Scleral Contact Lenses

The norm these days when someone mentions contact lenses, we often think about soft silicone or silicone hydrogel contact lenses that fit comfortably on the cornea (or the clear layer on the surface of the eye) and are mainly used for cosmetic purposes in lieu of glasses. A few dozen years ago rigid gas permeable, or RGP lenses, were the standard use for vision correction as a substitute to glasses; these lenses are hard (as the name suggests) and much smaller lenses that move quite significantly around the cornea. While they may not be the most comfortable, the optics of the rigid lenses allow for patients to achieve quite exceptional vision correction. With the emergence of soft contact lenses, the number of RGP wearers drastically decreased, as the comfort of the soft lenses seemed to outweigh the outstanding vision correction with the rigid lenses. These days the RGP lenses are generally used by two groups of patients: those who started wearing them at a young age, have gotten used to their fit and do not want to forfeit their crisp vision, and those who have medical eye conditions that cannot be corrected adequately with either glasses or soft contact lenses.

More recently, there is another type of rigid lens that has gained popularity within that latter group of patients: the scleral lens. This lens is able to achieve the same exceptional vision and does not sacrifice the level comfort to the patient. Scleral lenses are large rigid lenses that vault the entire cornea and rest on the sclera or white part of the eye. They are inserted with the bowl of the lens filled with saline; therefore the only areas the lens touches the eye after insertion is the sclera, which eliminates the friction of the lens on the cornea. Similar to the much smaller RGP lenses, the scleral lenses are specially ordered as a custom-fit for each individual patient based on the curvature of their cornea.

Who is a candidate for scleral lenses? Technically anyone, but it is more likely your eye care provider will recommend them to patients who have medical conditions that will benefit from the vision of scleral lenses. These include but are not limited to keratoconus, significant dry eye syndrome, irregular or high degree of astigmatism, other corneal ectasias, previous corneal surgeries (refractive or transplant), corneal scarring, Stevens Johnson Syndrome, and previous corneal trauma; many of these patients were previously told they were not candidates for “regular” or soft contact lenses. While anyone may be a candidate for these lenses, generally eye care providers will opt for soft contact lenses if possible as the insertion/removal process is much easier and the comfort of daily disposable soft contact lenses is second to none. Another reason the provider may choose the soft lenses is that the scleral lens fitting process is much more involved as scleral lens wearers have customized lenses; the contact lens evaluation is more time-intensive and also more costly. For patients with any of those aforementioned conditions, their vision insurance may cover a great deal of both the fitting/evaluation fee and the cost of the lenses.

If you have any of the previously listed conditions or think you may be a candidate and want to find out more information about scleral lenses, call Metrolina Eye Associates to schedule an appointment for a scleral lens evaluation today.

By Dr. Priya Sheth