Dr. Alfano Answers Your Questions About Scleral Lenses

What are scleral contact lenses?

Scleral lenses are hard contact lenses (also known as RGP or rigid gas permeable) that are larger than traditional lenses. These lenses fit on the sclera which is the white zone just outside of the cornea.

Who is a good candidate for scleral lenses?

Anyone can wear scleral lenses. However, the time and expense required to fit the lenses is usually reserved for people that cannot wear conventional RGP or soft lenses. People with severe dry eye, keratoconus, irregular corneas. large amounts of astigmatism are just a few of the people that are very good candidates.

What eye health issues do scleral contact lens treat (i.e. kerotoconus, corneal transplants, dry eyes? etc.)?

Scleral lenses can treat many corneal surface diseases that require intense lubrication by creating a well of fluid that protects the eye while correcting the vision. There is significant help for post-surgical dryness, corneal transplants, keratoconus etc.

What types of scleral lens are there?

There are several companies that manufacture scleral lenses. There are variations in size of lenses and many designs can also be made in multifocal vision designs.

Are scleral lenses typically covered by medical or vision insurance?

Some medical plans will cover the lenses (or in part) when there is considered to be a medical necessity. In most cases if the vision cannot be corrected to 20/40 by conventional means (glasses) then most extended benefits will provide funds towards the purchase and/or fitting costs.

What are the benefits of scleral lenses over other kinds of contact lenses?

Increased wear time, decreased corneal exposure to airborne irritants, better comfort, vision stability compared to tradition contact lenses for astigmatism or keratoconus.

How often should I replace my scleral contacts?

Well cared for lenses should last for approximately 2 years.

Are different types of Scleral lenses used at earlier vs. later stages of the onset of keratoconus?

If keratoconus progresses there is often a need to use larger and steeper lenses in order to provide clearance away from the cornea.

Sometimes the term “scleral lenses” (or “sclera lenses”) also is used to describe special-effect contact lenses that dramatically alter the appearance of the wearer’s eyes – used in movies – Explain?

Special effect contact lenses are even larger and are painted for effect and only minimally considered for vision correction. Special effect lenses are often not to be worn for extended periods of time.

At what age can a child begin wearing Scleral Lenses?

A child can wear scleral lenses when they are considered capable and responsible enough by their parents to proceed

What is the typical cost of Scleral lenses? Why are they higher cost than regular contacts?

Most Scleral lenses cost over $800 per pair and there is also several office visits required in order to be sure the vision and health benefits are not undone by poor fitting lenses. From start to finish the fees will range from $1100-1400.

I have had issues in the past with contact lenses being uncomfortable, do you recommend Sclerals?

This is precisely the benefit of scleral lenses. Most lenses dry the eyes out and “steal” moisture from the tear film. With scleral lenses there is a layer of lubricating saline that protects the cornea and remains coating the eye surface throughout the day.