Suppose you have previously been advised that you cannot wear contact lenses due to an uneven cornea or other issues. In that case, you should seek a second opinion and inquire about scleral contact lenses with your eye doctor.
Scleral contacts are large-diameter gas-permeable contact lenses that vault over the corneal surface and rest on the “white” part of the eye (sclera). Scleral lenses address vision difficulties caused by keratoconus and other corneal imperfections by effectively replacing the uneven cornea with a flawlessly smooth optical surface.
In addition, the area between the cornea and the rear side of a scleral lens works as a fluid reservoir, allowing those with severe dry eyes to wear contact lenses.
Scleral Contact Lenses Types
Scleral contacts are notably larger than ordinary gas permeable (GP) contacts, with a diameter comparable to or greater than soft contact lenses. The smallest scleral has a diameter of roughly 14.5 mm, while the largest can have a diameter of up to 24 mm.
Mini-scleral is typically lenses with a focal length of 18 mm or less. Even the smallest scleral contacts are designed to cover the entire corneal surface because the average human cornea is 11.8 millimeters in diameter. Most normal GP contact lenses, on the other hand, have a diameter of 9.0 to 9.5 mm and cover just 75 to 80% of the cornea.
Another type of gas permeable lens bridges the gap between standard GP and mini-scleral lenses. Corneo-scleral lenses are typically 13 to 15 mm eye diameter.
Corneo-scleral lenses are an excellent choice for people who require larger-than-normal GP lenses for comfort. They are also commonly used after LASIK or other corneal refractive surgery to treat uneven astigmatism using contact lenses.
The degree of complexity of the problem frequently determines the lens size utilized. After corneal grafts and refractive surgery, scleral lenses at the smaller end of the range are routinely used to treat milder forms of keratoconus and irregular astigmatism.
Smaller scleral and mini-scleral contacts are easier to use, less expensive, and require fewer maintenance items.
Larger scleral lenses are commonly used in more complex cases, such as advanced keratoconus, pathologically dry eyes, or severe ocular surface disease that necessitates an extensive tear reservoir because they have more ability to hold fluid or bridge substantial variations in corneal curvature.
Your eye care specialist will identify the appropriate scleral lens type and size for your unique needs during your contact lens assessment and fitting.
Scleral Contact Lenses For Keratoconus
Many optometrists and ophthalmologists advocate scleral contact lenses for a variety of hard-to-fit eyes, including those with keratoconus.
A conventional GP lens can be utilized in cases of early keratoconus. Switching to a large-diameter scleral contact lens may ease the problem if the lens does not center well on the eye or moves significantly with blinks, causing discomfort.
Scleral lenses are frequently more pleasant for people with keratoconus because they vault the corneal surface and rest on the less sensitive surface of the sclera.
In addition, compared to typical corneal gas permeable lenses, scleral lenses are engineered to fit with little or no lens movement during blinks, making them more stable on the eye.
Scleral Contact Lenses For Other Eye Problems
Scleral contact lenses can be used for persons with severe dry eyes caused by illnesses such as Sjogren’s syndrome, graft-versus-host disease (GVHD), Stevens-Johnson syndrome, and those with severe dry eyes who have had a corneal transplant.
Because of advances in lens design technology, manufacturers can now build scleral lenses that can cure more disorders than ever before, including bifocal scleral for presbyopia correction.
Scleral Contacts With a Special Effect
Costume contact lenses that substantially modify the appearance of the wearer’s eyes are sometimes referred to as “scleral lenses” (or “sclera lenses”).
Costume contact lenses (also known as theatrical contact lenses, Halloween contacts, or gothic lenses) are typically soft lenses with little in common with scleral gas permeable contacts, other from their enormous diameter to completely hide the cornea. Soft theatrical contacts are also typically designed for cosmetic purposes rather than vision correction.
Cost of Scleral Contact Lenses
Because scleral contact lenses are custom-made for each wearer, they require more expertise and time to fit than ordinary soft or GP contact lenses.
To make lens fitting easier, computerized maps of the entire cornea’s curvature are frequently created, and many trial lenses of various sizes and curvatures may be applied to the eye during the fitting procedure.
Additionally, depending on the severity of the problem and how the particular eye tolerates the scleral lens, lens parameters may need to be adjusted, which may need the creation and exchange of additional lenses. The fitting process for scleral lenses can take multiple visits to determine the best lens for each eye.
While many people who wear scleral lenses had previously used soft or corneal GP lenses, putting them on and taking them off can be tricky. Due to the increased size of the lenses and the fluid reservoir under the lenses, the extra time required to master this must be factored into the fitting process.
For these and other reasons, scleral contact lenses can be much more expensive than conventional contacts. Scleral contacts can cost three or four times as much as standard contacts. While this is not common, the cost of a complicated, highly tailored scleral lens can be as much as $4,000 per eye or more.
The majority of insurance plans do not cover the entire cost of scleral contact lenses. Vision insurance may lower the cost of your lenses and/or the applicable charge in some situations. In some cases, contacting your medical insurance carrier and enquiring about the processes required to receive coverage can be beneficial. For further information, contact your eye doctor’s office. Additionally, some optometrists provide financing options for scleral contacts.