If you have steered clear of contact lenses in the past or struggled with dry eye disease, scleral lenses may be the answer. You're not alone if you haven’t heard of these specialized lenses. Scleral contact lenses are often used by people with irregularities in the cornea, or clear front window of the eye, such as keratoconus.
- Dry eye or other ocular surface diseases, such as blepharitis and Sjogren’s Syndrome
- Lid and orbit disorders, such as Graves’ eye disease
- Irregular astigmatism
- People who have had cornea transplants
- People with strong prescriptions who don’t see well through glasses and cannot tolerate soft contact lenses
Among the most notable advances in contact lens technology, scleral lenses are “a big thing right now,” Meyer says. Around 2009, practitioners only had access to a few types of scleral lenses. But the designs, types, and customizations available during the last decade have exploded.
How do scleral contact lenses work?
Named for the sclera, the white part of the eye, the lenses are larger than their rigid counterparts.
“These special lenses rest on the sclera and tend to be much more comfortable than the rigid gas-permeable contact lenses that rest on the sensitive cornea,” Meyer explains. “Because of this, scleral lenses don’t pop out like some other lenses. They do a great job of sealing around the eye and not allowing any dust or debris to get underneath them.”
Another advantage: the space between the back of the lens and the corneal surface is filled with saline before being placed on the eye. This fluid remains behind the contact lens, providing comfort all day for people with severe dry eyes.
“When we design the scleral lens, we specify a certain curve to control the depth of the fluid chamber to improve vision and comfort,” says Meyer. “We have many patients who wear sclerals only because they have extreme dry eye. Because they act as a ‘liquid bandage,’ they can improve the signs and symptoms of moderate to severe dry eye.”
Why see a specialist?
Experts stress that contacts are medical devices that sit on your eye and should be tailored to each patient.
“There are tens of thousands of combinations of diameter, curvature, material—and more—that can affect how a lens fits on your eye,” says Meyer. “We need to evaluate your eye’s physiology and visual demands to determine which lens works best for you. Contact lens wearers must take extra care to ensure their eyes stay healthy. That’s why we recommend yearly eye exams by a contact lens specialist for those patients.”