Scleral lenses are used to treat a variety of conditions, including:
Keratoconus
Corneal Cross-Linking (CXL) Complications
Intacs Complications
Glare, Dry Eyes, Halos, Starbursts and Ghosting
Complications from LASIK, PRK, and RK
Pellucid Marginal Degeneration (PMD)
Sjogren’s Syndrome
What are Scleral Lenses?
Scleral contact lenses are large-diameter lenses that provide clear and comfortable vision because the lenses do not actually touch the cornea. Instead, scleral lenses vault over the entire corneal surface, resting on the “white” portion of the eye known as the “sclera.” The space between the back and front portions of the scleral lens is filled with unpreserved sterile saline solution, which means that the eye always remains in a liquid environment. Scleral lenses cover a larger portion of the sclera, whereas semi-scleral lenses cover a smaller area.
These larger lenses also are more stable than conventional gas permeable contact lenses, which move with each blink because they cover only a portion of the cornea. Moreover, scleral lenses do not fall out, bits of grit do not lodge behind them during wear, and they are surprisingly comfortable to wear when fitted properly.
Fitting the Scleral Contact Lens
There are three different types of scleral lenses:
Corneo-Scleral Lenses & Semi-Scleral Lenses
Larger than conventional GP lenses; sit near the junction between the sclera and the cornea
Mini-Scleral Lenses
Vault over the entire corneal surface and sit on the anterior sclera
Full Scleral Lenses
Largest scleral lenses; provide greatest amount of clearance between the cornea and back surface of the lens
Scleral lenses are typically manufactured with highly breathable, rigid gas permeable lens materials. Thus, even though the lenses cover the entire corneal surface, they allow plenty of oxygen to reach the front surface of the eye to maintain health and comfort.
There are five primary categories of lenses used to treat patients with keratoconus, glare, dry eyes, halos, starbursts, ghosting, complications from LASIK, PRK, and RK, Pellucid Marginal Degeneration (PMD) and Sjogren’s Syndrome:
Scleral contact lenses are large-diameter lenses that provide clear and comfortable vision for keratoconus patients because the lenses do not actually touch the cornea. Instead, scleral lenses vault over the entire corneal surface, resting on the “white” portion of the eye known as the “sclera.” The space between the back and front portions of the scleral lens is filled with unpreserved sterile saline solution, which means that the eye always remains in a liquid environment. Scleral lenses cover a larger portion of the sclera, whereas semi-scleral lenses cover a smaller area.
These larger lenses also are more stable than conventional gas permeable contact lenses, which move with each blink because they cover only a portion of the cornea. Moreover, scleral lenses do not fall out, bits of grit do not lodge behind them during wear, and they are surprisingly comfortable to wear when fitted properly.
These lenses are made of a firm durable plastic that transmits oxygen. The rigid material allows the lens to vault over the cornea, which replaces the cornea’s irregular shape with a smoother and more uniform surface that improves vision.
“Piggybacking” involves placing a soft contact lens over the eye and then fitting a gas permeable lens over the soft lens. This can increase comfort because the soft lens acts as a cushion pad under the more rigid gas permeable lens.
Hybrid contact lenses, which were specifically designed to treat keratoconus, combine a rigid center that is highly oxygen-permeable with a soft “skirt” on the peripheral. These lenses were designed specifically for keratoconus, and the central gas permeable zone of the lens vaults over the cone-shaped cornea for increased comfort. Hybrid contact lenses provide the crisp optics of a gas permeable contact lens and wearing comfort that rivals that of soft lenses.
Contact lens manufacturers recently introduced custom soft contact lenses that are specifically designed to correct mild-to-moderate keratoconus. The design of the lenses is based on precise measurements of your eye. These lenses are often more comfortable to wear than gas permeable lenses.
