Who is a good candidate for scleral Lenses

Challenges: Conditions like keratoconus, pellucid marginal degeneration, corneal scarring, or Terrien’s marginal degeneration create uneven corneal surfaces. This irregular shape can make standard lenses painful or ineffective, causing fluctuating vision and irritation throughout the day.

Why Scleral Lenses Help: Whether it’s keratoconus (conical cornea), pellucid marginal degeneration (thinning at the lower cornea), corneal scarring, or Terrien’s marginal degeneration, scleral lenses vault over these distorted or thinned areas and fill the gap with a fluid reservoir. This reservoir effectively masks surface irregularities and provides a smooth refractive surface, reducing the discomfort and fluctuating vision common with standard lenses.

• Keratoconus: Early, moderate, or advanced stages where traditional contact lenses are uncomfortable or unstable.
• Pellucid Marginal Degeneration (PMD): Helps smooth the irregular corneal shape.
• Corneal Scarring: Smooths out uneven surfaces caused by injury or infection scars.
• Terrien’s Marginal Degeneration: Provides stable vision in thinning areas around the cornea’s periphery.

Challenges: Post-LASIK ectasia, corneal transplants, radial keratotomy (RK), and other surgeries—or injuries that scar or alter the cornea—can leave the eye with unpredictable shapes and heightened sensitivity. Traditional lenses may not fit well, cause ongoing discomfort, or put harmful pressure on healing tissue.

Why Scleral Lenses Help: In cases like post-LASIK ectasia or post-RK (radial keratotomy), where the cornea has been weakened or reshaped, scleral lenses accommodate and protect the altered surface. After corneal transplants (e.g., post-keratoplasty) or penetrating keratoplasty (PK), they minimize pressure and improve vision by correcting uneven curves. For post-injury eyes, the fluid layer cushions sensitive tissue, promoting healing and comfort while providing excellent visual acuity.

• Post-LASIK Ectasia: When the cornea becomes irregular after refractive surgery.
• Post-Keratoplasty (Corneal Transplant): Protects the grafted cornea and improves clarity.
• Post-RK (Radial Keratotomy): Corrects fluctuating or unpredictable vision from older refractive procedures.
• Post-PK (Penetrating Keratoplasty): Offers a stable, comfortable lens option when standard lenses fail.
• Post-Injury: Protects sensitive tissue and aids in visual rehabilitation.

Challenges: Autoimmune conditions (e.g., Sjögren’s syndrome), severe inflammatory disorders (SJS, GVHD), and chronic dryness (aqueous-deficient, meibomian gland dysfunction) all reduce tear film quality and quantity. This makes wearing normal lenses painful or nearly impossible due to constant friction and irritation.

Why Scleral Lenses Help: When conditions like Sjögren’s syndrome, Stevens-Johnson Syndrome (SJS), graft-versus-host disease (GVHD), or neurotrophic keratitis deplete tears or damage the ocular surface, scleral lenses lock in moisture behind their dome-like shape. They compensate for severely diminished tear production (aqueous-deficient dry eye) and help stabilize oil layer issues (like in meibomian gland dysfunction), preventing the painful friction and dryness typical of regular contact lenses.

• Sjögren’s Syndrome: Maintains a fluid reservoir to combat severe dryness.
• Stevens-Johnson Syndrome (SJS): Alleviates discomfort from extremely dry and compromised ocular surfaces.
• Graft-Versus-Host Disease (GVHD): Addresses dryness and scarring to improve comfort and vision.
• Neurotrophic Keratitis: Protects the cornea when blinking or tear production is insufficient.
• Aqueous Deficient Dry Eye: Provides continuous hydration when tears are significantly lacking.
• Meibomian Gland Dysfunction (MGD): Can stabilize and protect the cornea from chronic dryness.

Challenges: Systemic diseases like rheumatoid arthritis, lupus, scleroderma, and severe allergies can significantly impact tear production and ocular surface health. Chronic inflammation, dryness, and hypersensitivity often lead to discomfort, redness, and reduced wear time with standard lenses.

Why Scleral Lenses Help: Disorders such as rheumatoid arthritis, lupus, and scleroderma often cause chronic inflammation and dryness that degrade tear quality. Scleral lenses establish a controlled, hydrating environment over the cornea, significantly reducing dryness and irritation. Even for severe allergy sufferers, the lens’s large vault can act as a barrier against environmental allergens, helping maintain clearer, more comfortable vision.

• Rheumatoid Arthritis: Relieves extreme dryness when systemic autoimmune factors affect tear production.
• Lupus: Helps soothe ocular surface issues associated with autoimmune inflammation.
• Scleroderma: Addresses ocular surface fragility and persistent dryness.
• Severe Allergy Sufferers: For whom the large diameter of the lens can block irritants from interacting with the eye.

Challenges: Patients with moderate to high myopia, hyperopia, or astigmatism frequently experience lens instability, reduced visual clarity, or discomfort with traditional lenses. High or complex prescriptions may cause excessive lens movement or distorted vision, resulting in unreliable vision correction.

Why Scleral Lenses Help: In cases of pronounced astigmatism, as well as very high myopia or hyperopia, scleral lenses offer superior stability because they do not rely on the corneal curvature for fit. By evenly distributing pressure on the sclera, these lenses eliminate lens rotation and deliver consistent, sharp vision, making them ideal for those who find traditional lenses inadequate for extreme prescriptions.

• High Astigmatism: Scleral lenses vault irregular or highly toric corneas to provide stable, clear vision.
• High Myopia or Hyperopia: Can offer superior comfort and clarity when standard lenses are less effective.