Medically reviewed by Dr. Niranjana Bejan Singh. Written to established clinical-education standards (AAO/Mayo/NHS/NEI) and adapted for this hospital. Not a substitute for professional medical advice.
Scleral contact lenses are large, rigid, gas-permeable lenses that vault over the entire cornea and rest on the white part of the eye (the sclera), rather than resting directly on the cornea like a standard contact lens. The space between the back of the lens and the cornea holds a reservoir of fluid, which can improve comfort and vision for people with irregular corneas, such as from keratoconus or previous corneal surgery, or severe dry eye disease that has not responded to other treatments.
Who typically needs this
- People with keratoconus or other irregular corneal shapes where glasses or standard contact lenses no longer give clear vision.
- People with corneal scarring after infection, injury, or previous surgery, including some who have had a corneal transplant.
- Patients with severe dry eye disease or ocular surface conditions where the fluid reservoir under the lens can protect and soothe the eye surface.
- Requires the ability to handle and care for a specialty lens, though fitting is feasible across a wide age range with proper training and support.
What to expect
- A detailed assessment maps the shape of the cornea and surrounding eye surface using corneal topography or similar imaging.
- Trial lenses are placed on the eye and evaluated for fit, movement, and the clearance of the lens over the cornea.
- Adjustments are made to the lens curvature, diameter, and other parameters over one or more follow-up visits until an optimal fit is achieved.
- The patient is trained in the specific techniques needed to insert, remove, clean, and fill the lens with sterile saline before wear.
Recovery
- There is no surgical recovery, but there is typically an adaptation period as the patient learns to handle and wear the lenses comfortably.
- Follow-up visits over the following weeks fine-tune the fit as needed.
- Ongoing periodic check-ups are needed to monitor eye health, since scleral lenses require diligent cleaning and hygiene to reduce infection risk.
- Vision with a well-fitted scleral lens is often achieved quickly, since the fluid reservoir masks much of the corneal irregularity.
Risks to know about
- Improper cleaning or handling can increase the risk of eye infection, including serious corneal infections.
- Poorly fitted lenses can cause discomfort, corneal swelling, or reduced oxygen supply to the cornea with prolonged use.
- Some patients experience difficulty with insertion and removal, particularly early in the adaptation period.
- Regular professional monitoring is needed, since lens fit can change over time and requires periodic reassessment.
Frequently asked questions
Are scleral lenses uncomfortable?
Most patients find them comfortable once properly fitted, in part because the lens does not directly touch the sensitive cornea, though there is usually an adjustment period.
How long can I wear scleral lenses each day?
This varies by individual and by the reason for wear, and your eye doctor will recommend a safe daily wearing schedule based on your specific eyes.
Do scleral lenses replace the need for a corneal transplant?
In many cases of keratoconus or corneal irregularity, scleral lenses can provide good vision and may delay or reduce the need for transplant surgery, though this depends on the severity of the condition.
How often do scleral lenses need to be replaced?
This depends on lens wear and care, but your eye doctor will advise a replacement schedule and monitor the lenses at regular visits.
Ready to see us?
Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: AAO — Contact Lenses for Vision Correction, NEI — Corneal Conditions . General medical information — not a substitute for professional diagnosis. Medically reviewed by Dr. Niranjana Bejan Singh.
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