Scleral lenses offer an innovative solution for dry eye sufferers, providing hydration, protection, and improved vision. Our experienced eye doctors are committed to helping you find relief with personalized scleral lens fittings tailored to your needs.
Scleral lenses have emerged as a versatile tool in managing dry eye symptoms for patients who have struggled with traditional therapies. These specialized contact lenses not only correct vision but also create a continuous reservoir of hydration over the cornea. This article explains how scleral lenses can treat dry eye by both protecting and soothing the ocular surface.
Dry eye disease (DED) is a chronic, multifactorial condition characterized by inflammation and an imbalance in the natural tear film. When the tear film fails to adequately lubricate the ocular surface, patients often experience itching, burning, grittiness, and even fluctuating vision. The complex interplay between reduced tear production, rapid evaporation, and inflammation disrupts the homeostasis of tissues including the cornea, conjunctiva, eyelids, lacrimal glands, and meibomian glands.
These imbalances not only cause discomfort but can also lead to long-term damage to the ocular surface. Researchers and professional bodies such as the Tear Film and Ocular Surface Society have mapped out the varied presentations of dry eye, ranging from evaporative and aqueous-deficient types to mixed forms where both mechanisms play a role. Patients who have tried topical lubricants, in-office treatments, punctal plugs, anti-inflammatory medications, and moisture goggles without sufficient relief often find themselves exploring advanced therapeutic solutions.
One of the most significant benefits of scleral lenses is their ability to hold a reservoir of non-preserved saline solution. This fluid layer is maintained around the cornea, countering the desiccating effects of a poor or unstable tear film. As the lens vaults over the cornea, it essentially “locks in” moisture, which continuously bathes the eye throughout the day.
By effectively mimicking a natural tear film, the reservoir not only alleviates discomfort but also protects the eye from environmental factors such as wind, dust, and allergens that can further aggravate dryness.
Scleral lenses act as a protective barrier against the mechanical forces of blinking. For patients with dry eye who have delicate corneal surfaces, even the friction caused by the eyelids can be disruptive. The lens, by vaulting over the cornea, prevents direct contact and minimizes the risk of epithelial abrasion and other related complications.
This protective aspect is particularly beneficial when patients have ocular surface changes stemming from systemic conditions such as Sjögren’s syndrome or graft-versus-host disease. In these scenarios, additional protection from external trauma and the reduction of friction contribute greatly to overall patient comfort.
Beyond hydration and protection, scleral lenses in many cases dramatically improve visual quality. As dry eye disease can cause light scattering due to an irregular ocular surface, the even optical surface created by the lens helps in achieving clearer and more stable vision. This improvement in optical performance is especially valuable for patients who have not found success with softer lens modalities. Furthermore the design reduces movement, and improves peripheral vision when compared to eye glasses.
Patients who previously experienced significant fluctuations in vision can enjoy a consistently improved visual outcome, thanks to the smooth refractive surface provided by the scleral lens.
Scleral lenses are most beneficial for patients with moderate to severe dry eye who have not responded well to conventional therapies.
According to clinical guidelines and management reports, scleral lenses are positioned as a step three intervention in the treatment protocol. This means that they are generally not the first choice for all dry eye patients, but rather for those whose symptoms persist despite a comprehensive regimen of dry eye treatments.
Our eye doctors carefully assess each patient’s history including prior contact lens experiences, ocular surface staining, tear break-up time, and overall ocular health. Factors such as the extent of corneal sensitivity, underlying systemic conditions like Graft Vs. Host Disease or Stevens-Johnson syndrome, and previous responses to conservative treatments all play a role in determining whether a scleral lens fit is appropriate.
The continuous presence of saline solution helps counteract the inadequate tear production or excessive evaporation frequently seen in dry eye disease.
By vaulting over the sensitive cornea, the lenses reduce friction from blinking while shielding the corneal epithelium from external irritants.
The smooth anterior surface provided by the lens results in more stable and consistently sharp vision, which is critical for many patients struggling with visual fluctuations due to dry eye.
Scleral lenses function best when used alongside continued dry eye management strategies. They provide a complementary method to conventional treatments rather than replacing them entirely.
First, our eye doctor will take detailed measurements of your eye. They'll look at things like the size of your iris (the colored part of your eye), how wide your eyes open, and the curve of your sclera. Advanced imaging tools create a detailed map of your eye’s surface to ensure the lens fits exactly to the unique shape and contours of your eye. These measurements help pick a trial lens that has the best chance of fitting comfortably.
Using those measurements, our doctor will choose a trial lens to see how it fits. The lens needs to "vault" over your cornea—imagine a bridge arching over water. At first, this vault should be pretty high (about 300 to 500 microns, which is just a fancy way of saying a very tiny gap). Over time, the lens settles into place, and the gap gets smaller, ideally ending up between 100 to 300 microns.
If you're struggling with dry eye and traditional treatments aren't providing relief, consider scleral lenses as a solution. Our expert eye doctors are ready to help you find the perfect fit and improve your comfort. Schedule your consultation today to learn more about how scleral lenses can benefit you!
If the lens vaults too high, it might not hold enough moisture. Too low, and it could touch your cornea, which isn't comfortable. The goal is a perfect balance: enough space for a healthy fluid reservoir without pressing on the eye.
Beyond the central fit, our doctor will check the edges of the lens. They want it to sit smoothly on the sclera without too much pressure or any sharp edges lifting up. This is where they might make tiny adjustments to ensure the lens hugs your eye just right.
Our eye doctor will use microscopes and imaging tools to make sure everything looks good. They’ll be checking that the lens is stable and not touching the cornea in a way that could cause discomfort.
In contrast to traditional lenses that may absorb moisture from the eye, scleral lenses retain and maintain a reservoir of saline solution, providing continuous hydration and reducing irritation.
Yes, patients can continue using preservative-free artificial tears as needed; in many cases, the frequency may even decrease once a proper scleral lens fit has been established.
While the initial adjustment period may vary, most patients become comfortable with lens handling and wear over several weeks, with proper training and follow-up appointments easing the transition.
Scleral lenses can be successfully fitted for patients across a wide range of ages, from pediatric cases with irregular corneas to elderly patients who experience severe dry eye symptoms. These answers help set realistic expectations and ensure that patients feel supported throughout their treatment journey. Our eye doctors emphasize that personalized guidance is key, and they strongly encourage anyone experiencing persistent dry eye symptoms to schedule a consultation for a detailed evaluation.
If you're struggling with dry eye and traditional treatments aren't providing relief, consider scleral lenses as a solution. Our expert eye doctors are ready to help you find the perfect fit and improve your comfort. Schedule your consultation today to learn more about how scleral lenses can benefit you!
Scleral lenses enhance dry eye management by providing hydration and ocular surface protection. Find top optometrists on Specialty Vision.
