Key Takeaways
- Scleral lenses are larger, rigid gas-permeable lenses that rest on the white of the eye instead of the cornea.
- Patients with an irregular cornea, such as those with keratoconus, often find that standard soft contact lenses no longer provide clear or comfortable vision.
- Scleral lenses vault over the cornea and hold a reservoir of fluid against the eye, which can also help patients with severe dry eye.
- Fitting scleral lenses takes more time and expertise than fitting standard contacts, but the comfort and vision benefits are often worth it for the right patient.
- Everett & Hurite Eyecare Specialists fits specialty contact lenses for patients throughout the Pittsburgh area, and those struggling with standard contacts should request an appointment to find out if scleral lenses are right for them.
Why Standard Contact Lenses Do Not Work for Everyone
Most people who wear contact lenses use soft lenses that rest directly on the cornea, the clear, dome-shaped front surface of the eye. These lenses work well when the cornea has a fairly regular, even curve. But some patients have a cornea that is irregular in shape, whether from a condition like keratoconus, scarring from an injury, or complications following eye surgery. For these patients, soft lenses may not sit evenly on the eye, which can lead to blurry vision, discomfort, or lenses that simply will not stay in place.
What Are Scleral Lenses?
Scleral lenses are a type of rigid gas-permeable contact lens that is significantly larger than a standard contact. According to Cleveland Clinic, scleral lenses are larger and cover more of the eye's surface than corneal lenses, resting on the sclera, or the white part of the eye, rather than directly on the cornea. The center of the lens vaults, or arches, over the cornea entirely, creating a small space that holds a reservoir of fluid against the eye.
How Scleral Lenses Are Different From Regular Contacts
| Standard Soft Contact Lenses | Scleral Lenses | |
|---|---|---|
| Where They Rest | Directly on the cornea | On the sclera, vaulting over the cornea |
| Best Suited For | Regularly shaped corneas | Irregular corneas, severe dry eye, or high refractive error |
| Material | Soft, flexible | Rigid, gas-permeable |
| Fitting Process | Standard sizes, quicker fitting | Custom-fitted, often requires multiple visits |
| Comfort With Irregular Corneas | May shift, blur, or feel uncomfortable | Vaults over irregularities for a stable fit |
Who Benefits Most From Scleral Lenses
Scleral lenses were originally developed for patients with irregular corneas, and Cleveland Clinic notes that they are especially useful for corneal ectasia conditions like keratoconus, as well as for severe dry eye and certain eye surface diseases. Patients who may benefit from scleral lenses include those who have:
- Keratoconus or another form of corneal ectasia.
- Scarring or irregularity from a previous eye injury or surgery.
- Severe dry eye that has not improved with standard treatments.
- Difficulty achieving clear or comfortable vision with standard soft or rigid lenses.
Because scleral lenses hold a fluid reservoir against the eye throughout the day, they can also provide relief for patients whose eye surface needs constant lubrication, which is part of why they are used for certain eye surface diseases in addition to vision correction.
What to Expect When Getting Fitted for Scleral Lenses
Fitting scleral lenses is a more involved process than picking up a box of standard contacts. Cleveland Clinic notes that most people go through two or three attempts before finding a scleral lens that fits properly, since these lenses are custom-made to the individual shape of each patient's eye. Patients should also expect an adjustment period, since scleral lenses can take longer to get used to wearing, inserting, and removing compared to standard contacts.
At Everett & Hurite, providers like Dr. Natalie Noble, who specializes in corneal disease and specialty contact lenses, work closely with patients throughout the fitting process to find the right fit for their specific eye shape and vision needs.
Finding the Right Lens for Your Eyes
Not every patient needs scleral lenses, but for those with an irregular cornea or a condition that standard contacts cannot accommodate, they can make the difference between blurry, uncomfortable vision and clear, stable sight. The team at Everett & Hurite Eyecare Specialists evaluates each patient's cornea individually to determine whether standard contacts, specialty soft lenses, or scleral lenses are the best fit.
If standard contact lenses have never felt quite right, or if you have been told you have an irregular cornea, schedule an appointment with Everett & Hurite Eyecare Specialists to discuss whether scleral lenses could help.
Frequently Asked Questions
How do I know if I need scleral lenses instead of regular contacts?
Patients who have an irregular cornea, a condition like keratoconus, severe dry eye, or ongoing discomfort or blurry vision with standard contacts may be good candidates for scleral lenses. An eye doctor can determine this during a comprehensive contact lens evaluation.
Are scleral lenses more expensive than regular contacts?
Scleral lenses typically cost more than standard contacts because they require custom fitting and specialized manufacturing. Your eye doctor can review specific pricing and insurance coverage during your evaluation.
Do scleral lenses feel uncomfortable to wear?
Scleral lenses often feel more comfortable than expected once a patient adjusts to them, since their edges rest on the less sensitive sclera rather than the cornea. Some patients need time to get used to inserting and removing them.
How long do scleral lenses last?
Scleral lenses generally last one to two years, though the exact lifespan depends on the material, brand, and how well the lenses are cared for.
Where can I find scleral lens fitting near me in the Pittsburgh area?
Everett & Hurite Eyecare Specialists offers specialty contact lens fittings, including scleral lenses, at locations throughout Pittsburgh, Warrendale, Butler, Greensburg, Southpointe, Monroeville, Steubenville, and Weirton.
