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Benefits vs Disadvantages of Scleral Contact Lenses

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A woman putting on a scleral contact lens.

Wearing contact lenses is a convenient and often life-changing experience for those who need vision correction but don’t want to rely on glasses. But as a quick scan while ordering contacts will tell you, there are many types of lenses available. Scleral contact lenses are gaining popularity, particularly for those with complex vision issues.

These lenses cover the entire eye’s surface, providing numerous benefits for users, such as:

  • Improved comfort, stability, and clarity
  • Improved durability
  • Dry eye relief
  • Ideal for keratoconus and other corneal conditions

However, like anything, there are also some downsides to consider before deciding if scleral lenses are right for you.

  • Increased maintenance
  • More complex fitting process
  • Greater upfront cost

What are Scleral Lenses

Scleral lenses are large-diameter contact lenses with a unique function you may have guessed from the name. Instead of sitting on the eye’s clear front dome, also known as the cornea, scleral lenses rest on the sclera (the white part of the eye). This unique function allows them to vault over the cornea, creating a comfy, fluid-filled reservoir.

Everyone’s eyes are different sizes, so scleral lenses are customized for patients. Optometrists usually measure corneal shape using computer-assisted topography to create a detailed map of the eye surface. Some lens specialists also use optical coherence tomography (OCT), a sophisticated imaging technique that provides even more data on the eye’s tissue layers. Taking things a step further, at Tree City Eyecare, we create a 3D map of your eyes surface using an advanced technique called scleral profilometry.

This way, your optometrist should have all they need to customize your scleral lenses from the shape to the diameter, and other specifications to help create a comfy fit.

Benefits of Scleral Lenses

Scleral contact lenses provide numerous benefits for those with vision issues.

Improved Comfort & Stability

Scleral lenses are typically 14.5 to 24 mm in diameter. In comparison, traditional rigid contact lenses are only 9 mm, even smaller than the average human cornea. This size allows them to vault over the entire cornea, resting on the less sensitive sclera. Because they don’t touch the cornea directly, they can help reduce friction irritation to the delicate tissue.

Additionally, because they’re so large, they’re less likely to come out of your eye or shift around. This can enhance their already impressive comfort and make them more stable than conventional lenses.

Scleral lenses are typically made from gas-permeable materials, which allow oxygen to pass through the lens to the cornea. This is important for maintaining healthy corneal tissue and reducing the risk of infections or other complications. They also form a seal around the eye, reducing the amount of environmental irritants looking to make your cornea a home.

Increased Durability

Scleral lenses are made from a high-grade rigid gas-permeable (RGP) material that makes them more durable than soft lenses. RGP lenses are durable, hold their shape, and can resist debris or bacteria build-up with proper care.

RGP lenses are known to last longer than traditional contact lenses. With proper care, they can last for 2–3 years before needing a replacement. A yearly eye exam is recommended with contact lens wear, and it will be determined by your optometrist whether your RGP lenses are safe for another year of use.

Dry Eye Relief

Uniquely, scleral lenses don’t sit on the cornea but rather surround it with a pocket of fluid between the lens and the eye.

This mini-reservoir stores tears or a saline solution that bathes the cornea in hydration. This moist environment helps keep the eye lubricated, providing relief for dry eye symptoms. Dry eye sufferers typically have difficulty wearing contact lenses, but the pocket of fluid creates a cushion effect between the lens and eye, enabling a comfortable and improved lens fit.

Ideal for Keratoconus

Keratoconus is a condition that affects the cornea’s shape, and in doing so, directly affects vision. That’s where scleral lenses come in. These specialty lenses can fit irregularly shaped corneas and provide vision correction.

The scleral lenses’s signature fluid layer can create an optically smooth surface to provide clear, unimpeded vision. And since they don’t touch the cornea, they can be an effective and more comfortable means of vision correction for people with keratoconus or other conditions that cause irregular corneas. This includes scarring, corneal transplant, post-LASIK ectasia, and many other conditions.

Disadvantages of Scleral Lenses

When considering any treatment, it’s vital to recognize potential downsides. Some can easily overlook these disadvantages, while others may decide they’re dealbreakers. The only way to know is to ask, and your optometrist can help you weigh your options.

Increased Maintenance

A contact lens is being cleaned using a cleaning solution.

Unlike daily disposable soft contact lenses, scleral lenses must be cleaned and stored to maintain their longevity and avoid infections. Always use cleaning solutions recommended by your eye care professional, as they may vary depending on your individual needs and lens type.

More Complex to Fit

Fitting scleral lenses typically requires a more intense and complex process compared to fitting other types of contacts. The lenses fit over more of your eye, and so need to be sized correctly to avoid the fluid reservoir leaking. Your optometrist needs a deep understanding of eye anatomy and experience fitting scleral lenses. At Tree City Eyecare, we have fit hundreds of patients in scleral contact lenses to treat numerous conditions.

Optometrists may need to consider parameters such as the corneal diameter and curvature, limbal diameter, and scleral profile. Fortunately, modern diagnostic technology enables optometrists more accurate measurements and fewer trial lenses while finding your fit.

Greater Upfront Cost

Scleral lenses are custom-made and constructed from durable materials. The fitting process also requires specialized imaging devices that could be more labor-intensive. This can make scleral lenses and lens replacements more costly than traditional lenses. Though they last longer and could cost less in the long run, this greater upfront cost can be a reasonable concern for many.

Discover if Scleral Lenses are Right for You

There’s much to consider with scleral lenses, and the Tree City Eyecare team is ready to answer your questions and help you feel comfortable with the process.

The only way to learn is by asking. So book your appointment, and let’s find out together if scleral lenses are right for you! 

Written by Dr. Jaimen Dixon O.D.

Dr. Dixon grew up in Boise, Idaho and couldn’t be happier serving the community where he was raised. After graduating Magna Cum Laude from Brigham Young University-Idaho, Dr. Dixon received his Doctorate of Optometry from the Southern College of Optometry in Memphis, Tennessee. He also graduated Magna Cum Laude from SCO and was honored to receive his graduating class’s Outstanding Clinician Award. Dr. Dixon is a member of Idaho Optometric Physicians, the American Optometric Association, the Scleral Lens Society, and the American Academy of Orthokeratology & Myopia Control.

Dr. Dixon enjoys providing full-scope eye care to all ages, from kids to adults to seniors. He has training in managing ocular diseases, including keratoconus, glaucoma, macular degeneration, diabetic retinopathy, dry eye disease, and others. He has a passion for myopia control and difficult-to-fit contact lenses, and he is proud to be an expert in specialty contact lens fitting, including scleral contact lenses, orthokeratology, rigid gas permeable, and more. Dr. Dixon especially loves helping those who previously thought they were “not a candidate for contact lenses” discover that with the right contact lens design, just about anyone can gain freedom from glasses. Few things bring him as much satisfaction as seeing a custom-designed lens change a patient’s life.

When not bringing new clarity to his patients, Dr. Dixon loves enjoying the outdoors with his beautiful wife, 3 crazy kids, and naughty golden retriever. He especially enjoys building and using bikes to explore Idaho’s thousands of miles of trails and dirt roads. He and his family also love camping, backpacking, climbing, skiing, and exploring Idaho’s many hidden corners.

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