Scleral Lenses for Ptosis
Understanding How Ptosis Affects Your Vision
Ptosis is the medical term for a drooping upper eyelid. It happens when the muscle that lifts your lid becomes weak, stretched, or damaged.
Some people are born with ptosis, while others develop it with age, after an injury, or due to nerve or muscle disorders. The droop can be mild or severe enough to cover part of your pupil.
When your eyelid hangs lower than normal, it can cut off the top part of your vision. You might have to tilt your head back or raise your eyebrows just to see straight ahead.
This blocked field of vision makes daily tasks like reading, driving, and watching TV more difficult. Over time, constantly working around the droop can lead to other problems.
Many people with ptosis develop eye strain and headaches from trying to peek under their drooping lid. You may also experience neck and shoulder pain from holding your head in awkward positions.
- Fatigue from the extra effort needed to keep your eyes open
- Difficulty with tasks that require upward gaze
- Social concerns about appearance or expression
- Challenges applying makeup or wearing regular eyeglasses
Standard soft or rigid gas permeable lenses sit directly on your cornea and move with every blink. A drooping eyelid presses down unevenly, which can push the lens out of position or even cause it to pop out.
The constant rubbing and friction between your lid and a traditional lens also leads to discomfort, redness, and a gritty feeling. Many people with ptosis give up on contact lenses altogether after repeated frustration.
What Scleral Lenses Are and Why They Work for Ptosis
Scleral lenses are larger than traditional contact lenses, measuring between 14 and 24 millimeters in diameter. Instead of resting on the cornea, they rest on the white part of your eye, called the sclera.
This larger footprint spreads out the weight and creates a more stable platform. The lens is also custom designed to match the unique curves of your eye.
A scleral lens creates a gentle dome or vault over your cornea, leaving a tiny space between the lens and the front surface of your eye. This space is filled with preservative-free saline solution.
- The vault protects your cornea from direct contact and friction
- The fluid layer keeps your eye moist and comfortable
- The design reduces irritation even if your lid presses down
- Your cornea stays hydrated throughout the day
Because scleral lenses sit on the sclera, they are much less affected by eyelid motion than smaller lenses. Even if your drooping lid pushes down, the lens remains centered and stable.
This stability means you can blink normally without worrying about the lens shifting or falling out. Many patients find they can wear sclerals comfortably for the entire day.
The saline reservoir between the lens and your cornea acts as a cushion. It keeps your eye surface moist and reduces symptoms of dryness.
For people with ptosis, this fluid layer also helps buffer against the extra pressure from the drooping eyelid. You get clear vision and soothing comfort at the same time.
Getting Evaluated and Fitted for Scleral Lenses
We start by reviewing your medical history, including details about your ptosis and any other eye conditions. Our eye doctor will discuss your vision goals and daily challenges with contact lenses.
This conversation helps us understand whether scleral lenses are a good match for your needs. We will also examine your eyelids and check the health of your eyes.
Fitting scleral lenses requires precise measurements of your eye. We use advanced imaging technology to map the shape of your cornea and sclera.
- Corneal topography to capture the curves of your front eye surface
- Scleral profilometry or imaging to measure the white part of your eye
- Tear film evaluation to assess moisture levels
- Pupil and iris diameter measurements
After taking measurements, our eye doctor selects diagnostic lenses that match your eye shape. You will try on several lenses during the fitting appointment.
We check how each lens sits on your eye, evaluate the vault over your cornea, and make sure the edges land comfortably on your sclera. Small adjustments to size or curve can make a big difference in comfort and vision.
Scleral lenses are larger than regular contacts, so insertion and removal require a bit of practice. We provide hands-on training to build your confidence.
You will learn how to fill the lens with saline, place it on your eye using a small plunger or your fingers, and remove it safely at the end of the day. Most people master the technique within a few sessions.
While scleral lenses help many people with ptosis, they are not right for everyone. We may recommend other options if you have certain conditions.
- Severe eye allergies that make lens wear difficult
- Active eye infections or significant inflammation
- Difficulty handling lenses due to limited dexterity or vision
- Unwillingness to follow strict cleaning and care routines
Daily Use and Proper Lens Care
Inserting a scleral lens with ptosis takes a steady hand but becomes easier with practice. We recommend using a well-lit mirror and a stable surface.
- Fill the bowl of the lens with preservative-free saline
- Use your non-dominant hand to gently hold your drooping lid out of the way
- Look straight ahead or slightly downward as you bring the lens to your eye
- Let the lens settle onto your sclera, then release your lid slowly
- Blink a few times to center the lens and clear any trapped air bubbles
Proper removal prevents damage to your lens and keeps your eye healthy. Always wash and dry your hands thoroughly before touching your lenses.
To remove the lens, look to the side, gently press on the white part of your eye near the lens edge, and break the seal. You can also use a small suction plunger designed for scleral lenses.
Clean your lenses every time you remove them to prevent buildup of protein, oils, and debris. Use only the solutions our eye doctor recommends.
- Rinse the lens with preservative-free saline
- Apply a few drops of approved cleaner to each side of the lens
- Rub gently with your fingertip for about 20 seconds per side
- Rinse thoroughly again, then store the lens in fresh disinfecting solution overnight
Most people can wear scleral lenses comfortably for 12 to 16 hours per day. However, your eyes still need regular breaks to stay healthy.
Remove your lenses before sleeping unless our eye doctor specifically prescribes overnight wear. If your eyes feel tired or dry, take the lenses out early and give your eyes a rest.
Contact our office right away if you notice any of these red flags while wearing your scleral lenses.
- Sudden vision loss or significant blurring that does not clear
- Severe pain or a feeling that something is stuck in your eye
- Intense redness, especially if it spreads or worsens
- Discharge, swelling, or light sensitivity
- Persistent discomfort that does not improve after removing the lens
Follow-Up Care and Long-Term Management
We typically schedule your first follow-up visit within one to two weeks of receiving your new scleral lenses. This appointment lets us confirm the fit is still correct after you have worn the lenses at home.
Our eye doctor will examine your eyes for any signs of irritation, check the lens position, and answer any questions about handling or comfort. We may make small adjustments to optimize your fit.
After your initial follow-up, plan to see us every three to six months for routine monitoring. These visits help catch potential problems early and keep your eyes healthy.
- Assessment of lens fit and corneal health
- Evaluation of the tear reservoir and vault clearance
- Inspection of the lens surface for scratches or deposits
- Discussion of any changes in comfort or vision
Scleral lenses are durable, but they do not last forever. Most lenses need replacement every one to two years depending on wear and care.
We will let you know when it is time for new lenses. Signs that replacement is due include persistent cloudiness, warping, scratches, or changes in how the lens fits your eye.
If you are considering surgery to lift your eyelid or medical treatment for the underlying cause of your ptosis, talk to our eye doctor about timing. In some cases, we may recommend treating the ptosis first and then refitting your scleral lenses.
Surgery can change the shape and position of your eyelid, which may affect lens fit. Coordinating care ensures you get the best possible outcome for both your eyelid position and your contact lens comfort.
Frequently Asked Questions
Scleral lenses do not lift your drooping eyelid or cure the underlying ptosis. They are designed to improve your vision and comfort by staying stable despite the droop, but they do not treat the muscle or nerve problem that causes the lid to sag.
Coverage varies widely depending on your plan and the medical reason for the lenses. Some health insurance policies may cover part of the cost if ptosis significantly impairs your vision, while vision plans typically offer limited or no benefits for specialty lenses. We can provide documentation to help you file a claim.
Ptosis crutch glasses have a small attachment on the frame that helps hold your eyelid up. They can improve your field of vision but do not correct refractive error the way contact lenses do. Some people use both options at different times, choosing sclerals for active days and crutch glasses when they want a break from lens wear.
Scleral lenses are often an excellent choice for people with dry eye because the fluid reservoir keeps the cornea moist. Many patients with conditions like keratoconus, irregular astigmatism, or ocular surface disease also benefit from sclerals. Our eye doctor will review your full health history to determine if they are safe and effective for you.
Cloudiness can happen if debris, protein, or air bubbles get under the lens. Remove the lens, rinse it with saline, refill it, and reinsert it. If discomfort persists or the cloudiness returns quickly, take the lens out and call our office. Ongoing issues may signal a need to adjust the fit or replace the lens.
Getting Help for Scleral Lenses for Ptosis
If you are struggling with drooping eyelids and traditional contact lenses are not working, scleral lenses may offer the stability and comfort you need. Our eye doctor can evaluate your eyes, discuss your options, and guide you through every step of the fitting process to help you see clearly and feel confident again.