Scleral Lenses

Welcome to everything scleral lenses! I’m excited to have you here. I’m Dr. Laura and I’ve been working with these amazing lenses for almost a decade. I’m still surprised by the new ways this technology can be used to help my patients. I’ll get into that below, but I wrote this page because so many of my patients have great questions and I created this as a reference for them to look at after our visit. Besides the Q&A subpage, there are links to YouTube videos about how to insert and remove the lenses, common solutions used (both on the lens and in the bowl) as well as how to care for your lenses. Hope you find this helpful whether you’re just starting your journey with sclerals or wearing them for many years.

One quick disclaimer: all the information on our website is educated from what I’ve learned from both formal education (I regularly attend seminars like those at the Global Specialty Lens Symposium), research articles and my own clinical experience. Every patient is unique and figuring out the best vision or comfort solution for you likely involves time spent with a professional familiar with this technology.

Brief Review About Scleral Lenses

Scleral lenses are names for the part of the eye they rest on, the sclera or white of the eye. There are smaller versions of these lenses called corneal lenses that rest directly on the cornea. Both of these lens types are what we consider “hard lenses” or a rigid gas permeable lenses and commonly referred to as RGPs. They are called gas permeable because oxygen can readily pass through the material and get to the cornea (which doesn’t have its own blood vessels, so it get oxygen from the air or the eyelids while you sleep). This feature allows for even large lens to create a healthy environment for the tissue. Older materials didn’t allow much oxygen through, so they were only safe for the eye when the lens was small enough for the tear film to supply oxygen to the cornea.

Many people are much more familiar with soft contact lenses which drape over the cornea and scleral, matching its contours. RGP lenses on the other hand are created to hold their shape; they are designed and customized for your eye and each is made to order after the fitting.  Unlike a soft lens which can be removed by pinching the lens in half, hard lenses will break if you try to fold them. They are removed using your fingers and eyelids or a small plunger. Using any RGP material lens, whether large or small, requires different tools and solutions than the soft ones. More on that later.

Scleral lenses are versatile

Scleral lenses can be considered a “PROSE” device which stands for prosthetic replacement of the ocular surface ecosystem; this acronym was coined by Boston Sight Foundation, a world authority on this technology. Scleral lenses are most commonly used for patients with irregular corneal shapes like keratoconus, corneal ectasia from refractive surgery (Lasik, RK, etc) or corneal injuries. The cornea is the window to eye. If light doesn’t focus through this tissue very well, your vision wouldn’t be very clear.

There is a plethora of issues that can cause the light to focus poorly in the eye, but many can be solved by placing a new front surface over the tissue. The magic lies with something optics calls index of refraction (a measure of how much a material bends light); this property is similar for the cornea, saline and your tears to work with the lens to act like it’s all one system. So, if we vault over the irregular tissue with a smooth uniform surface (aka the lens) and fill in the space with saline, we can mask the distortion and improve your vision.  

Some patients with astigmatism have been told they can’t wear contacts, but often scleral designs can correct for their prescription. Because this type of lens allows for more stable vision than soft contact lenses, they can achieve excellent vision. Also, a lot of people are pleasantly surprised at how comfortable these lenses are, although they can be daunting at first.

Even more uses

Other uses for scleral lenses include patients who have very sensitive eyes, either from dryness or light sensitivity. These patients often arrive wearing sunglasses, a hoodie, or baseball cap. Some even request the lights be turned off! These patients usually struggle with driving (vents dry out their eyes), working environment (glare from office lighting) and just keeping their eyes open in general, making everyday tasks much more challenging than they should be. One of the most satisfying parts of my job is taking a patient like this and putting a lens on their eye; after about 15 minutes, usually much to their companion’s surprise, the patient’s eyes are open and they’ve taken off the sunglasses or hat and lowered the hoody.

There are few experimental ways I’ve used these lenses to help heal the cornea when nothing else would work and they’ve performed amazingly well. There is also a technology that can reshape the cornea called orthokeratology but that is for another page.

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Learn More About Scleral Lenses

Frequently Asked Questions

Frequently Asked Questions about Scleral Lenses

Frequently Asked Questions

Cleaning and Solutions

Scleral and corneal RGP Lens Solutions: Cleaning and Storage

Cleaning and Solutions

Chronic Dry Eye Disease and Scleral Lenses

Studies show that up 1 of 8 Americans will suffer from some form of dry eye.

Chronic Dry Eye Disease and Scleral Lenses

Keratoconus and Scleral Lenses

We’re committed to helping you decide which refractive procedure is right for you.

Keratoconus and Scleral Lenses

GVHD Dry Eye and Scleral Lenses

Ocular Graft vs. Host Disease (GVHD)

GVHD Dry Eye and Scleral Lenses

Scleral Lenses: Fact or Fiction

Have questions about scleral lenses?

Scleral Lenses: Fact or Fiction

Insertion and Removal Tips

Our guide to inserting & removing Scleral Lenses

Insertion and Removal Tips

Special Effects Contact Lenses

Available in both prescription and non-prescription styles

Special Effects Contact Lenses

Eye Doctors at Eyecare Associates

Think we can help you? Call Eyecare Associates today to discuss your needs, make an appointment online or refer a friend. Our scleral lens specialists include Dr. Laura Nennig and Dr. Alyssa (Sherwood) Foster

Known for specializing in treatment of a number of complex corneal diseases, Eyecare Associates works hard to find the best solution for your visual needs. Our eye doctors and staff occupy a modern facility with some of the most advanced technology available.

Our staff prides themselves on the warm and compassionate care we deliver. We understand the pain and frustration our patients often experience with their diseases. Our goal is to provide an excellent experience through the entire process.