We asked Dr. Alexandra Sadanowicz some questions about Scleral Lenses. Here's what she had to say:
1. What are scleral contact lenses?
Scleral lenses are large diameter rigid gas permeable (or “hard”) lenses that are designed to vault over the cornea and rest on the white of the eye instead of the cornea as other contacts do. Because of the way they sit on the eye, they can be more comfortable than other gas permeable lenses and can be beneficial to those who previously had been unable to wear contacts for fit or comfort issues.
2. Who is a good candidate for scleral lenses?
In theory, anyone who is motivated to correct their vision without glasses is a good candidate for scleral lenses. With other types of contact lenses, the cornea must be regular and healthy in order for contacts to be worn. However, since scleral lenses bypass the cornea, almost anyone can wear a scleral lens. In addition, because scleral lenses are inserted and removed with the help of a small plunger, those who have had trouble with insertion and removal of conventional soft and rigid gas permeable contact lenses may find these lenses easier to insert and remove.
3. What eye health issues do scleral contact lens treat (i.e. keratoconus, corneal transplants, dry eyes? etc.)?
Scleral contact lenses can treat a variety of eye health issues. First and foremost, if you have keratoconus or an irregular cornea due to eye disease, corneal transplant, or trauma, scleral lenses can correct your vision. Unlike rigid gas permeable lenses which sit directly on an irregular cornea and can bear down on it causing discomfort, scleral lenses’ large diameter helps us vault over corneal irregularities. In addition, because the lens sits over the cornea instead of on top of it, corneal irregularities are masked by fluid reservoir within the contact. Lastly, traditional gas permeable lenses tend to move over the cornea, while scleral lenses tend to sit in place on the sclera, improving comfort greatly.
Scleral lenses are also a great tool for treating dry eye disease. Because of the high vault of the scleral lens design, there is a fluid reservoir between the cornea and the back surface of the contact lens. This bathes the cornea in liquid throughout the day and can treat your dryness. In addition, your non preserved artificial tears can be added to the reservoir of the contact lens to further treat your dry eye.
4. What types of scleral lens are there?
Scleral lenses come in a variety of diameters and vaults depending on your needs. They come in spherical, toric (for astigmatism) and multifocal to suit all your needs.
5. Are scleral lenses typically covered by medical or vision insurance?
Scleral lenses are not typically covered by medical insurance. Some patients with keratoconus may be able receive some reimbursement from their medical insurance providers. Vision insurance may reduce the cost of scleral lenses. Please keep in mind that scleral lenses are made custom to each person’s eye.
6. Anything else you would like to add?
Scleral lenses are an exciting new tool we have not only in treating eye disease such as keratoconus and dry eye, but also for correcting vision of all patients. I like to think of scleral lenses as having the clarity of vision of the old rigid gas permeable lenses, but with the comfort and ease of a soft contact. Because of this, I think that as time goes on, this modality will gain popularity quickly.