If you struggle with chronic dry eye, you may have already tried artificial tears, warm compresses, prescription eye drops, or other treatments without finding lasting relief.
For some patients, dry eye symptoms can become so severe that everyday activities like reading, working on a computer, driving, or even keeping their eyes open comfortably become challenging.
Fortunately, scleral lenses can provide significant relief for many patients with moderate to severe dry eye disease, particularly when traditional treatments haven't been effective.
Unlike regular contact lenses, scleral lenses are specially designed to protect the surface of your eyes while maintaining a reservoir of fluid over the cornea.
At Miami Contact Lens Institute, Dr. Elise Kramer specializes in customized scleral lenses for patients with complex ocular surface conditions, including severe dry eye disease.
What Are Scleral Lenses?
Scleral lenses are large-diameter, rigid gas-permeable contact lenses that rest on the sclera, the white part of your eye, rather than directly on the cornea.
The cornea is the clear, sensitive surface at the front of your eye. In patients with dry eye disease, this surface can become irritated, inflamed, or damaged.
Scleral lenses are designed to vault over the cornea, creating a small space between the lens and the eye.
Before insertion, this space is filled with sterile, preservative-free saline solution.
The result is a protective fluid reservoir that remains over the cornea throughout lens wear.
Unlike traditional contact lenses, which can sometimes worsen dryness, scleral lenses may actually improve comfort by protecting the ocular surface and reducing exposure to environmental irritants.
How Do Scleral Lenses Help Relieve Dry Eye?
Scleral lenses offer several benefits that make them particularly useful for patients with severe or persistent dry eye symptoms.
1. Continuous Hydration
One of the biggest advantages of scleral lenses is the fluid reservoir they maintain over the cornea.
Rather than relying entirely on artificial tears that may provide only temporary relief, scleral lenses hold preservative-free saline against the corneal surface during wear.
This can help maintain hydration and reduce dryness-related discomfort.
2. Protection of the Corneal Surface
In severe dry eye disease, the cornea can become irritated or develop areas of epithelial damage.
Because properly fitted scleral lenses vault over the cornea, they reduce direct mechanical contact with its sensitive surface.
This protective environment can be particularly beneficial for patients with significant ocular surface disease.
3. Reduced Exposure to Environmental Irritants
Wind, air conditioning, dry air, and other environmental factors can worsen dry eye symptoms.
Scleral lenses provide a protective barrier over the cornea, helping reduce direct exposure to these irritants.
Many patients find this particularly helpful during computer use, travel, and other activities that typically make their symptoms worse.
4. More Stable Vision
Dry eye can cause fluctuating vision because an unstable tear film affects how light passes through the front of the eye.
Scleral lenses provide a smooth optical surface that can improve visual clarity and stability.
This is especially beneficial for patients who have both dry eye and irregularities of the cornea.
5. Support for Ocular Surface Healing
For patients with significant corneal irritation or epithelial damage, scleral lenses may help create a more protected environment for healing.
In some cases, they are used to manage persistent epithelial defects and other complex ocular surface conditions.
However, these patients require careful monitoring to ensure safe lens wear and appropriate healing.
Do Scleral Lenses Cure Dry Eye?
Scleral lenses can provide substantial relief from dry eye symptoms, but they do not necessarily correct the underlying cause.
For example, patients with meibomian gland dysfunction may continue to have blocked or poorly functioning oil glands even when their eyes feel more comfortable with scleral lenses.
Similarly, patients with autoimmune conditions may continue to experience inflammation or reduced tear production.
For this reason, scleral lenses are often used as part of a comprehensive dry eye treatment plan.
Depending on your condition, additional dry eye treatment options may include:
- Prescription anti-inflammatory eye drops
- Preservative-free artificial tears
- Warm compresses and eyelid hygiene
- Intense pulsed light (IPL) therapy
- LipiFlow, TearCare, or other treatments for meibomian gland dysfunction
- Punctal plugs
- Other therapies directed at the underlying cause of your dry eye
The goal is not simply to make your eyes feel better temporarily, but to improve comfort while supporting long-term ocular surface health.
Who Can Benefit From Scleral Lenses for Dry Eye?
Scleral lenses may be particularly helpful for patients whose symptoms have not improved adequately with conventional treatments.
They are also used for patients with certain medical conditions that affect the ocular surface.
Sjögren's Syndrome
Dry eye can be caused by Sjögren’s syndrome, an autoimmune condition that significantly reduces tear production.
Patients with Sjögren's may experience severe dryness, burning, irritation, and corneal damage.
Scleral lenses can help protect the cornea and provide a reservoir of fluid throughout the day.
Graft-Versus-Host Disease (GVHD)
Ocular graft-versus-host disease can develop following certain stem cell or bone marrow transplants.
It may cause severe inflammation, tear deficiency, and ocular surface damage.
Scleral lenses can provide meaningful relief and protection for selected patients with ocular GVHD.
Stevens-Johnson Syndrome
Stevens-Johnson syndrome can cause significant damage to the ocular surface, resulting in chronic dryness, scarring, and discomfort.
Highly customized scleral lenses may help protect the cornea and improve vision and comfort in appropriately selected patients.
Dry Eye Following Eye Surgery
Some patients develop persistent dry eye symptoms after procedures such as LASIK, PRK, or corneal transplantation.
Scleral lenses may be helpful when traditional treatments do not provide sufficient relief.
Other Ocular Surface Conditions
Scleral lenses may also be considered for patients with:
- Neurotrophic keratopathy
- Exposure keratopathy
- Persistent corneal epithelial defects
- Severe ocular surface inflammation
- Dry eye associated with irregular corneas
Not every patient with these conditions is an appropriate candidate, and some may require additional treatment or specialized monitoring before scleral lens wear can begin.
Are Scleral Lenses Safe?
When properly fitted, cared for, and monitored, scleral lenses can be a safe and effective option for many patients with dry eye disease.
However, as with any contact lens, there are potential risks.
These may include:
- Corneal swelling: Inadequate oxygen delivery can sometimes cause corneal edema.
- Eye infections: Improper cleaning, water exposure, or unsafe wearing habits can increase infection risk.
- Redness or irritation: An improper fit or excessive wearing time may cause discomfort.
- Midday fogging: Debris may accumulate in the fluid reservoir, causing cloudy vision.
- Conjunctival changes: In some patients, the lens may cause localized compression or changes in the tissue beneath its edges.
Certain patients, particularly those with compromised corneal endothelial function, may require additional evaluation and monitoring.
If you experience significant pain, redness, light sensitivity, or a sudden decrease in vision, remove your lenses and seek prompt evaluation by an eye care professional.
Regular follow-up appointments are important even when your lenses feel comfortable.
What to Expect During a Scleral Lens Fitting
Scleral lenses are not one-size-fits-all contact lenses.
Because each eye has a unique shape, scleral lenses must be carefully selected and customized to achieve an appropriate fit.
At Miami Contact Lens Institute, the fitting process generally involves several steps.
Step 1: Comprehensive Eye Evaluation
We begin by examining your eyes, reviewing your symptoms, and evaluating the health of your cornea and ocular surface.
This helps us determine whether scleral lenses are appropriate for your condition.
Step 2: Advanced Eye Measurements
Using specialized imaging technologies, we evaluate the shape of your cornea and sclera.
These measurements help guide the design of your lenses.
For particularly complex eyes, highly customized options such as EyePrintPRO may be considered.
Step 3: Trial Lens Evaluation
Trial lenses may be placed on your eyes to assess comfort, vision, corneal clearance, and the relationship between the lens and your ocular surface.
Adjustments may be necessary to optimize the fit.
Step 4: Custom Lens Design
Based on the examination findings and measurements, lenses are ordered or customized for your eyes.
The goal is to achieve a balance of visual clarity, comfort, corneal protection, and adequate oxygen delivery.
Step 5: Insertion and Removal Training
Our team teaches you how to safely insert, remove, clean, and care for your lenses.
Although handling scleral lenses may initially seem challenging, many patients become comfortable with the process through practice.
Step 6: Follow-Up Appointments
Follow-up visits allow us to evaluate how your eyes respond to the lenses during actual wear.
Small adjustments may be needed to improve comfort, vision, or the overall fit.
What Is It Like to Wear Scleral Lenses Every Day?
Many patients are surprised by how comfortable scleral lenses can feel once they become familiar with them.
Because the lenses rest on the sclera rather than directly on the cornea, they may be more comfortable than smaller rigid lenses.
Before inserting the lenses each morning, you fill them completely with the recommended sterile, preservative-free saline.
The lenses are then placed on your eyes using your fingers or a specialized insertion device.
Your wearing schedule will depend on your eye health, lens fit, and individual needs.
Some patients wear scleral lenses throughout most of their waking hours, while others benefit from shorter wearing periods or occasional removal and refilling.
Your eye care provider will recommend a schedule appropriate for you.
Important Scleral Lens Care Tips
- Wash and dry your hands before handling your lenses.
- Use only approved sterile, preservative-free saline to fill the lenses.
- Clean and disinfect your lenses using the recommended products.
- Never use tap water or homemade saline on your lenses.
- Avoid swimming or showering while wearing contact lenses.
- Do not sleep in your scleral lenses unless specifically instructed by your eye care provider.
- Attend regular follow-up appointments.
Proper lens hygiene is essential for protecting your eyes and maintaining comfortable wear.
How Much Do Scleral Lenses for Dry Eye Cost?
Scleral lenses generally cost more than standard contact lenses because they are individually customized and require specialized fitting expertise.
The total cost depends on several factors, including:
- The complexity of your eye condition
- The type of scleral lens required
- Whether advanced customization is necessary
- The fitting process and follow-up care involved
At Miami Contact Lens Institute, we provide a personalized estimate based on your examination findings and treatment needs.
Does Insurance Cover Scleral Lenses for Dry Eye?
Some medical or vision insurance plans may provide coverage for medically necessary scleral lenses.
However, coverage varies considerably depending on the diagnosis, insurance provider, and specific policy.
Our team can help review your available benefits and explain potential out-of-pocket costs.
Specialized Scleral Lens Care at Miami Contact Lens Institute
Living with severe dry eye can affect nearly every part of your daily life, particularly when conventional treatments provide only temporary relief.
At Miami Contact Lens Institute, Dr. Elise Kramer specializes in managing complex ocular surface conditions and fitting customized scleral lenses for patients with severe dry eye, Sjögren's syndrome, graft-versus-host disease, Stevens-Johnson syndrome, and other challenging eye conditions.
Using advanced imaging and highly customized lens designs, our goal is to help patients achieve improved comfort, clearer vision, and better ocular surface protection.
We welcome patients from across the United States and around the world who travel to our Miami and Weston locations for specialized scleral lens and ocular surface care.
If you've struggled to find relief from chronic dry eye, scleral lenses may be an option worth exploring. Schedule a scleral lens consultation at Miami Contact Lens Institute.
