Challenges: Conditions like keratoconus, pellucid marginal degeneration, corneal scarring, or Terrien’s marginal degeneration create uneven corneal surfaces. This irregular shape can make standard lenses painful or ineffective, causing fluctuating vision and irritation throughout the day.

Why Scleral Lenses Help: Whether it’s keratoconus (conical cornea), pellucid marginal degeneration (thinning at the lower cornea), corneal scarring, or Terrien’s marginal degeneration, scleral lenses vault over these distorted or thinned areas and fill the gap with a fluid reservoir. This reservoir effectively masks surface irregularities and provides a smooth refractive surface, reducing the discomfort and fluctuating vision common with standard lenses.

• Keratoconus: Early, moderate, or advanced stages where traditional contact lenses are uncomfortable or unstable.
• Pellucid Marginal Degeneration (PMD): Helps smooth the irregular corneal shape.
• Corneal Scarring: Smooths out uneven surfaces caused by injury or infection scars.
• Terrien’s Marginal Degeneration: Provides stable vision in thinning areas around the cornea’s periphery.

Challenges: Post-LASIK ectasia, corneal transplants, radial keratotomy (RK), and other surgeries—or injuries that scar or alter the cornea—can leave the eye with unpredictable shapes and heightened sensitivity. Traditional lenses may not fit well, cause ongoing discomfort, or put harmful pressure on healing tissue.

Why Scleral Lenses Help: In cases like post-LASIK ectasia or post-RK (radial keratotomy), where the cornea has been weakened or reshaped, scleral lenses accommodate and protect the altered surface. After corneal transplants (e.g., post-keratoplasty) or penetrating keratoplasty (PK), they minimize pressure and improve vision by correcting uneven curves. For post-injury eyes, the fluid layer cushions sensitive tissue, promoting healing and comfort while providing excellent visual acuity.

• Post-LASIK Ectasia: When the cornea becomes irregular after refractive surgery.
• Post-Keratoplasty (Corneal Transplant): Protects the grafted cornea and improves clarity.
• Post-RK (Radial Keratotomy): Corrects fluctuating or unpredictable vision from older refractive procedures.
• Post-PK (Penetrating Keratoplasty): Offers a stable, comfortable lens option when standard lenses fail.
• Post-Injury: Protects sensitive tissue and aids in visual rehabilitation.

Challenges: Autoimmune conditions (e.g., Sjögren’s syndrome), severe inflammatory disorders (SJS, GVHD), and chronic dryness (aqueous-deficient, meibomian gland dysfunction) all reduce tear film quality and quantity. This makes wearing normal lenses painful or nearly impossible due to constant friction and irritation.

Why Scleral Lenses Help: When conditions like Sjögren’s syndrome, Stevens-Johnson Syndrome (SJS), graft-versus-host disease (GVHD), or neurotrophic keratitis deplete tears or damage the ocular surface, scleral lenses lock in moisture behind their dome-like shape. They compensate for severely diminished tear production (aqueous-deficient dry eye) and help stabilize oil layer issues (like in meibomian gland dysfunction), preventing the painful friction and dryness typical of regular contact lenses.

• Sjögren’s Syndrome: Maintains a fluid reservoir to combat severe dryness.
• Stevens-Johnson Syndrome (SJS): Alleviates discomfort from extremely dry and compromised ocular surfaces.
• Graft-Versus-Host Disease (GVHD): Addresses dryness and scarring to improve comfort and vision.
• Neurotrophic Keratitis: Protects the cornea when blinking or tear production is insufficient.
• Aqueous Deficient Dry Eye: Provides continuous hydration when tears are significantly lacking.
• Meibomian Gland Dysfunction (MGD): Can stabilize and protect the cornea from chronic dryness.

Challenges: Systemic diseases like rheumatoid arthritis, lupus, scleroderma, and severe allergies can significantly impact tear production and ocular surface health. Chronic inflammation, dryness, and hypersensitivity often lead to discomfort, redness, and reduced wear time with standard lenses.

Why Scleral Lenses Help: Disorders such as rheumatoid arthritis, lupus, and scleroderma often cause chronic inflammation and dryness that degrade tear quality. Scleral lenses establish a controlled, hydrating environment over the cornea, significantly reducing dryness and irritation. Even for severe allergy sufferers, the lens’s large vault can act as a barrier against environmental allergens, helping maintain clearer, more comfortable vision.

• Rheumatoid Arthritis: Relieves extreme dryness when systemic autoimmune factors affect tear production.
• Lupus: Helps soothe ocular surface issues associated with autoimmune inflammation.
• Scleroderma: Addresses ocular surface fragility and persistent dryness.
• Severe Allergy Sufferers: For whom the large diameter of the lens can block irritants from interacting with the eye.

Challenges: Patients with moderate to high myopia, hyperopia, or astigmatism frequently experience lens instability, reduced visual clarity, or discomfort with traditional lenses. High or complex prescriptions may cause excessive lens movement or distorted vision, resulting in unreliable vision correction.

Why Scleral Lenses Help: In cases of pronounced astigmatism, as well as very high myopia or hyperopia, scleral lenses offer superior stability because they do not rely on the corneal curvature for fit. By evenly distributing pressure on the sclera, these lenses eliminate lens rotation and deliver consistent, sharp vision, making them ideal for those who find traditional lenses inadequate for extreme prescriptions.

• High Astigmatism: Scleral lenses vault irregular or highly toric corneas to provide stable, clear vision.
• High Myopia or Hyperopia: Can offer superior comfort and clarity when standard lenses are less effective.

Challenges: Eyes affected by chemical burns, recurrent corneal erosions, and persistent epithelial defects are prone to chronic discomfort, scarring, and ongoing inflammation. These conditions often make corneal lenses painful and risk further damage if the lens rubs or dries out the compromised tissue.

Why Scleral Lenses Help: For patients recovering from chemical burns, battling recurrent corneal erosions, or dealing with persistent epithelial defects, scleral lenses protect compromised tissue and encourage healing. The fluid layer cushions the cornea, reduces mechanical friction from blinking, and maintains a moist surface—key factors in minimizing pain and promoting tissue repair.

• Chemical Burns: Protects and heals scarred or compromised corneas.
• Recurrent Corneal Erosions: Shields the cornea and minimizes pain from repeated erosions.
• Persistent Epithelial Defects: Maintains a moist environment conducive to healing.

Challenges: Whether due to scarring, abnormal lid structure, or laxity, significant eyelid irregularities can continually disrupt traditional contact lenses. Chronic dryness, poor lens stability, and discomfort are common when the lids interact improperly with a corneal or small-diameter lens.

Why Scleral Lenses Help: Scleral lenses sit on the less sensitive sclera, so conditions like entropion or ectropion do not push or pull the lens off-center. Inward-turned lids (entropion) and outward-turned lids (ectropion) can cause friction or dryness with typical lenses, but scleral lenses remain stable. For ptosis (drooping eyelid) or floppy eyelid syndrome, the lens’s large diameter and scleral support help it stay in place, reducing discomfort and corneal exposure.

• Entropion (Inward-Turning Eyelid): Can cause discomfort and corneal irritation with typical lenses.
• Ectropion (Outward-Turning Eyelid): May prevent traditional contacts from fitting securely, leading to dryness and irritation.
• Ptosis (Drooping Eyelid): Can affect lens positioning and stability.
• Floppy Eyelid Syndrome: Unstable or excessively mobile lids can interfere with standard contact lens wear.
• Other Lid Irregularities: Any significant eyelid malposition, scarring, or structural abnormality that makes traditional soft or rigid lenses uncomfortable or unstable.

Challenges: High-intensity sports, dusty or windy job environments, and prolonged focus requirements (e.g., pilots, drivers) can cause lens dryness, displacement, or contamination. Regular lenses may not withstand the extreme conditions or rapid movements, leading to fluctuating vision and discomfort.

Why Scleral Lenses Help: For sports participants or first responders in dusty, windy, or high-impact settings, scleral lenses offer excellent stability and reduce the chance of lens dislodgement. Their large diameter and fluid reservoir also guard against dryness and debris, ensuring dependable vision. Pilots and drivers benefit from the consistent hydration in low-humidity or air-conditioned environments, allowing them to maintain clear focus for extended periods.

• Sports Participants: Offers a stable fit during rapid movement and keeps debris away from the cornea.
• First Responders (Firefighters, Police, Military): Protects eyes in dusty or harsh environments, reduces risk of lens dislodgement.
• Pilots and Drivers: Minimizes dryness from air circulation and ensures sustained, sharp vision.

Challenges: Individuals with contact lens intolerance, long screen exposure, or frequent travel in low-humidity environments (like airplane cabins) often encounter dryness and irritation. Standard lenses can become uncomfortable or cause redness after extended wear, reducing productivity and quality of life.

Why Scleral Lenses Help: Scleral designs often succeed where standard contact lenses fail, particularly for those with contact lens intolerance or jobs that involve long screen hours (reducing blink rates) or frequent air travel (low humidity). By maintaining a continuous fluid cushion over the cornea, scleral lenses significantly reduce dryness, irritation, and lens awareness, leading to improved comfort and visual performance throughout the day.

• Contact Lens Intolerance: For patients who experience discomfort or excessive dryness with traditional soft, hybrid, or RGP (rigid gas permeable) lenses.
• Computer Users or Office Workers: Those who spend long hours in dry, air-conditioned environments often find scleral lenses help maintain stable vision and comfort.
• Frequent Flyers: Airplane cabins are low-humidity environments where scleral lenses can be more comfortable than standard contacts.
• Patients Experiencing “GP Burnout”: Specifically those who once succeeded with RGP lenses or Hybrid lenses but can no longer tolerate them due to comfort, instability, or handling issues.