My Decision to Try Scleral Lenses
Last updated: December 2022
After working relentlessly for nearly two years to improve my chronic dry eye condition, I decided to try scleral lenses. These large hard contact lenses rest on the sclera (the white part of the eye) and vault over the cornea. Traditional contact lenses rest on the cornea and are many times incompatible with dry eye patients’ eyes. Scleral lenses, on the other hand, are filled with a saline solution that continuously bathes the cornea with moisture throughout the day.
Differing opinions on scleral lenses
I have seen a couple of different dry eye doctors who have differing opinions on scleral lenses. One of my specialists doesn’t like scleral lenses, or contact lenses of any type, because he says they disturb the microbiome of the eye. His goal is to restore the eyes to be able to produce tears on their own.
However, after almost two years of extensive treatments, my eyes are still not normal or comfortable. They are definitely better, but they still bother me a lot. I am producing some tears, but not enough. Also, I suspect that I have an autoimmune disease called Sjogren’s that causes dry eye, and a lot of Sjogren’s patients may benefit from scleral lenses. So I decided to try them.
Giving them a try
My other dry eye specialist fits the most scleral lenses of any other eye doctor in the state of Louisiana. In fact, he said his practice is fifth in the nation in the number of sclerals that they fit. He calls sclerals a “last resort,” meaning that once other treatments are exhausted, he goes to them.
At my yearly vision exam, I asked him if I would be a candidate. I also mentioned that I had explored the option of PROSE lenses. PROSE stands for Prosthetic Replacement of the Ocular Surface Ecosystem. These highly customized lenses are made at BostonSight in Massachusetts. My doctor didn’t seem to think that these would be necessary for me. He said that PROSE lenses are more for people with irregular corneas or corneal erosions. He said that my corneas look to be in good condition, and he believed that I could benefit from scleral lenses alone.
Figuring out how to pay for them
I asked about whether or not my insurance would cover scleral lenses. His office staff checked my vision benefits, and my insurance would cover the lenses and the fitting under my lens benefit, if they were deemed medically necessary. However, I had gotten new glasses recently and used my lens benefit for the year already. So I would have to wait several months to be able to get my insurance to cover them.
Ultimately, I decided to go ahead and pay for the lenses out of pocket because I didn’t want to wait several months to get the extensive fitting process started. In the future, though, I know to save my insurance benefit for these more costly lenses rather than using it for eye glasses.
See my experience getting fitted for scleral lenses.
Has having dry eye helped you better advocate for yourself?