Top 5 Q&A: Scleral Contact Lenses
1. What are Scleral Lenses?
Scleral lenses are a large diameter, custom, hard contact lens that vaults (arches) over the cornea, the clear part of the front of the eye, and rests entirely on the sclera, the white part of the eye. They range in size from 14-20mm.
At Eyes for Life, we most commonly fit a 15.8mm diameter lens.
2. I used to wear hard contact lenses, are these the same?
Traditional hard contact lenses, or RGPs (rigid gas permeable), are different to that of scleral lenses due to the fit and size of the contact lens. RGP contacts were popular in the 80’s and 90’s and are much smaller (8-10mm in size) than scleral lenses. RGPs rest directly on the cornea, which is densely innervated with nerves, and can cause some discomfort when wearing RGPs. However, scleral lenses do not touch the cornea and thus are much more comfortable than RGPs. They can even be more comfortable than soft contact lenses!
Cleaning scleral lenses is the same as RGPs because they are made of the same material type. At Eyes for Life, we use Boston Advance Cleaning solutions or ClearCare. Scleral lenses come with extra tools to help with insertion and removal and the contact lens bowl is filled with preservative-free saline solution before insertion. You will get a complete guide on contact lens care and handling at your fitting appointment.
3. Am I a good candidate for scleral lenses?
Scleral lenses can be fit on almost anyone! A general requirement is that the opening between one’s eyelids needs to be sufficient for the insertion of an approximate 14-20mm contact lens.
Scleral lenses are an excellent option for patients that have certain eye diseases and are recommended for those with:
- Keratoconus
- Pellucid Marginal Degeneration
- Post-Laser Surgery (LASIK and PRK) Corneal Irregularities
- Dry Eye Disease
- Graft vs. Host Disease and Corneal Transplant Patients
- Ocular Cicatricial Pemphigoid
- Sjogren’s Syndrome
- Steven Johnson Syndrome
- Neurotrophic Keratopathy
Patients who have a lot of astigmatism and/or difficulties with vision through glasses or soft contact lenses also make excellent candidates for scleral lenses. Scleral lenses mask any corneal irregularities and can provide better vision than soft contact lenses or glasses. Patients who notice their vision blur with each blink through soft contact lenses can get more stable vision with a scleral lens.
4. How much do scleral lenses cost?
The cost of scleral lenses range mainly based on manufacturer and lens type. The cost of a scleral lens fitting is more than soft contact lenses since further testing, measurements and additional follow-up appointments are involved. A scleral lenses fitting is a 90 day trial period which consists of an initial appointment where trial lenses will be placed on your eyes by the doctor and evaluated for a good fit.
A refraction over the contacts will be performed to determine your prescription with the scleral lenses. This prescription will most likely be different than your glasses or soft contact lens prescription. An order will be placed for your personal trial lenses, which are then made and shipped from the manufacturer. It is not uncommon to make further adjustments after the initial trial lenses to ensure optimal results.
Please contact us for an appointment to see if you are a candidate for scleral lenses and to quote the cost of your lenses.
5. How long do scleral lenses last?
Scleral lenses are made to wear daily for typically 10-16 hours and cleaned every night. Depending on your lens care habits and your tear film dynamics, scleral lenses should last about 1-2 years (similar to that of traditional RGPs).
For more information on services offered at Eyes For Life or to schedule an appointment, please call our office at (509) 448-7300.
Written By: Kellen Robertson, O.D.