Managing Irregular Cornea with Scleral Contact Lenses

If you have heard that wearing contact lenses is impossible for you because of a problem such as an irregular cornea, it’s time to see your local eye care practitioner about scleral contact lenses. Scleral lenses are large-diameter gas-permeable lenses shaped to form a vault over the surface of the cornea and rest on the white of the eye (the sclera). This shape allows the lens to function as a replacement for the irregular cornea and correct the vision problems caused by corneal irregularities such as keratoconus. The space provided between the lens and the cornea also acts as a reservoir for fluid, providing more comfort for people with dry eye syndrome who might not otherwise be able to wear contact lenses.

Scleral Contact Lenses for Keratoconus

Many eye doctors recommend scleral lenses for patients with difficult-to-fit eyes, including patients with keratoconus. Keratoconus is a progressive eye disorder in which the cornea – usually spherical – begins to thin and bulge into a cone shape, which deflects light and distorts vision. In the early stages of keratoconus, the patient can usually wear traditional contact lenses. However, if the lens moves around excessively, will not center on the eye properly, or causes the wearer discomfort, then switching to scleral lenses may solve the problem. Because the “vault” shape of scleral lenses keeps them from resting on the sensitive cornea, they are often more comfortable; they are also fitted to the individual, making them more stable on the eye and less prone to movement.

Miami Patient with Keratoconus Testimonial

Scleral Lenses for Other Problems

Along with keratoconus, several other cornea-related conditions indicate the use of scleral lenses. For example, people who have undergone a cornea transplant can benefit from the use of scleral lenses. Scleral lenses can also help patients with GVHD (graft-versus-host disease), Stevens-Johnson syndrome, or Sjogren’s syndrome, all of which can cause severe dry eyes. Today, there are even bifocal scleral lenses to correct presbyopia (age-related farsightedness). Scleral contact lenses are now being used to address more conditions than ever, thanks to advances in lens design technology.

Types of Scleral Lenses

Scleral contact lenses are about the size of regular soft lenses, which is larger than standard gas permeable lenses. The diameter of the average human cornea is about 11.8 millimeters; scleral contact lenses range in diameter from 14.5mm to 24mm. That means that even the smallest scleral lenses (14.5mm or smaller) cover the entire surface of the cornea with ease. By contrast, most corneal lenses are anywhere from 9 to 9.5mm and cover only about 75 percent of the cornea.

What diameter lens is right for you is determined by the complexity of your condition. In general, milder forms of keratoconus can be managed with smaller scleral lenses. These smaller lenses are usually lower-maintenance, easier to apply, and more affordable. More complex conditions may require larger lenses; these conditions include advanced keratoconus, severe dry eyes, and severe ocular surface disease. That’s because larger scleral lenses can hold more fluid as well as correct larger irregularities in the curvature of the cornea.

Related post: Am I a Good Candidate for Scleral Contact Lenses?

Miami Patient with Scleral Lenses Reviews

If you are interested in wearing contact lenses but are concerned about a corneal irregularity, contact Miami Contact Lens Institute to schedule an appointment. We’ll help determine whether scleral lenses are right for you and which diameter and design will best suit your needs.