Who Is a Good Candidate for Scleral Lenses
Key Features of Scleral Lenses
Scleral lenses are custom designed to match the unique mapping of your eye. By resting on the white part of the eye instead of the cornea, they create a liquid-filled shield that cushions and hydrates the surface beneath.
Each lens is precisely tailored to your corneal contours using advanced 3D mapping technology. This custom design ensures maximum comfort and clarity, with measurements accounting for even the smallest irregularities in your eye's surface. The personalized approach means your lenses work with your eye's specific shape rather than forcing your eye to adapt to a standard lens.
A reservoir of preservative-free saline sits between the lens and your cornea throughout the day. This fluid layer keeps sensitive or scarred corneas protected, provides continuous hydration, and acts as a cushion that shields your eye from environmental irritants and eyelid friction.
The large diameter design eliminates lens rotation or movement that causes vision to fluctuate. Even with significant astigmatism or corneal irregularities, the rigid lens surface creates a smooth optical pathway. Many patients report seeing better in scleral lenses than they ever have with glasses or traditional contact lenses.
The continuous dome of fluid reduces friction between your eyelid and eye surface, making the lenses ideal for sensitive or irritated eyes. Because the lens vaults over the cornea without touching it, you avoid the discomfort that rigid gas permeable lenses can cause. Most wearers report forgetting they have lenses in after the initial adjustment period.
The lens shape and size create a barrier that helps prevent dust, pollen, and other particles from getting trapped against your cornea. This protection is especially valuable for people working in dusty environments, participating in outdoor activities, or living in dry, windy climates.
Scleral lenses are generally safe to wear for up to 16 hours a day, with many patients comfortably wearing them throughout their entire workday. The fluid reservoir maintains hydration far longer than traditional contact lenses, meaning fewer interruptions for rewetting drops and consistent comfort from morning to evening.
Medical Conditions That Benefit from Scleral Lenses
Scleral lenses offer a versatile solution for many eye conditions where standard contact lenses or glasses fail to provide adequate vision or comfort. The following conditions often find dramatic improvement with this lens design.
Scleral lenses vault over uneven, thinned, or cone-shaped corneas to deliver stable, comfortable vision. The rigid lens surface replaces the irregular corneal surface, creating a smooth optical pathway for light to enter the eye. Conditions include keratoconus at all stages, pellucid marginal degeneration, corneal scarring from injury or infection, and Terrien's marginal degeneration.
After procedures like LASIK, radial keratotomy, or corneal transplants, the corneal surface may become irregular or develop complications. Scleral lenses protect altered tissue while dramatically improving visual clarity. They are particularly effective for post-LASIK ectasia, post-keratoplasty vision correction, post-RK vision fluctuations, and eyes healing after corneal injury or surgery.
The fluid reservoir continuously bathes the eye, bringing significant relief to those with chronic dryness or compromised tear production. This therapeutic effect can be life-changing for patients with Sjogren's syndrome, Stevens-Johnson syndrome, graft-versus-host disease, neurotrophic keratitis, and severe aqueous-deficient dry eye with meibomian gland dysfunction.
When systemic diseases cause inflammation, reduced tear production, or ocular surface damage, scleral lenses create a controlled, soothing environment. They protect the eye while providing clear vision for patients managing rheumatoid arthritis, lupus, scleroderma, and severe environmental or seasonal allergies affecting the eyes.
Scleral lenses provide sharp, reliable vision for prescriptions that are too complex, too extreme, or too unstable for conventional contact lenses or glasses. They excel at correcting high astigmatism that standard soft lenses cannot address and extreme levels of myopia or hyperopia where vision quality in other options is compromised.
Because the lenses rest on the sclera rather than the cornea, they remain stable even with eyelid irregularities or during intense physical activity. They benefit patients with entropion, ectropion, ptosis, or floppy eyelid syndrome, as well as athletes, first responders, pilots, professional drivers, office workers with long screen exposure, and frequent travelers in low-humidity cabin environments.
Who Can Benefit from Scleral Lenses?
Understanding whether scleral lenses are right for you depends on your specific eye condition, lifestyle needs, and vision goals. These questions address common concerns patients have when considering this specialized lens option.
Many patients who have been told they cannot wear traditional contact lenses find success with scleral lenses. If you have experienced discomfort with rigid gas permeable lenses, chronic dryness with soft lenses, or have corneal irregularities that prevent proper lens fit, scleral lenses may be the solution. The unique design vaults over the cornea and rests on the less sensitive white part of your eye, making them comfortable even for those with contact lens intolerance.
Scleral lenses are particularly effective for severe dry eye because they create a moisture chamber that continuously bathes your cornea with preservative-free saline. This fluid reservoir provides relief throughout the day without needing frequent rewetting drops. Patients with Sjogren's syndrome, meibomian gland dysfunction, or dry eye from medications often experience dramatic improvement in both comfort and vision quality.
Scleral lenses are considered the gold standard for keratoconus management at all stages of the condition. Whether you have mild keratoconus that causes slight vision distortion or advanced keratoconus with significant corneal thinning and steepening, these lenses can restore clear, stable vision. The rigid lens surface compensates for the irregular corneal shape, and the fluid vault protects your cornea without applying pressure to the thinned areas.
Athletes and active individuals often prefer scleral lenses because they stay securely in place during physical activity and protect the eyes from environmental elements. The large diameter prevents the lenses from dislodging during movement, and the design shields your eyes from wind, dust, and debris. Swimmers, runners, cyclists, and contact sport athletes have successfully worn scleral lenses, though specific water sports may require additional precautions.
Scleral lenses are excellent for people who spend extended hours on computers or in air-conditioned office environments. The fluid reservoir maintains consistent hydration despite reduced blink rates and dry indoor air. Many office workers report they can work comfortably for their entire shift without the burning, dryness, or vision fluctuation they experienced with other contact lens types.
Post-surgical patients often benefit from scleral lenses, especially when complications like ectasia, irregular astigmatism, or corneal haze affect vision quality. The lenses create a new optical surface that bypasses corneal irregularities from surgery. They also provide therapeutic protection for healing corneas after transplant procedures while delivering clearer vision than glasses can provide for these complex prescriptions.
The Scleral Lens Fitting Process
Determining candidacy and achieving optimal fit involves precise measurements and careful follow-up to ensure comfort and effectiveness. The process is thorough but designed to deliver the best possible outcome for your unique eyes.
Your journey begins with a detailed assessment of your eye health, vision needs, and any underlying conditions. Our doctors evaluate your corneal health, tear production, and overall eye surface to determine if scleral lenses are the right solution. This initial consultation includes discussing your lifestyle, visual goals, and any challenges you have experienced with previous vision correction methods.
During the fitting session, our doctors use specialized diagnostic equipment to create a precise 3D map of your cornea's shape and curvature. This detailed topography guides the selection of the right lens design, diameter, and vault depth. The measurements capture even minute irregularities to ensure your lenses fit perfectly.
You will try diagnostic lenses to evaluate comfort, vision quality, and fit. Our team observes how the lenses settle on your eye, checks the fluid reservoir depth, and ensures proper alignment. This hands-on evaluation allows for real-time adjustments to the lens parameters before your custom lenses are ordered.
Learning to handle scleral lenses confidently is an essential part of the fitting process. Our staff provides step-by-step instruction on proper insertion technique using a plunger and mirror, safe removal methods, and lens care protocols. You will practice under supervision until you feel comfortable managing your lenses independently.
Subsequent appointments allow the team to monitor how your eyes adapt to the lenses and make any needed adjustments. We check for proper lens movement, evaluate the health of your ocular surface, and address any comfort concerns. These visits ensure your lenses continue to perform optimally as your eyes adapt to wearing them.
Daily Life with Scleral Lenses
Integrating scleral lenses into your routine becomes natural with proper care and understanding of best practices. Most patients find the extra care steps worthwhile given the dramatic improvement in vision and comfort.
Your day begins with thorough handwashing and drying before handling your lenses. Fill each lens with preservative-free saline solution, check for air bubbles by holding the lens up to light, and use the insertion plunger to place the lens gently on your eye while looking down into a mirror. The entire process takes just a few minutes once you become practiced at it.
Scleral lenses can safely be worn for up to 16 hours daily, though individual tolerance may vary. Never sleep in your lenses unless your doctor explicitly advises it. If you experience fatigue or dryness during the day, take short breaks by removing the lenses. Most wearers comfortably wear their lenses throughout their entire workday without needing rewetting drops.
Removal requires clean hands and a gentle technique using either your fingers or a small removal plunger attached to the lower edge of the lens. Never suction the center of the lens, as this creates excessive suction. After removal, rub each lens gently in your palm with approved cleaning solution, rinse thoroughly with preservative-free saline, and store in fresh multipurpose solution overnight.
Proper hygiene is essential for maintaining eye health and optimizing lens performance. Always use fresh solution and never reuse or top off old solution in your lens case. Replace your lens case every three months to prevent bacterial buildup. Inspect your lenses daily for scratches, deposits, or damage, and contact your eye care provider if you notice any changes.
Schedule appointments every six to twelve months to monitor your eye health and lens condition. Your doctor will assess the fit, check for any changes in your corneal shape, and determine if adjustments are needed. These regular visits help ensure your lenses continue to provide optimal vision and comfort while protecting your eye health long-term.
Caring for Your Vision
If traditional lenses no longer meet your needs or you struggle with vision clarity and comfort, scleral lenses could transform your daily experience. Our eye doctors serve patients across central and northern New Jersey and are ready to guide you through every step of the fitting process. We combine advanced diagnostic technology with personalized care to ensure your lenses deliver the vision quality and comfort you deserve.
My appointment was on time and very efficient. Everyone was friendly and took the time to answer my questions.
William Newcomb
I think I may have seen every doctor and nurse over the years, and they all make me feel very secure in their hands. With my cataract surgeries, Dr. Hosler is the best!
Steven Thornburg
Friendly and caring retina surgeon, I highly recommend Dr. Arnett.
Shirly
Staff nice and friendly. Dr. Liva is a great doctor. Always pleased with visits.
David Lima
You have a professional excellent service
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