Scleral Contact Lenses

Published on
December 4, 2023
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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.

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

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.

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