lenses are filled with isotonic fluid before installing. The space between the cornea and the back surface of the lenses acts as a tear reservoir to help moisten the eye. This moisture helps to fight dry eyes, providing comfort for people suffering from a severe ocular disease. 

Benefits of Scleral Lenses

Scleral lenses are larger compared to conventional lenses, making them more stable and reducing the risk of them accidentally moving or falling off, even with blinking. Though scleral lenses are larger, they provide a high degree of clarity and comfort compared to the standard lenses.

Scleral lenses provide a tear reservoir which continually provides moisture and oxygen to the eye, bringing relief to patients suffering from dry eye disease. This constant supply of moisture also helps to prevent eye injuries like corneal abrasions.

The scleral lens does not only correct your vision, it improves the health of your eyes. It can help to reduce the need for surgical intervention for patients suffering severe ocular surface diseases.

Types of Scleral Lens

There are 3 types of scleral lenses, differentiated by their sizes. The sizes range from 14.5 – 24mm, more extensive than standard lenses, which usually are 9 – 9.5 in magnitude. The size of the scleral lens allows it to cover the entire cornea, extending to the sclera. With the average human cornea being 11.4mm, the smallest scleral lens will still be able to cover the whole cornea.

The size of the contact lens used is usually as a result of the complexity of the vision problem it corrects. Your optometrist will decide which type of lens to use during your contact lens exam.

Types of scleral lenses include:

  • Corneo-scleral and semi–scleral lenses are larger than conventional gas permeated lenses and rest near the junction between the cornea and the sclera. This type of scleral lens is used if contacts are needed after LASIK or other corneal refractive surgery to correct irregular astigmatism.
  • Mini scleral lenses vault over the cornea and rest on the anterior sclera.
  • Full scleral lenses are the largest of the scleral lenses. It provides the most significant coverage between the back surface of the lens and the cornea. A full scleral lens is used in complex situations like advanced keratoconus, severe dry eyes, or severe ocular disease.

Are Scleral Lenses For You?

At your contact lens exam and fitting, your optometrist will tell you if the scleral lens is right for you and which type will be best for you. 

Scleral lenses are typically a good option for patients with:

  • corneal irregularities caused by either keratoconus or surgical procedure
  • ocular surface disease
  • severe refractive errors
  • inability to easily fit conventional lenses, or lack of stability with traditional contacts

Scleral lenses may also work for you if you have dry eye disease. The ample space between the back surface of the lens and the cornea acts as a tear reservoir, moisturizing the eye and providing a more comfortable contact lens experience

EyePrintPro Scleral Lenses

EyePrintPro lenses are a prosthetic scleral cover shell that improves vision by providing a new, smooth refractive surface for the eye. The EyePrintPro lens can match the exact curvature of the eye, providing a lens that is a perfect fit for you.

Much like scleral lenses, the EyePrintPro is made from gas permeable material, and vaults over the cornea to rest on the sclera. The main difference is in the design of an EyePrintPro lens to achieve a perfect fit. 

EyePrintPro uses 3D printing and scanning technology to get an exact fit; meanwhile, scleral lenses fit by a system of trial and error with prefabricated lenses.

Achieving the highest quality result from EyePrintPro will depend on the health of your eye and how you take care of your lenses. Also, optical factors such as retinal diseases, corneal scarring and other conditions may affect the quality of your vision with this lens.

Ask your eye health team if you are a good candidate for EyePrintPro.

Cost of Scleral Contact Lens

The cost of scleral lenses will vary from patient to patient, given the individualized nature of the lens. Your optometrist can provide you with information on the cost of the procedure and whether your insurance policy will cover some of the expenses.

Contact lens solution being dispensed into a contact lens case.

Taking Care of Scleral Lenses

It’s important you take good care of your lenses to avoid transferring bacteria into your eyes and causing infections. Care for your scleral lenses as you would your standard lenses.

Follow any instructions given to you by your optometrist in addition to the following:

  • Always wash your hands thoroughly before handling the contacts or touching your eyes
  • Put the lenses in the palm of your hand with some drops of multi-purpose solution
  • Gently rub the lens in a circular motion rubbing both sides of the lens
  • Rinse the lens with the multi-purpose solution
  • Put each lens into the right lens case and fill with fresh solution
  • Close the case tightly
  • Use a fresh solution each that you rinse and store your lenses and case
  • Replace your case every 3 months

Don’t Give Up on Contact Lenses

A bad experience with contact lenses can certainly be off-putting. But contact lenses may still be an option for you, without sacrificing comfort or clarity.  Book an appointment to see your optometrist and discuss how scleral lenses or the EyePrintPro can help improve your vision.

Written by Stephen Lobaugh

Dr. Lobaugh is an affiliate doctor with TLC Laser Eye Centers, a position that allows him to effectively co-manage a variety of refractive surgeries including LASIK, PRK, and KAMRA inlay. He is also certified by the International Association of Board of Examiners in the treatment and management of ocular disease.

More Articles By Stephen Lobaugh

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