What are scleral contact lenses?
Scleral contact lenses are large-diameter rigid gas permeable (RGP) contact lenses that vault completely over the cornea and rest on the sclera (the white part of the eye). Unlike conventional hard lenses, these specialised lenses create a smooth, regular optical surface while maintaining a protective fluid reservoir beneath the lens. The hard surface provides crisp vision for patients with irregular corneas, while the liquid reservoir can mask extremely irregular surfaces and act as therapy for compromised corneas.
Lens design and materials
All scleral lenses are manufactured from high-oxygen-transmission rigid gas permeable materials designed for extended wear. Each lens features a central vault that completely clears the cornea, multiple peripheral curves for scleral alignment, and polished edges for comfort.
Every scleral lens is individually designed and manufactured based on precise corneal topography measurements and scleral shape mapping. The custom fabrication process considers individual optical requirements and specific anatomical considerations to ensure optimal fit and performance.
Lens fitting process
The fitting process begins with comprehensive ocular surface evaluation including corneal topography, scleral profilometry, and conjunctival assessment. A properly fitted scleral lens must achieve complete corneal vault with no contact.
The fitting process requires several appointments over 1-2 weeks, with diagnostic trials followed by custom lens manufacturing and careful optimisation of fit and vision.
Lens handling and care
Insertion involves filling the lens bowl completely with preservative-free saline, checking for air bubbles, and inserting using proper technique to ensure centration and comfort.
Daily care includes immediate cleaning after removal, storage in fresh solution, regular protein removal as needed, and replacing the lens case with each new solution bottle.
Proper handling requires gentle techniques to avoid surface damage, using clean workspaces with lint-free materials, and never using tap water or saliva. Lenses should be inspected regularly for scratches, deposits, or other damage that could affect performance or comfort.
Lens performance characteristics
Scleral lenses provide superior optics by completely masking corneal irregularities, delivering stable vision without lens movement and offering a wide field of view through their large optical zone.
Most patients find scleral lenses comfortable from first wear due to no corneal contact and the maintained tear reservoir. The typical wearing schedule starts with 4-6 hours daily, gradually increasing by 1-2 hours as tolerated, with most patients achieving 12-16 hour wear times through consistent daily use.
When to use scleral lenses
Scleral lenses excel in managing corneal irregularities including keratoconus – particularly in advanced stages, post-surgical complications after corneal transplant or refractive surgery, and corneal scarring from trauma or infection.
For severe dry eye conditions, these lenses provide a constant tear reservoir, protection from environmental factors, and dramatic improvement in comfort and function.
After corneal transplant, scleral lenses offer complete graft vault protection, superior vision compared to spectacles, and serve as a long-term alternative to repeat transplantation.
Lens lifespan
Standard scleral lenses typically last 12-18 months with proper care, though heavy use may require replacement every 6-12 months due to material degradation or surface changes. Monthly assessments monitor lens condition, wear patterns, vision stability, and comfort maintenance.
Lenses should be replaced when showing surface scratches or chips, persistent protein deposits, reduced wearing time, vision changes, or comfort issues. Regular professional monitoring ensures optimal lens performance and ocular health throughout the wearing period.
Getting your scleral contact lenses
Scleral lenses require specialised fitting expertise and sophisticated equipment. At The Eye Practice, we have extensive experience in advanced scleral lens fitting for complex corneal conditions and severe dry eye management. These remarkable lenses can provide life-changing vision and comfort for patients who have struggled with other correction methods.
Whether you’re dealing with keratoconus, post-surgical complications, or debilitating dry eyes, scleral lenses may offer the solution you’ve been seeking. Our expertise ensures you receive lenses designed specifically for your unique eye shape and visual needs.
Call us on (02) 9290 1899 or make an appointment online today to discuss whether scleral contact lenses are right for you.
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