Scleral Lenses for Dry Eye

Are Scleral Lenses the Solution for Dry Eyes?

Are you frequently using eye lubricants to alleviate the discomfort of parched, irritated eyes? Do conventional contact lenses leave your eyes feeling parched and irritated? If that’s the case, you’re not alone. Dry eye syndrome is a prevalent affliction impacting millions globally, significantly affecting their day-to-day activities and overall ocular well-being.

Many individuals are turning to scleral lenses as a potential solution in their search for relief. These specialized contact lenses offer a unique approach to managing dry eyes, providing comfort and clarity that traditional lenses often fail to deliver. But what exactly are scleral lenses, and how do they work to alleviate the symptoms of dry eye syndrome?

Overview: Understanding Scleral Lenses and Dry Eye Syndrome

  1. Definition of Dry Eye Syndrome: Dry eye syndrome is a multifactorial ocular condition characterized by insufficient tear production or excessive tear evaporation.
  2. Challenges with Traditional Approaches: Conventional methods like lubricating eye drops and standard contact lenses often fail to provide long-term relief from dry eye symptoms, prompting individuals to seek alternative solutions.
  3. Introduction of Scleral Lenses: Scleral lenses represent a cutting-edge advancement in contact lens technology. They differ from traditional lenses by vaulting over the cornea to create a fluid reservoir between the lens and the ocular surface.
  4. Unique Design Features: Scleral lenses offer superior comfort and protection against environmental irritants, shielding delicate ocular tissues from desiccation and inflammation.
  5. Maintenance of Tear Film Stability: Scleral lenses effectively alleviate dry eye symptoms by maintaining a stable tear film on the ocular surface, addressing burning, stinging, redness, and blurred vision.
  6. Enhanced Fit and Stability: Scleral lenses’ larger diameter extends beyond the limbus, ensuring a secure fit and minimizing lens movement, thereby reducing discomfort associated with traditional lenses.
  7. Optical Correction and Comfort: Scleral lenses correct refractive errors and relieve dry eye symptoms, offering clear, crisp vision without compromising comfort.
  8. Customization and Personalization: Scleral lenses are customizable to accommodate individual ocular anatomy and visual needs, with practitioners employing advanced diagnostic tools and fitting techniques for optimized performance.
  9. Advancements in Materials and Manufacturing: Innovative materials and manufacturing techniques have enhanced scleral lenses’ oxygen permeability, durability, and biocompatibility, improving patient options and satisfaction.
  10. Evolving Landscape of Scleral Lens Technology: The continuous advancements in scleral lens technology highlight the evolving landscape of ocular care, promising improved outcomes and patient satisfaction.

 Therapeutic Benefits of Scleral Lenses

Scleral lenses offer myriad therapeutic benefits for individuals suffering from dry eye syndrome, making them a preferred choice among eye care practitioners and patients. Let’s delve deeper into the unique advantages of scleral lenses in managing dry eye symptoms:

  1. Continuous Hydration: Unlike conventional contact lenses, which can worsen dryness by interfering with the tear film, scleral lenses establish a saline solution reservoir between the lens and the ocular surface. This reservoir acts as a moisture chamber, providing continuous hydration and lubrication to the eyes, thus alleviating discomfort associated with dry eye syndrome.
  2. Mechanical Protection: The ample diameter of scleral lenses guarantees that they rest on the sclera, the protective outer layer of the eye, rather than the delicate cornea. This anatomical positioning reduces the risk of corneal abrasions and provides mechanical protection against environmental irritants, such as dust, pollen, and pollutants, which can exacerbate dry eye symptoms.
  3. Enhanced Comfort: Scleral lenses are renowned for their superior comfort thanks to their custom-designed fit and oxygen-permeable materials. By minimizing lens movement and maintaining a stable position on the eye, scleral lenses eliminate friction and irritation, allowing patients to enjoy extended wear without discomfort or fatigue.
  4. Visual Clarity: Scleral lenses relieve dry eye symptoms and offer excellent visual acuity and optical quality. Their rigid design corrects refractive errors with precision, ensuring crisp, clear vision even in patients with irregular corneas or high astigmatism. This dual functionality makes scleral lenses ideal for patients seeking therapeutic relief and optimal visual performance.
  5. Long-Term Management: Scleral lenses effectively provide immediate relief from dry eye symptoms and offer long-term management of the condition. By promoting ocular surface health and minimizing inflammation, scleral lenses can help prevent disease progression and reduce the need for adjunctive therapies, such as anti-inflammatory eye drops or punctual plugs.

Table: Key Features of Scleral Lenses for Dry Eye

Feature Description
Continuous Hydration Creates a reservoir of saline solution between the lens and the ocular surface for ongoing lubrication
Mechanical Protection Rests on the sclera, providing mechanical protection against environmental irritants
Enhanced Comfort Custom-designed fit and oxygen-permeable materials ensure superior comfort and extended wear.
Visual Clarity Corrects refractive errors with precision, ensuring crisp, clear vision
Long-Term Management Promotes ocular surface health and reduces the need for adjunctive therapies

Clinical Considerations for Scleral Lens Fitting

Here are vital considerations for fitting and prescribing scleral lenses:

  1. Ocular Surface Assessment: The ocular surface must be comprehensively evaluated before fitting scleral lenses. This includes assessing tear film quality, meibomian gland function, corneal health, and ocular surface irregularities or pathology. Identifying underlying ocular conditions is crucial for determining the suitability of scleral lenses and addressing any potential contraindications.
  2. Corneal Topography and Tomography: High-resolution topography and tomography are invaluable tools for evaluating corneal shape, curvature, and irregularities. These diagnostic tests aid in selecting the appropriate lens design, diameter, and sagittal depth to achieve optimal alignment and vaulting over the cornea.
  3. Customized Lens Design: Scleral lenses are highly customizable to accommodate individual ocular anatomy and visual needs. Factors such as lens diameter, base curve, peripheral curves, and optical zone diameter are meticulously tailored to ensure a precise fit and adequate tear exchange beneath the lens.
  4. Tear Reservoir Assessment: An adequate tear reservoir beneath the scleral lens is critical for maintaining the ocular surface’s hydration and oxygenation. Methods for assessing tear reservoirs include slit-lamp biomicroscopy, optical coherence tomography (OCT), and fluorescein clearance tests. An optimal tear reservoir ensures comfort, visual clarity, and ocular health during lens wear.
  5. Lens Material and Oxygen Permeability: The appropriate lens material ensures adequate oxygen transmission to the cornea and maintains ocular health. Modern scleral lens materials offer high oxygen permeability, promoting corneal physiology and minimizing the risk of hypoxia-related complications, such as corneal edema and neovascularization.
  6. Patient Education and Follow-Up: Patient education is crucial in successful scleral lens wear. Patients should be instructed on proper lens insertion, removal, care procedures, potential complications, and troubleshooting strategies. Regular follow-up visits allow monitoring of ocular health, lens fit, and patient satisfaction, with adjustments to optimize outcomes.

Frequently Asked Questions (FAQs)

Are scleral lenses suitable for all types of dry eye?

Scleral lenses can benefit various forms of dry eye syndrome, including aqueous-deficient, evaporative, and mixed-mechanism dry eye. However, the suitability of scleral lenses will depend on individual patient factors and ocular characteristics.

How do I insert and remove scleral lenses?

Inserting and removing scleral lenses requires proper technique and practice. Generally, the lens is filled with preservative-free saline solution and positioned on the eye using a scleral lens inserter. To remove the lens, gentle pressure is applied to the edge of the lens, breaking the suction, followed by careful removal using a plunger or suction cup.

Can I wear scleral lenses for extended periods?

Scleral lenses are designed for extended wear, typically 8 to 14 hours daily. However, the recommended wearing time may vary depending on individual factors such as ocular health, comfort, and visual demands. It’s essential to follow the guidance of your eye care practitioner regarding wearing schedules and lens care.

Do scleral lenses require special care and maintenance?

This includes daily cleaning and disinfection using recommended solutions and regularly replacing lens storage solutions. Additionally, adherence to hygiene practices, such as hand washing before handling lenses, is essential to prevent contamination and infection.

Are scleral lenses covered by insurance?

Coverage for scleral lenses may vary depending on your insurance plan and individual policy. Certain insurance providers may extend partial or complete coverage for scleral lenses, mainly when prescribed for medically essential conditions like dry eye syndrome or corneal irregularities. Verifying coverage eligibility and reimbursement options with your insurance provider is recommended.

What should I do if I experience discomfort or blurry vision while wearing scleral lenses?

Discomfort or blurry vision while wearing scleral lenses may indicate improper fit, lens debris, or other underlying issues. If you encounter ongoing discomfort or notice changes in your vision, removing the lenses and seeking evaluation from your eye care professional is essential. Adjustments to lens parameters or modifications to treatment may be required to address the issue effectively.

Key Takeaways:

  1. Scleral Lenses Offer Advanced Relief for Dry Eye Syndrome:
    • Scleral lenses represent a groundbreaking solution for individuals suffering from dry eye syndrome. Unlike traditional contact lenses, scleral lenses provide continuous hydration and lubrication to the ocular surface, alleviating symptoms such as burning, itching, and blurred vision. By creating a protective barrier over the cornea and promoting tear film stability, scleral lenses offer superior comfort and clarity for patients with dry eyes.
  2. Customized Fitting and Precision Design Enhance Therapeutic Efficacy:
    • The success of scleral lenses in managing dry eye hinges is due to precise fitting and customized design. Eye care practitioners utilize advanced diagnostic tools and specialized software to tailor scleral lenses to each patient’s unique ocular anatomy and visual needs. Lens diameter, base curve, and tear reservoir assessment are meticulously evaluated to optimize comfort, visual acuity, and ocular health.
  3. Patient Education and Follow-Up are Key to Long-Term Success:
    • Patient education and regular follow-up are crucial in ensuring the long-term success of scleral lens wear. Patients should receive comprehensive instructions on lens insertion, removal, and care procedures, as well as potential complications and troubleshooting strategies.


In the realm of ocular health, the quest for relief from dry eye syndrome has led to remarkable advancements in contact lens technology. Scleral lenses stand at the forefront of this innovation, offering a beacon of hope for individuals grappling with the daily challenges of dry, irritated eyes. Through their unique design, customized fitting, and therapeutic efficacy, scleral lenses have emerged as a game-changer in managing dry eye, providing unparalleled comfort, clarity, and ocular surface protection.

As we conclude our exploration of scleral lenses for dry eye, it’s evident that these specialized lenses offer more than just vision correction—they offer a lifeline for those burdened by the debilitating symptoms of dry eye syndrome. From continuous hydration and lubrication to mechanical protection and enhanced visual acuity, scleral lenses address the multifaceted nature of the dry eye, empowering patients to reclaim their quality of life and enjoy newfound freedom from ocular discomfort.

Moving forward, continued research, innovation, and collaboration among eye care practitioners, researchers, and industry leaders will further refine and expand the therapeutic potential of scleral lenses. With a steadfast commitment to patient-centered care and a dedication to advancing ocular health, the future of scleral lenses shines bright, illuminating the path toward a world where dry eye is no longer a barrier to vision and vitality.