Scleral lenses provide superior vision and comfort, particularly for those with irregular corneas or severe dry eyes. However, they also involve higher costs, complex care, and a longer adjustment period.
What Are Scleral Lenses?
Scleral lenses are large, breathable contact lenses that sit on the white part of your eye (the sclera) instead of directly on the cornea. Unlike conventional lenses that sit on the cornea and rely on tears for smoother contact, scleral lenses create a reservoir of saline solution between the lens and the eye. This reservoir enhances hydration and provides a smoother refractive surface, making scleral lenses ideal for people with certain eye conditions.
Advantages Of Scleral Lenses
Superior Comfort For Dry Eyes
A key advantage of scleral lenses is their remarkable ability to provide exceptional comfort for individuals suffering from severe dry eye conditions. The saline reservoir in the lens keeps the eye consistently hydrated, preventing irritation and discomfort.
- Great for individuals with Sjögren’s Syndrome or keratoconjunctivitis sicca.
- Reduces dependency on artificial tears or lubricating eye drops.
Clear Vision For Irregular Corneas
Scleral lenses are an excellent choice for people with irregular corneas caused by conditions such as:
- Keratoconus and Pellucid Marginal Degeneration
- Post-surgical complications, such as after corneal transplants or refractive surgery
- Eye injuries or corneal scars
By vaulting over the irregular surface of the cornea, these lenses provide a smooth optical surface, delivering crystal-clear visual correction that traditional lenses often fail to achieve.
Highly Stable Fit
The larger size of scleral lenses ensures stability on the eye, reducing the likelihood of the lens moving or falling out. Unlike smaller contact lenses, scleral lenses fit snugly and are less likely to cause disruption during activities like sports.
Ideal For Severe Lens Intolerance
Some individuals find standard soft or RGP (rigid gas-permeable) lenses uncomfortable due to their smaller size and direct contact with the sensitive corneal tissue. Scleral lenses bypass the cornea altogether, delivering unparalleled comfort for individuals with lens intolerance.
Customised Design
Scleral lenses are custom-made for each individual, accounting for unique corneal and scleral shapes. This level of precision enhances both comfort and efficiency, making them suitable even for those with challenging prescriptions or unique eye structures.
Protects The Cornea
For individuals with corneal injuries, chronic inflammatory diseases, or surgical wounds, scleral lenses act as a protective barrier, safeguarding the cornea from irritants.
Longevity And Durability
Due to their construction from high-quality materials, scleral lenses are more durable than their disposable counterparts. With proper care, a single pair can last 1 to 3 years, making them a cost-effective long-term solution.
Effective For Advanced Eye Conditions
Scleral lenses are not only effective for basic visual correction but can also help manage complex conditions such as:
- Severe dry eye syndrome
- Irregular astigmatism
- Stevens-Johnson Syndrome
Supports Healing And Relieves Pain
Creating a moist environment for the eye encourages healing for damaged corneal tissues while relieving discomfort. This is especially useful for individuals recovering from corneal surgeries or managing ocular surface diseases.
Disadvantages Of Scleral Lenses
High Cost
One of the most significant drawbacks of scleral lenses is their price tag. The initial cost of scleral lenses is significantly higher than that of soft or RGP lenses.
- Prices typically range from INR 45,000 to INR 1,25,000, including fitting, depending on customization and specific needs.
- Insurance coverage for scleral lenses can be limited unless deemed medically necessary, such as for severe dry eye syndrome or keratoconus.
Longer Adjustment Period
It can take some time to adjust to wearing scleral lenses. Due to their larger size compared to traditional lenses, some people may initially feel discomfort during wear.
- It may take a few weeks of regular use for the eyes to adapt fully.
- Patience is essential during the adjustment phase, but with time, scleral lenses become second nature for most users.
Complex Fitting Process
The process for fitting scleral lenses can be time-consuming and highly specialised. Unlike conventional lenses, scleral lenses require detailed measurements for proper customisation:
- Patients often require multiple appointments with their optometrist or ophthalmologist.
- The fitting process may include imaging technologies to create an optimal design tailored to the wearer’s unique eye shape.
Maintenance And Care
The maintenance of scleral lenses is more intricate compared to that of disposable lenses. Their larger size and thickness necessitate extra cleaning and rinsing to prevent bacterial buildup and maintain clarity.
- A dedicated care routine must be followed, including cleaning solutions designed specifically for gas-permeable lenses.
- Improper care can increase the risk of infections, such as microbial keratitis.
Limited Accessibility
Not all optical practitioners are trained in fitting or working with scleral lenses, which can make access to specialised care more difficult.
- You may need to seek out an advanced optometrist or ophthalmologist with extensive experience in scleral lens fitting.
Need For Regular Follow-Up
Due to the customised nature of scleral lenses, ongoing follow-up appointments are necessary to ensure the lenses maintain their comfort and effectiveness. These follow-ups can add to the overall cost and time commitment.
Challenges With Handling
For first-time users, inserting and removing scleral lenses can be daunting. Unlike smaller contacts, their larger size requires careful handling, and while plunger-like tools can assist, many users also learn to insert and remove them manually with practice.
- This additional step may prove cumbersome for individuals used to simpler soft lenses.
- Routine use improves handling ease over time, but initial frustration is common.
Potential For Fogging
Some users may experience fogging while wearing scleral lenses, often due to the accumulation of debris or tear film in the fluid reservoir beneath the lens. While this issue is manageable through removal and cleaning, it can interrupt daily activities for wearers.
Not Suitable For Everyone
While scleral lenses offer remarkable advantages, they may not work effectively for individuals with excessive lens intolerance or extreme eye sensitivities. Consulting a qualified eye care professional is essential to determine their feasibility for individual cases.
Factors To Consider Before Choosing Scleral Lenses
Before opting for scleral lenses, it’s essential to weigh the pros and cons carefully. Some key factors to consider include:
- Your specific vision needs and whether they align with the benefits scleral lenses offer.
- Budgetary constraints, as the high initial cost may be a deciding factor.
- Commitment to maintenance, as keeping scleral lenses clean requires dedicated time and effort.
Speak to an experienced optometrist who specialises in scleral lenses to assess your eligibility and address your concerns.
Final Thoughts On Scleral Lenses
Scleral lenses are a game-changer for individuals with complex eye conditions or unique vision needs. Their ability to provide superior comfort, excellent vision correction, and long-term durability makes them an attractive option for many users. However, high costs, a more complex care routine, and the need for custom fitting are factors that should not be overlooked.
If you think scleral lenses may be the right choice for you, schedule a consultation with a trained ophthalmologist or optometrist to explore your options.
