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Scleral Contact Lenses

Published on

December 4, 2023

Soft Disposable Contact Lenses

Night Lenses (Ortho-K)

Rigid Gas Permeable Contact Lenses

Contact Lenses

At our Adelaide and Henley Beach practices, optometrists have the ability to fit custom design large diameter scleral contact lenses with advanced technologies and materials to treat a range of eye conditions, including keratoconus.¹ If you are interested in scleral lenses and would like to know more about whether they are right for you, please make an appointment or contact us.

Please see down below for FAQs.

See this page for more information on scleral lens care.

Sclerals are a larger type of RGP lens. It provides more contact with the sclera (white part of the eye) where there is less sensation. The large diameter means that the eyelids do not move across the edges of the lenses as much, which makes scleral lenses surprisingly comfortable to wear while providing more stable vision. Unlike smaller diameter RGPs, scleral lenses are designed to not touch the central cornea (clear structure at the front of the eye). This makes them even more comfortable, as the cornea is the most sensitive part of the eye.

An anterior OCT scan of a scleral lens landing on the sclera. — Figure 1. OCT scan displaying a cross section of a scleral lens on a steep keratoconic cornea. The lens lands on the sclera and makes no contact with the cornea.

Sclerals are commonly used for conditions such as keratoconus and corneal grafts.^1,2,3 In these cases the cornea is often irregular and compromised, so scleral lenses are better for vision and the health of the eye as they vault right over the cornea to limit contact. This principle can also be used to effectively correct high prescriptions such as hyperopia, myopia and astigmatism.^1,3 Patients with dry eye also benefit from using scleral lenses as the fluid contained between the lens and the eye bathes the cornea during wear, easing symptoms and helping to rehabilitate the ocular surface.^1,3

Scleral contact lens close up, placed uprighton a finger. — Figure 2. Scleral contact lens

Scleral lenses are complex and difficult to design and manufacture. Innovative Eye Care uses a range of technologies including anterior OCT, corneal topography, corneal tomography and wavefront aberrometry to custom design these lenses as accurately as possible to improve comfort, eye physiology and vision.

Corneoscleral topography display taken on the eaglet eye surface profiler — Figure 3. Corneoscleral topography taken using the Eye Surface Profiler

CSP for a scleral lens fit — Figure 4: Cornea Scleral Profile (CSP) taken using the Pentacam AXL Wave

References

1) Harthan, J. et al. (2018). “Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations”. Clin Optom (Auckl). 10: 65-74.

2) Koppen, C. et al. (2018). “Scleral lens reduce the need for corneal transplants in severe keratoconus”. Am JOphthalmol. 185: 43-47.

3) Shorter, E. et al. (2018). “Scleral lenses in the management of corneal irregularity and ocular surface disease”. EyeContact Lens. 44(6): 372-278.

FAQs

Please browse through some of our most frequently asked questions on this topic.

What is the difference between scleral contact lenses and corneal rigid lenses (RGPs)?

Scleral lenses are larger than corneal rigid lenses (RGPs) as they are designed to rest on the white of the eye. This offers improved comfort, as unlike RGPs the highly sensitive cornea is never touched. Scleral lenses act as a sealed system which means they provide more stable vision compared to a RGP. As it is a sealed system and a larger lens, the insertion and removal techniques are different to a RGP but the cleaning solutions are similar.

Can scleral lenses damage your eyes?

As with any contact lenses, there is the potential for inflammation or infection. Careful hygiene, correct lens care regimes and replacement of the lenses every 1-2 years reduces the risk of any complications.

Can I sleep with scleral lenses?

Scleral lenses cannot be slept in. This is because the lenses allow less oxygen through to the cornea when the lids are closed, which can cause problems over time to your eye health. Your lenses also must be sterilised and cleaned each day to reduce risk of infection, so nightly wear is not recommended.

How new are scleral lenses?

Scleral lenses were the first type of contact lens available. In the past ten years where advancements in lathe technology, improvements in breathable lens materials and an updated process to fit your eye with greater precision, have lead to scleral lenses increasing in popularity.

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