Scleral contact lenses are large contact lenses named for the portion of the eye on which they rest when worn by the patient (the sclera, or white part of the eye). The sclera is much less sensitive than the cornea (the clear part of the front of the eye). The cornea is extremely important for clear vision as it is responsible for most of the focusing of light. It’s also the part of the eye where LASIK, PRK, and other refractive procedures are performed. The cornea can be damaged from diseases such as keratoconus or trauma. When the cornea is damaged, a scleral contact lens can allow for restoration of vision by vaulting the entire cornea and essentially optically replacing it.
The lens is placed on the eye with a special preservative free solution that acts as a middle layer in the system between the cornea and the contact lens. This fluid reservoir helps correct astigmatism, and can help with dryness and comfort issues that other lens options may fall short. Scleral lenses are one of the most comfortable types of contacts available. Once a good fit has been obtained, the lenses don’t move. The lack of movement, the fact it’s sitting on the sclera, and the fluid resivor makes this type of lens one of the best options for those who need the best comfort and optics possible.
The process begins with a traditional eye exam to determine your eye’s health and baseline prescription. We use a specially designed fitting lens to help create a lens that’s custom designed for you. This normally takes about an hour. Your lenses are then manufactured to our exact specifications. We have you return a few days later to learn how to put the lenses in, take them out, and care for them. We always aim for perfection with the first fit, but sometimes the first pair of lenses need minor adjustments. We will work with you to redesign the lenses to attain the best vision possible, and the followup or any lenses needed to get you there are included.
Who Is A Good Candidate For Scleral Lenses?
Irregular astigmatism, keratoconus or pellucid marginal degeneration.
These patients have conditions that limit the quality of vision that can be achieved with glasses or soft contact lenses. For many of these patients, a rigid lens of some type is the only way to obtain vision that is adequate. The abnormal shape of the cornea can be bypassed by this type of lens. Once fit, many patients are able to achieve vision that is far better than their vision with glasses or soft contact lenses.
Complications from corneal transplants, LASIK, RK, or PRK
These procedures affect the shape of the cornea. Although rare, they can leave lasting changes that can occasionally cause a reduction in vision. Because of the procedure involved, the cornea is typically much flatter or steeper than typical. This can make the vision poor, and soft lenses not fit in a way that is healthy. A scleral lens can be a great option because it can correct the vision without needing to touch the damaged cornea.
Relief For Dry Eyes
Dry eyes can cause both pain and poor vision. For some patients, artificial tears or prescription drops are not sufficient to resolve their symptoms. Scleral lenses can provide relief to these patients by using the scleral lens tear reservoir to bathe the eye in soothing solution all day. The eye is kept in a controlled environment so dryness symptoms are minimized for many patients. They may not be able to eliminate the need for other forms of dry eye treatment, but they typically greatly assist the overall management.
How Much Do Scleral Lenses Cost?
At Central Ohio Vision and Eyecare, we do our best to keep your costs low. We will work with your insurance to minimize your out of pocket expenses. Call us and we can analyze your benefits to give you an idea of what you can expect.
If you have questions about scleral lenses, feel free to call us anytime. Dr. Karres or Dr. Keller will be able to help you determine your candidacy, costs, and the benefits of scleral lenses!