Scleral Lenses for Chronic Dry Eye

Many people with chronic dry eye shy away from contact lenses. They may worry that using them will worsen symptoms, or maybe they tried them in the past with poor results. Standard contact lenses can indeed increase dryness and irritate the eyes, especially when they are dry. However, scleral lenses might improve symptoms by increasing the moisture in your eyes.

What are scleral lenses?

Scleral lenses are large-diameter, rigid, gas-permeable lenses. They are designed to cover the entire surface of the cornea (the clear front surface of the eye) and rest on the sclera (the white area around the eyeball). This is different from traditional contact lenses, which rest on the surface of the cornea.¹

Scleral lenses have a small area between the eye and the lens that fills with fluid and continuously hydrates the eye.²

What are the benefits?

Many people find scleral lenses more comfortable than traditional contact lenses because the sclera is less sensitive than the cornea.¹

A 2015 study found scleral lenses effective and well-tolerated by people with severe chronic dry eye. They not only improved symptoms but also improved visual sharpness in some cases.³

For people with chronic dry eye, the constant flow of moisture to the eye is the most notable benefit of scleral lenses. But these lenses also have other advantages, including:⁴

• They are custom-made for each person, allowing for better vision correction
• The gas-permeability allows oxygen to reach your eyes and keep them healthy
• They are durable and scratch-resistant
• The lenses can last 1 to 2 years

They are available as prescription lenses, including multifocal and bifocal. People with astigmatism can also use scleral lenses.⁵

Are there any disadvantages?

Getting ready for scleral lenses is a time-consuming process. Because they are custom, your optometrist must take accurate measurements of your eyes. Fittings can take about 1 hour, and you may need more than 1 visit to the eye doctor.^5,6

Other drawbacks include:^5,6

Cost

Scleral lenses can be costly. Depending on the lens type and the fitting process, the price can be anywhere from $500 to several thousand dollars per eye. Health insurance does not usually cover the price. Some vision plans might pay a portion or all the cost. Before starting the process, talk with your insurer to see what is covered under your plan.

Mid-day maintenance

Some people find the lenses fog up or collect debris in the reservoir during the day. When this happens, you might need to take the lenses out, clean them, and put them back in. You could need to bring solutions and cases with you when working or away from home for more than a few hours. You might find this to be a bother or disruption to your day.

Adjustment period

There is an adjustment period when you first start wearing scleral lenses. You may need to first wear them for a short time and gradually build up your wear time until you feel comfortable wearing them all day.

Before considering scleral lenses, you should properly treat the underlying cause of your chronic dry eye. Sometimes, finding the underlying cause of chronic dry eye is difficult. This is why it is important to work with your doctor to get a proper diagnosis and create a treatment plan that is right for you. While scleral lenses can provide relief, they do not treat chronic dry eye.