Introduction to Scleral Contact Lenses

Scleral contact lenses are high-diameter gas-permeable lenses that arc over the cornea and sit on the sclera, the white of the eye. In contrast to the conventional contact lens that rests directly on the cornea, scleral lenses establish a reservoir of tears between the eye and the lens, providing a smooth optical surface and superior comfort for individuals with irregular corneas or severe dry eye.

Scleral lenses were previously niche products applied only for medical purposes, yet they have become increasingly popular among both patients and eye care practitioners because of their versatility and visual advantages. Their distinctive design not only enhances vision but also enhances eye health by keeping the ocular surface constantly hydrated.

Why Choose Scleral Lenses?

Scleral lenses are usually selected by patients who are unable to see clearly or comfortably with conventional soft or rigid gas-permeable contact lenses. They are particularly useful for patients with:

  • Keratoconus or other corneal anomalies
  • Post-surgical problems (such as after LASIK or corneal transplants)
  • Severe dry eye syndrome
  • Significant refractive errors (such as high astigmatism or nearsightedness)

In addition, athletes and individuals with dynamic lifestyles tend to opt for scleral lenses because they resist dislodging during motion and are stable. The stability of the lenses in enabling constant, high-quality vision is a great asset for most visual requirements.

How Often Are Scleral Lenses Prescribed?

Scleral lenses are being prescribed more and more, particularly as diagnostic equipment becomes more advanced and increasing numbers of optometrists learn to fit them. Although they still account for a smaller percentage of all contact lens prescriptions than soft lenses, their usage is increasing in patients with complicated vision problems. Recent surveys have indicated that scleral lenses currently account for approximately 2–5% of specialty lens fittings in the United States, with this percentage steadily increasing based on increasing awareness and rates of success.

Advantages of Scleral Lenses

Scleral lenses provide many advantages in addition to enhanced vision. Some of the most prominent benefits include:

Increased Comfort: Since they sit on the sclera, which contains fewer nerve endings, scleral lenses are generally more comfortable than traditional rigid lenses.

Stable Vision: They tend to move less around the eye, giving stable and consistent visual correction.

Ocular Surface Protection: The reservoir of tears is a therapeutic bath for the eye, which protects and heals dry or injured corneas.

Broad Field of Vision: Due to their dimensions, there is a wider, unobstructed field of vision.

Custom Fit: Scleral lenses are fitted to each individual eye, both enhancing comfort and function.

For individuals who have a corneal disease or chronic dry eye, these lenses are a lifesaver, both for their visual acuity and relief from irritation and discomfort.

Drawbacks to Wearing Scleral Lenses

Even with all their advantages, scleral lenses are not without drawbacks. The most common issues users will experience are:

Complicated Fitting Process: Fitting scleral lenses involves specialized tools and training, requiring many to make multiple visits.

Higher Cost: Scleral lenses are generally more costly than regular lenses because they are custom-made and fit into place.

Initial Learning Curve: It is challenging to insert and remove the lenses initially, and needs training and practice.

Maintenance Needs: Cleaning and storage of scleral lenses require strict hygienic practices to avoid infection or damage to the lenses.

While these challenges are manageable for most users, they may be a consideration for people seeking a simpler vision correction option.

How Durable Are Scleral Lenses?

Scleral lenses are constructed of robust gas-permeable material intended to withstand daily wear. Proper care allows a pair of scleral lenses to be worn for one to two years. Their lifespan relies on the attention the wearer pays to them—regular cleaning, safe storage, and avoiding scratches or drops will make them last longer.

Aside from their physical strength, scleral lenses are also chemically stable and resistant to deformation. Nevertheless, they must still be checked periodically by an eye care practitioner to ensure that they are in good shape and are functioning at their best.

How Many Hours Can You Use Scleral Lenses Per Day?

Most individuals can wear scleral lenses comfortably for 12 to 16 hours per day. The wear time, however, can differ depending on individual eye health, the fit of the lens, and lifestyle requirements. Some patients will need to remove and fill the lenses intermittently to rejuvenate the tear reservoir, particularly if dryness or irritation becomes a problem during the day.

It is advisable to wear the eye care practitioner’s recommended time and observe your eyes for signs of fatigue or irritation. Overwearing any contact lens, including scleral, can cause complications if not handled carefully.

Putting on Scleral Lenses

It is a bit more involved than putting in soft lenses, but with practice, it becomes second nature. Here are the general steps:

Wash and Dry Hands: Always start with the cleansing of your hands to prevent contamination.

Prepare the Lens: Put the lens inside a plunger or on a tripod made out of your fingers. Fill the lens bowl with a preservative-free saline solution.

Lean Over a Mirror: Position your face parallel to a mirror or flat surface to avoid spilling the saline.

Hold Eyelids Open: One hand holds your top eyelid open while the other hand pulls the bottom one down.

Insert the Lens: Bring the lens slowly into your eye, keeping it filled with saline. Press it gently onto the eye.

Blink and Check Fit: After placing the lens on, blink several times and check that the lens sits comfortably and centrally.

If bubbles form under the lens or if it becomes uncomfortable, remove, refill, and reinsert the lens. Regular follow-up visits with your eye care specialist, such as Dr Rahul Raghav, help ensure proper technique and optimal lens performance.