Eye health resource
3 Myths About Scleral Lenses
Scleral lenses are specialty rigid gas-permeable lenses used for selected irregular corneas, ocular-surface disease, and difficult contact-lens fits. Learn why they are not only a last resort, why comfort varies, and why safe wear still requires careful fitting and hygiene.
Reviewed for accuracy by Justin Bazan, OD on .
Scleral lenses are larger-diameter rigid gas-permeable contact lenses that vault the cornea and rest on the sclera, the white part of the eye. They can provide excellent vision and useful ocular-surface protection for selected patients, but they are specialty medical devices rather than a universally better contact lens.
Myth 1: Scleral Lenses Are Only a Last Resort
Scleral lenses are often considered when ordinary soft or corneal GP/RGP lenses have not provided adequate vision, fit, or comfort, but “last resort” is too simplistic.
They may be an appropriate option for selected patients with:
- keratoconus or another irregular cornea;
- irregular astigmatism after surgery, trauma, or corneal transplantation;
- significant ocular-surface disease or dry eye in which a fluid reservoir may be helpful; or
- another difficult-to-fit situation where the lens design offers a practical advantage.
They are not automatically the best choice for every ordinary refractive error. Lens selection depends on the prescription, corneal shape, tear film, eyelids, ocular surface, handling ability, and wearing goals.
Myth 2: Because Scleral Lenses Are Large, They Must Be Uncomfortable
Many patients are surprised that a well-fitted scleral lens can be comfortable. The lens lands on the relatively less-sensitive sclera and generally moves less with blinking than a small corneal GP lens.
That does not mean every patient experiences perfect comfort. A lens can feel uncomfortable if the landing zone, edge, clearance, filling technique, tear exchange, or ocular surface is not working well for that eye.
Scleral lenses are also larger to insert and remove, so handling can take practice.
Myth 3: Scleral Lenses Have No Meaningful Risks or Maintenance
Scleral lenses can be worn safely, but no contact lens is risk-free. Poor hygiene, water exposure, overwear, trapped debris or bubbles, inadequate fit, or an unhealthy ocular surface can cause complications.
Safe wear generally includes:
- clean, dry hands before handling;
- the prescribed cleaning and disinfection system;
- preservative-free saline or another specifically prescribed filling solution inside the lens bowl;
- keeping lenses and accessories away from tap water;
- following the prescribed wearing and replacement schedule; and
- scheduled follow-up to monitor fit and eye health.
Pain, marked redness, light sensitivity, discharge, or reduced vision warrants lens removal and prompt evaluation.
Are Scleral Lenses Expensive?
They usually involve more professional fitting time, specialized measurements, custom lens design, and follow-up than a routine soft-lens fit, so total cost can be higher.
Insurance and vision-plan coverage varies substantially. Do not assume a scleral lens is automatically covered because it is medically useful, and do not assume it is never covered. Park Slope Eye can help verify available benefits and estimate patient responsibility.
How Are Scleral Lenses Fitted?
A specialty fitting generally begins with a recent comprehensive eye exam and additional corneal/ocular-surface measurements. Park Slope Eye may use corneal topography and diagnostic lenses to evaluate clearance, alignment, landing, centration, and vision.
The first diagnostic or ordered lens is not necessarily the final lens. Adjustments and follow-up are a normal part of many scleral fittings.
Scleral Lenses at Park Slope Eye
Park Slope Eye fits scleral lenses as part of our specialty contact lens services, along with corneal GP/RGP, toric, multifocal, monovision, and Ortho-K lenses.
If standard contacts have not provided the vision, fit, or comfort you need, book an appointment to discuss whether a scleral or other specialty lens is appropriate.
Originally published . Substantially updated .