Specialty Eye Care
Scleral Lenses
A scleral lens is a large rigid lens that vaults completely over the cornea and rests on the sclera, the white of the eye. The space beneath fills with sterile saline, creating a smooth optical surface and a permanent fluid cushion.
In short
Vaults the cornea entirely and sits on the white of the eye. Vision and comfort together.
Scleral lenses solve two problems at once, which is why they have transformed care for irregular corneas. Because the lens never touches the cornea, the fluid reservoir underneath replaces the eye's own distorted front surface with a perfectly smooth optical one. Light entering the eye meets a regular surface for the first time, and vision that glasses could not reach becomes achievable.
The second benefit is comfort. A lens that rests entirely on the sclera avoids the corneal nerve endings that make conventional rigid lenses feel uncomfortable. The sclera is far less sensitive, and the reservoir keeps the cornea continuously bathed. For patients with severe dry eye or ocular surface disease, that reservoir alone can be the reason to wear them.
Fitting is where the skill lies. The lens has to clear the highest point of the cornea without touching it, and land evenly on the sclera without compressing it. That takes a proper diagnostic set, OCT imaging to measure the vault, and the willingness to iterate. It is not a lens that can be ordered from a prescription.
What to expect
- OCT measurement of the vault
- The clearance between lens and cornea is measured directly with cross sectional imaging, not estimated.
- Diagnostic lenses on the eye
- Multiple trial lenses are assessed with fluorescein before anything is ordered.
- Filling technique taught properly
- Sclerals are inserted filled with sterile saline. Getting that right without bubbles is the main handling skill and it is taught with practice time.
What is included
- Corneal topography and OCT vault measurement
- Diagnostic scleral lens fitting
- Custom lens design and manufacture
- Insertion, removal, filling and care training
- Follow up through settling and ongoing review
What this does not do
- Insertion takes practice. Most people are competent within a week or two but the first attempts are fiddly.
- They require sterile saline for filling, which is an ongoing consumable.
- Fitting takes longer than any other lens type, typically two to three appointments over two to four weeks.
Questions and answers
What is the difference between scleral lenses and regular contacts?
Scleral lenses are considerably larger and vault completely over the cornea, resting on the white of the eye. The space beneath holds a fluid reservoir that provides both exceptional comfort and a smooth optical surface for irregular corneas. A regular lens sits directly on the cornea and follows its shape, including its irregularities.
Are they uncomfortable because they are so big?
Counterintuitively, they are often more comfortable than smaller rigid lenses. The sclera has far fewer nerve endings than the cornea, and nothing is touching the sensitive surface at all.
Who benefits most from scleral lenses?
Keratoconus, post corneal transplant, post refractive surgery irregularity, corneal scarring, and severe dry eye or ocular surface disease where the fluid reservoir provides continuous relief.
How long can I wear them each day?
Most wearers manage a full waking day. Some need to remove, refill and reinsert once during a long day if the reservoir clouds, which is normal rather than a fitting fault.
How long does fitting take?
Most patients complete the initial fitting process across two to three appointments over two to four weeks, including custom manufacture time.
Talk to someone about scleral lenses
Appointments are scheduled two per hour, so there is time to answer questions properly. Call (480) 706-3937 or request a time online.