Scleral Contact Lenses

Scleral contact lenses are large-diameter, gas-permeable lenses that vault over the entire cornea and rest on the white of the eye (the sclera), creating a smooth optical surface and a protective reservoir of saline solution against the corneal surface. According to the Contact Lens Spectrum Annual Report, scleral lens prescribing has increased by over 300% in the past decade as more practitioners recognize their benefits for complex vision cases (Contact Lens Spectrum, 2024). For patients whose vision cannot be fully corrected with glasses or standard contacts, scleral lenses often provide the clarity, comfort, and stability that other options cannot match. At Greenwich Ophthalmology Associates, our specialty contact lens fitters in the greater NY/CT region work with patients to design a scleral lens that addresses each person's unique needs.

Scleral contact lenses are made from rigid gas-permeable material and range from about 14.5 mm to over 24 mm in diameter. Unlike standard GP lenses that sit directly on the cornea, a scleral lens arches completely over it, landing instead on the less sensitive scleral tissue. This vaulting design means the lens never touches the cornea itself, which is especially important for eyes with irregular or damaged corneal surfaces.

Before a scleral lens is placed on the eye, it is filled with preservative-free saline solution. Once seated, this fluid reservoir remains trapped between the back surface of the lens and the front surface of the cornea. The saline layer continuously bathes the cornea, providing constant hydration throughout the day.

Because the rigid lens material creates a perfectly smooth front optical surface, light entering the eye is refracted evenly regardless of the cornea's underlying shape. In conditions such as keratoconus or pellucid marginal degeneration, the cornea's irregular curvature distorts incoming light. The scleral lens essentially replaces the irregular corneal surface with a uniform one, allowing focused light to reach the retina.

Most patients find scleral lenses very comfortable once properly fitted. Because the lens rests on the less sensitive sclera and never touches the cornea, discomfort is minimal. The fluid reservoir also provides continuous lubrication throughout the day.

Scleral lenses require a specific insertion and removal technique. The lens is filled with saline and placed on the eye using a suction cup or large plunger device. Removal also uses a small suction device. Our team provides thorough training during your fitting visits.

With proper care, scleral lenses typically last one to two years before needing replacement. Regular follow-up visits ensure your lenses remain in good condition and your prescription stays current.

Most patients wear scleral lenses comfortably for 12-16 hours per day. Some patients with severe dry eye may need to remove and refill the lenses with fresh saline midway through the day. Following proper lens care practices is essential.

Many medical insurance plans provide coverage for scleral lenses when they are medically necessary. Documentation of your underlying condition helps support insurance claims. Our staff can assist with insurance questions.

Both hybrid lenses and scleral lenses can address irregular corneas. Hybrid lenses are smaller and may be preferred for milder conditions. Scleral lenses provide a larger fluid reservoir and are often better for severe dry eye or advanced keratoconus.