In the past, scleral contact lenses were usually reserved for the most severely damaged or diseased corneas. Because of advancements in both material technology and design, normal patients are now being fitted in small scleral lenses because they offer some unique advantages over soft contacts and traditional gas-permeable (GP) lenses. First, because they are about the same size as soft contact lenses, they are large enough to extend beyond the eyelids, which allows for incredible lens comfort, even from the moment you first try them on. Second, because they are fitted to the white part of the eye, instead of the cornea, even the most complex prescriptions can be successfully fitted into scleral lenses.
If you have been diagnosed with a corneal dystrophy, such as keratoconus, or if you have undergone a corneal transplant, obtaining a good contact lens fitting can be a challenge. Because of their unique lens design, which rests on the white part of the eye, instead of the cornea, scleral lenses can provide restoration of vision to patients with the most severe forms of corneal dystrophy, post lasik ectasia, and corneal transplant irregularity. Scleral lenses can also provide great relief for patients suffering from the most severe forms of dry eye syndrome, which can be debilitating.
Unlike traditional contact lenses, which are fitted to the surface of the cornea, scleral lenses are actually shaped to fit the white part of the eye, sometimes referred to as the “sclera.” These lenses are so different from traditional contact lenses, that they really fall into a category that is all their own.
In the past, scleral lenses were usually fitted as “medically-necessary” contact lenses, for patients with the most serious eye conditions, such as the most severe forms of keratoconus, corneal irregularity after transplantation, post-surgical complications, and the most advanced forms of dry eye syndrome, usually associated with autoimmune disease.
Some of the conditions that warrant medically-necessary use of scleral lenses are the most severe forms of:
- post-lasik complications
- post-RK complications
- irregular astigmatism
- highly irregular corneal transplants
- dry eye syndrome
Scleral lenses have become incredibly popular over the past few years. This is good news for normal patients, who seek the sharpness of a gas-permeable contact lens, the comfort of a soft contact lens, and the flexibility that comes with a custom design, such as adding multifocal optics. While sclerals used to be reserved for only the most complex contact lens fittings, they are now being used by many who want to take advantage of all the benefits offered by these incredible pieces of technology.
Those who might be ideal candidates for elective mini-scleral lenses are patients with:
- moderate to high astigmatism
- failures in soft toric contact lenses
- failures in traditional GP contact lenses
- intolerance for soft lens materials