Scleral lenses are specialized, large-diameter contact lenses designed to vault over the irregular post-surgical cornea, offering unparalleled comfort and visual clarity. They are an innovative solution for patients experiencing complications after refractive procedures such as LASIK, PRK, and RK, where traditional lenses no longer meet their needs. Our eye doctors are committed to helping you regain sharp, stable vision by tailoring lens designs to your unique corneal profile.

Understanding Post-Refractive Surgery Challenges

Refractive surgeries like LASIK, PRK, and RK have revolutionized vision correction; however, they can sometimes lead to complications that affect the corneal surface. One common issue is corneal ectasia, a condition where the cornea becomes weakened and begins to bulge or distort. Patients may experience residual astigmatism, aniseikonia (a significant difference in perceived image size between the two eyes), glare, halos, and persistent dry eye, all of which can lead to decreased visual quality after surgery.

Even with top surgical success rates, many patients find that glasses or standard soft contact lenses no longer provide satisfactory correction. Traditional lenses may struggle to compensate for the irregularities of a reshaped cornea, leaving patients with distorted images and discomfort. Here’s the thing: if you’re facing these challenges, scleral lenses can offer a viable pathway back to clear vision and comfort.

Mechanism and Function of Scleral Lenses

Scleral lenses differ significantly from conventional contact lenses in their design and function. Rather than sitting directly on a delicate, altered corneal surface, scleral lenses vault over the cornea and rest on the sclera – the white, less sensitive part of the eye. This creates a fluid-filled reservoir between the lens and the cornea that smoothes out any irregularities on the eye’s surface.

The fluid reservoir not only offers a stable optical surface but also continuously bathes the cornea in saline. This constant lubrication is particularly beneficial in addressing post-surgical dry eye syndrome, a frequent complication following laser vision correction procedures. In essence, by providing smooth optics and hydration, scleral lenses correct residual refractive errors while protecting and healing the ocular surface.

Benefits and Advantages of Scleral Lenses

Scleral lenses deliver a range of benefits that make them an excellent option for patients encountering vision issues after refractive surgery. These include:

Smoother Optical Surface

The unique design creates a uniform refractive surface that neutralizes irregular astigmatism and minimizes higher order aberrations.

Enhanced Comfort

With their larger diameter and vaulting mechanism, scleral lenses distribute weight evenly over the less sensitive sclera, reducing discomfort during prolonged wear.

Protection of the Cornea

By avoiding direct contact with the surgical cornea, these lenses reduce the risk of mechanical trauma or further damage, which is especially important if the cornea is healing or has residual irregularities.

Hydration and Relief for Dry Eyes

The saline reservoir works as a constant source of moisture, alleviating the symptoms of dry eye that many patients experience post-surgery.

Customization for Individual Needs

Scleral lenses are highly customizable. Their shape, diameter, optical design, and mid-peripheral clearance can be fine-tuned based on your specific eye topography and the nature of your corneal irregularities.

Customized Fitting for Optimal Lens Performance

Corneal Clearance

Successful use of scleral lenses begins with a comprehensive eye examination. Our eye doctors utilize advanced diagnostic tools such as corneal topography to create a detailed map of the ocular surface. This analysis helps in tailoring the scleral lens precisely to your eye’s unique shape, ensuring an optimal fit and function. Ensuring there is enough space between the lens and the cornea is essential to prevent mechanical stress and to maintain a healthy tear reservoir.

Sagittal Depth and Lens Diameter

In cases of severe irregularity or residual astigmatism, increasing the lens diameter or adjusting the sagittal depth can aid in vaulting over the corneal surface, providing added comfort and protection. This highly individualized process ensures that each lens is a perfect match, which is critical not only for vision correction but also for the overall ocular health post-surgery.

Limbal Clearance

Special attention is paid to the junction where the cornea meets the sclera. Adjustments in the lens design can help avoid impingement on the limbus, thereby reducing irritation.

Ideal Candidates for Scleral Lenses

Después de aproximadamente un mes de uso constante cada noche, muchos niños logran los beneficios correctivos completos de los lentes Orto-K. Este proceso de transformación da como resultado una visión estable y clara durante el día, lo que hace que las actividades cotidianas desde asistir a la escuela hasta practicar deportes sean más cómodas y agradables visualmente.

Indications

Many patients wonder if scleral lenses are the right choice after undergoing refractive surgery. Here’s a practical answer: if you’re experiencing any of the following issues, it might be time to consider a consultation with our eye doctors:

Persistent visual distortions such as glare, halos, or double vision, especially in low-light conditions.
Residual refractive errors or irregular astigmatism that glasses or standard soft lenses fail to correct.
Chronic dry eye symptoms that remain unresponsive to conventional treatments after laser surgery.
Overall discomfort with traditional contact lenses due to an irregular corneal surface.

For those with post-refractive surgery complications, the fitting of scleral lenses is often considered once the cornea has sufficiently stabilized after the procedure, usually within a few months. This waiting period allows for the eye to heal and the sutures, if any, to be removed. Close follow-up with our eye doctors is key to determining the optimal time for lens fitting and ensuring the best outcomes.

Managing Concerns and Potential Complications

Corneal Edema

Although scleral lenses offer numerous advantages, it is important to approach their use with well-informed expectations, particularly after refractive surgery. One common concern is the development of corneal edema—a mild swelling of the cornea—which might occur if the lens is worn for extended periods. For healthy eyes, short periods of wear might show a slight (1-2%) increase in corneal edema; however, the impact can be more significant in post-surgical eyes.

Precautions and Monitoring

To minimize risks, our eye doctors take several precautions during the fitting process:

Regular Monitoring: Patients fitted with scleral lenses are encouraged to attend regular follow-up appointments to monitor corneal health, endothelial cell counts, and overall ocular response.
Material and Design Optimization: Selecting lenses made from the highest oxygen-permeable material (Dk/t) and reducing lens thickness as much as possible helps prevent hypoxic complications.
Individualized Adjustments: In cases where the corneal clarity is compromised or where there is significant corneal edema, modifications such as increased mid-peripheral clearance or a fenestrated design might be recommended.

By maintaining open communication and scheduled check-ups, our eye doctors ensure that any early signs of complications are managed effectively, helping to safeguard the long-term health of your eyes.

Scleral Lens Considerations Based on Surgery Type

Laser-Assisted In Situ Keratomileusis (LASIK)

Some patients encounter issues like post-LASIK dry eye, glare, halos, and residual refractive errors that can lead to visual disturbances. The vaulting design of scleral lenses addresses these distortions without exerting pressure on the newly shaped cornea.

Photorefractive Keratectomy (PRK)

In PRK, the corneal surface is more directly affected since the outer layer is removed. The protective fluid reservoir of the scleral lens is particularly beneficial for reducing post-operative discomfort and promoting a smoother optical interface.

Radial Keratotomy (RK)

Although less common today, RK can result in significant corneal irregularities and instability due to the surgical incisions. In these cases, larger scleral lenses that can easily accommodate irregular topographies have proven effective in restoring clear and consistent vision.

By tailoring the scleral lens design according to the type of refractive surgery performed and the resultant corneal changes, our eye doctors can optimize both vision correction and ocular health. During your consultation, the specifics of your surgery, along with the unique shape of your cornea, will be carefully evaluated to determine the ideal lens parameters.

Daily Adaptation and Care for Scleral Lenses

Insertion and Removal

The journey to clear vision with scleral lenses doesn’t stop at the fitting appointment. It is an ongoing process of adaptation, monitoring, and care. Initially, you might experience a short adjustment period as your eyes adapt to the new lens system—this is normal and expected. Our eye doctors will guide you through personalized instructions on how to insert and remove the scleral lenses safely, ensuring that you avoid any undue pressure or suction forces that could stress the delicate post-surgical surface.

Daily Care and Hygiene

Cleanliness is key when handling any contact lens, more so after surgery. You will be provided with recommended solutions for cleaning and reservoir preparation, along with tips to maintain proper hygiene.

Gradual Increase in Wear Time

Initially, your lenses might be worn for a few hours each day, gradually increasing to full-day wear as your eyes build tolerance and adjust to the lens fit.

Regular Check-Ups and Follow-Ups

Continuous monitoring of your ocular surface health is essential. Regular examinations will help identify any early signs of corneal edema or other complications, allowing timely interventions and adjustments. Adapting to scleral lenses can be a rewarding journey as you notice a remarkable improvement in visual clarity, comfort, and overall ocular health—even in cases where standard lens options fell short post-refractive surgery.

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What Our Patients are Saying

“Insight Vision Center staff were excellent and extremely kind as always. The office is super clean and the technology of the machines they use to assist in examining patients in second to none. I am extremely happy to have found Insight Vision Center and their doctors.”

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“10/10 experience. Everybody was friendly, and incredibly knowledgeable. I’m so happy I have a go-to optometrist now.”

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Technical Aspects of the Scleral Lens Fitting Process

Determining whether you’re a good candidate for scleral lenses starts with a detailed map of your cornea and precise measurements of your eyes. Our eye doctors use advanced technology to choose the ideal lens design and size for your unique eye shape. Follow-up appointments help fine-tune the lenses to ensure maximum comfort and clear vision. This personalized evaluation sets scleral lenses apart from other options, offering a solution tailored to your specific visual and comfort needs.

Top-Rated Specialty Contact Lens Center in Orange County

At Insight Vision Center Optometry, we’re proud to serve the diverse communities of Orange County and even patients who travel from abroad for expert specialty contact lens care. Conveniently located in Costa Mesa, our clinic is easily accessible from Newport Beach, Huntington Beach, Irvine, Santa Ana, and beyond.

Our world-class team of specialists has extensive experience fitting contact lenses for even the most challenging cases. With cutting-edge technology and a true passion for improving lives, we deliver the highest level of care from early diagnosis to advanced treatment options.

As Orange County’s leading experts in scleral and specialty contact lenses, we’re committed to helping you achieve the best possible results. Whether you need advanced lenses or expert guidance, we’re here to help you see the world clearly again.

Insight Vision Center Optometry is a proud member of Vision Source, the premier network of private practice optometrists.

Our Testimonials

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Dr. Chen and the staff are very friendly and professional and can provide patients with sincere service and advice.

Elise Fu

Insight Vision Center Optometry has truly transformed my eyecare experience over the past year. Under the expert care of Dr. Chen, Dr. Schramm, Dr. Lam, and Dr. Mai, I've received unparalleled attention and personalized service. Their commitment to excellence extends beyond the doctors to the outstanding admin and tech team who ensure a seamless and efficient visit every time.

The level of expertise, professionalism, and genuine care exhibited by the entire staff sets Insight Vision Center Optometry apart. From thorough examinations to comprehensive explanations of my eye health, they have created an atmosphere of trust and confidence. It's not just about eye care; it's about an extraordinary commitment to the well-being of their patients.

I wholeheartedly recommend Insight Vision Center Optometry to everyone seeking top-notch optometric services. It's more than an eye clinic; it's a place where your vision is valued, and your experience is exceptional. This team has undoubtedly set the standard for excellence in eyecare.

Nathaniel Choi

Dr. Mai and the entire personnel are amazing! Extremely polite, kind and professional. In addition, I can now see 20/20!!! Thank you, thank you all

Franchezka 777

Dr. Schramm is stellar. He really cares about his patients. Great staff. Scleral lenses are life changing.

Kevin W

My first eye exam in fifteen years. I am so thankful that I found Insight Vision Center. Dr. Lam and staff made me feel like a welcome guest. My eye exam revealed very minor blurriness and Dr. Lam did not pressure me into purchasing eyewear for a condition not necessitating glasses… yet. Maybe next year? I am getting older. They took my VSP insurance. Yay!

Scott H.

Dr. Lam and staff are amazing. Every phone call or interaction is friendly. You can feel the smiles and joy over whatever mode of communication you are interacting with them. Dr. Lam is very knowledgeable and helps you to better understand everything that is going on with your eyes. She made me aware of potential problems I may have with my eyes and walked me through every step of the process. She helped me understand the various factors that could be causing my vision to be a little impaired and followed up with me as I had to see an ophthalmologist. Great team, great office.

Virgilio S.