Specialty Contact Lenses
Who Needs Specialty Contact Lenses
Keratoconus is a condition where the cornea thins and bulges into a cone shape, often making standard soft lenses difficult to fit comfortably or clearly. We often recommend specialty lenses for this condition because they vault over the irregular surface and create a smooth optical zone. This design can restore clear vision and protect the delicate corneal tissue.
Specialty lenses improve vision and comfort but do not stop the progression of keratoconus. We monitor your corneal shape over time and may recommend treatments such as corneal cross-linking when appropriate to help stabilize the condition.
Other corneal irregularities, such as pellucid marginal degeneration or corneal ectasia, also benefit from custom lens designs that accommodate unique surface contours.
If you suffer from severe dry eye, regular contact lenses may feel uncomfortable or even painful. Specialty lenses can hold a reservoir of moisture against your eye throughout the day, providing relief and better vision. We may recommend these lenses for conditions like Sjögren's syndrome, graft-versus-host disease, or chronic inflammation of the ocular surface.
Underlying dry eye or ocular surface inflammation often requires concurrent medical therapy. Specialty lenses can be an important part of a broader treatment plan that may include medications, lid hygiene, and environmental modifications.
- Reduced friction between the lens and your eyelid
- Constant hydration for the front surface of your eye
- Protection from environmental irritants like wind and dust
- Improved comfort that lasts all day long
Corneal transplants, refractive surgery complications, and eye injuries can leave the cornea with an uneven shape. Standard contact lenses will not sit correctly on these surfaces. Specialty lenses are designed to match the new shape of your cornea and provide stable, clear vision.
We fit many patients who have had radial keratotomy, LASIK enhancements, or penetrating keratoplasty successfully using custom lens designs. Some post-surgical eyes require multiple design iterations and close co-management with your corneal surgeon to achieve the best possible outcome.
Very high degrees of nearsightedness, farsightedness, or astigmatism often exceed the range of standard contact lenses. We can order specialty lenses with extended parameter ranges to correct your vision accurately. These lenses are manufactured individually to your exact prescription.
- Correction for prescriptions beyond typical limits
- Better optical quality than stretched standard designs
- Options for multifocal needs combined with high astigmatism
Sometimes your eyes are simply shaped in a way that makes regular contacts unstable, uncomfortable, or unable to provide clear vision. You may have very flat or very steep corneas, or significant differences between your two eyes. We evaluate each patient individually and create a lens design that works with your anatomy, not against it.
Many people who thought they could never wear contacts successfully discover that specialty lenses offer a solution that works for them.
Types of Specialty Contact Lenses We Offer
Scleral lenses are large-diameter lenses that vault over the entire cornea and land on the conjunctiva over the sclera. Because they do not touch the cornea directly, they are often very comfortable, though individual experiences vary. The space between the lens and your cornea fills with preservative-free saline solution, supporting ocular surface protection and symptom relief.
- Ideal for keratoconus and severe dry eye
- Often provide all-day comfort with minimal awareness of wearing a lens
- Exceptional stability during sports and daily activities
- Can provide outstanding visual clarity even with very irregular corneas
Potential challenges we monitor for include:
- Midday fogging or blur
- Bubbles on insertion
- Redness from tight landing zones
- Suction or difficulty removing lenses
- Need for preservative-free filling solution and strict hygiene
RGP lenses are smaller than scleral lenses and made from firm, oxygen-permeable materials. They sit directly on the cornea and create a tear layer beneath the lens that corrects irregular astigmatism. These lenses provide crisp vision and allow high oxygen transmission relative to older rigid materials, though oxygen delivery depends on material, thickness, and wear schedule.
We may recommend RGP lenses for mild to moderate keratoconus, post-surgical corneas, or high astigmatism when a smaller lens design is appropriate for your eye shape.
Hybrid lenses combine a rigid gas permeable center for clear vision with a soft outer skirt for comfort and stability. This design offers the optical performance of an RGP lens with the comfortable fit of a soft lens. We often fit hybrid lenses for patients who want crisp vision but find traditional RGP lenses too uncomfortable.
- Good option for moderate irregular astigmatism
- Less likely to pop out during activity than small RGP lenses
- Easier adaptation period for first-time RGP wearers
Orthokeratology lenses, often called ortho-k, are rigid lenses you wear only while you sleep. They gently reshape the front surface of your cornea overnight, and you remove them in the morning to often experience clear vision for much of the day, though some patients may notice end-of-day blur or need occasional backup correction. This approach is particularly popular for children with progressive myopia, as it may slow the worsening of nearsightedness.
Overnight wear increases infection risk, so strict hygiene, water avoidance, and urgent evaluation for pain, photophobia, or reduced vision are essential. We use ortho-k as part of myopia management strategies, combined with other interventions when appropriate for your child's needs. Other myopia management options may include atropine and soft multifocal or dual-focus lenses depending on candidacy.
Some patients need the comfort of soft lenses but have eye shapes or prescriptions that require customization. We can order soft lenses made to your exact measurements, including unusual diameters, curves, and prescription parameters. These lenses are manufactured individually rather than mass-produced.
- Tailored to very steep or very flat corneas
- Available in toric designs for high or irregular astigmatism
- Options for multifocal corrections in non-standard parameters
- More comfortable than trying to force a standard lens to work
What to Expect During Your Specialty Lens Fitting
Your specialty lens journey begins with a thorough eye exam to assess your overall eye health and vision. We check for conditions that might affect lens wear and measure your current prescription carefully. This appointment typically takes longer than a routine eye exam because we gather detailed information about your corneal shape and eye surface.
We also discuss your lifestyle, visual goals, and any challenges you have experienced with glasses or previous contact lenses.
We use corneal topography to create a detailed map of your cornea's surface, showing even tiny irregularities. This technology takes thousands of measurements in seconds and produces color-coded maps that guide our lens design. Advanced imaging may also include optical coherence tomography to assess anterior segment anatomy and, when needed, scleral lens vault and landing zones as well as corneal thickness.
- Painless imaging completed in minutes
- Precise measurements of corneal curvature and shape
- Detailed data to customize your lens parameters
- Baseline documentation for future comparisons
We place diagnostic lenses on your eyes to evaluate the fit and vision they provide. You will sit in the exam chair while we observe how the lenses settle and move with each blink. We may try several different lenses to find the optimal design, and we assess your comfort and visual clarity with each option.
This process helps us determine the final lens specifications to order for you, ensuring the best possible fit on the first custom lens.
Once we have determined the right lens design, we teach you how to handle your lenses safely. For scleral lenses, you will learn to fill the lens with saline and apply it using a special technique. For smaller lenses, we demonstrate proper finger placement and insertion methods. We also show you the safest ways to remove each lens type.
- Hands-on practice with our guidance and support
- Written instructions and video resources to take home
- Tips for building confidence and speed with practice
After you receive your custom lenses and wear them for a week or two, we see you again to evaluate the fit and vision. Small adjustments in lens parameters are common to achieve the perfect result. We may modify the lens curvature, diameter, or prescription based on how the lenses perform in your daily life.
Our goal is for you to have excellent vision, all-day comfort, and a healthy ocular surface with your specialty lenses.
Daily Care and Maintenance of Specialty Lenses
Always wash and dry your hands thoroughly before handling your lenses. For scleral lenses, place the lens on an insertion tool or your fingertips, fill it to the brim with preservative-free saline, and apply it to your eye while looking down into a mirror on a table. For smaller RGP or hybrid lenses, balance the lens on your index finger, hold your eyelids open, and place the lens directly on your cornea.
- Use only recommended solutions for filling or wetting lenses
- For soft lenses, check that the lens is clean and not inside-out before insertion
- Avoid touching the lens with your fingernails
- Take your time until the process becomes routine
- Use sterile single-use preservative-free saline for scleral lens filling, not multipurpose solutions
To remove a scleral lens, lean over a table with a mirror, look to the side, and use a small plunger designed for lens removal. Gently press the plunger onto the lower edge of the lens and rock it slightly to break the seal. For RGP lenses, pull the outer corner of your eyelid tight and blink firmly, or use your fingertips to gently slide the lens off the cornea. Perform removal over a clean towel or surface to avoid losing the lens, and stop if pain occurs.
Never try to pinch a rigid lens off your eye, as this can damage the lens or scratch your cornea.
Each time you remove your lenses, rub them gently with the cleaner we recommend, even if the solution is labeled no-rub. This mechanical cleaning removes protein deposits, oils, and debris. Rinse the lenses thoroughly with fresh solution, then place them in a clean case filled with the appropriate disinfecting solution. Let them soak for at least the minimum time specified by the solution manufacturer.
Redness or burning can be due to solution toxicity or preservative sensitivity and should prompt evaluation by our office.
- Never use tap water, saliva, or homemade saline on your lenses
- Replace your cleaning and disinfecting solutions as directed
- Use only products approved for your specific lens type
- Do not rinse your lenses or lens case with tap water
Always store your lenses in fresh disinfecting solution in a clean case. Empty your lens case every morning, rinse it with fresh solution (never tap water), and let it air-dry completely. Replace your lens case at least every three months, or more often if it becomes cracked or cloudy. Never reuse old solution or top off partially used solution in your case.
Contaminated lens cases are a common source of eye infections, so proper case hygiene is just as important as lens cleaning. Avoid exposing your lenses to water, including while showering.
Specialty lenses typically last one year with proper care, though some materials and designs may have different lifespans. We will tell you the expected replacement schedule for your specific lenses. Replace your lenses earlier if they become warped, scratched, or cloudy, or if deposit buildup cannot be removed with cleaning. Annual replacement ensures optimal vision, comfort, and eye health.
- Mark your calendar for replacement dates
- Order new lenses before your current pair expires
- Keep a backup pair if possible for emergencies
Most patients adapt to specialty lenses within a few days to two weeks. You may notice awareness of the lens at first, especially when blinking, but this sensation usually fades quickly. Some lens types, particularly scleral lenses, often feel comfortable from the very first wear. Build up your wearing time gradually if we recommend it, starting with a few hours and increasing daily as your eyes adjust.
Contact our office if discomfort persists beyond the expected adaptation period, as this may indicate a fit issue that needs correction.
Follow-Up Visits and Long-Term Success
We will see you one to two weeks after you receive your lenses to check the fit and your eye health. Additional follow-up visits may be scheduled at one month, three months, and then annually. These appointments allow us to confirm that your lenses are not causing any complications and that your vision remains excellent. We also assess the condition of your lenses and replace them if needed.
- Never skip scheduled follow-up appointments
- Each visit includes evaluation of lens fit and eye surface health
- We update your prescription if your vision has changed
- Early detection of problems prevents serious complications
Contact us if your lenses become less comfortable over time, if you notice blurred or fluctuating vision, or if your eyes appear red after lens wear. Excessive mucus or discharge, lenses that move too much or feel loose, and lenses that no longer stay centered are all signs that an adjustment may be necessary. Changes in your eyes or lenses often develop gradually, so pay attention to any shift from your normal experience.
We can often resolve these issues with simple parameter changes or a fresh pair of lenses.
Remove your lenses and call us right away if you experience sudden vision loss, severe eye pain, intense light sensitivity, or significant redness. Discharge that is yellow or green, symptoms that worsen rapidly, or a feeling that something is stuck under your lens all require urgent attention. Eye infections and corneal abrasions can develop quickly in contact lens wearers, so prompt evaluation is critical.
If you are unable to reach our office promptly or if symptoms are severe or worsening, seek urgent or emergency eye care. Do not reinsert your lenses until you have been cleared by a clinician.
- Do not wait for your next scheduled appointment if you have urgent symptoms
- Remove your lenses immediately and leave them out until we evaluate you
- Bring your lenses and lens case to the appointment for inspection
Even if your vision seems stable, you need a comprehensive eye exam every year. We check your eye health, update your prescription if necessary, and evaluate whether your lens fit is still optimal. Your eyes and vision can change over time, and conditions like keratoconus may progress. Regular monitoring ensures that your specialty lenses continue to meet your needs and that we catch any problems early.
We incorporate the latest technology and clinical findings into your care to provide the best outcomes possible.
Frequently Asked Questions
Coverage varies widely depending on your insurance plan and the medical reason for the lenses. Many medical insurance plans cover specialty lenses when they are medically necessary for conditions like keratoconus or corneal disease, but vision insurance may not. We will help you verify your benefits and submit claims on your behalf, and we can discuss payment options if your plan does not provide full coverage.
Most patients adapt within a few days to two weeks, though the timeline depends on the lens type and your individual sensitivity. Scleral lenses often feel comfortable immediately because they vault over the cornea, while smaller RGP lenses may take a bit longer as your eyelids adjust to the sensation. Most patients can adapt successfully with proper fitting and follow-up, though some require alternative designs or additional adjustments.
Orthokeratology lenses are designed specifically for overnight wear, and you must sleep in them to achieve daytime vision correction. For other specialty lens types, overnight wear is generally not recommended unless we specifically prescribe it for your situation. Sleeping in lenses increases the risk of serious eye infections and reduces oxygen flow to your cornea, so always follow our instructions about wearing schedules. Only lenses explicitly prescribed for overnight wear should be slept in, and risk and monitoring requirements are higher for any overnight wear.
We recommend removing your lenses before swimming or using hot tubs because water contains bacteria and other organisms that can cause serious eye infections. For sports, specialty lenses often perform exceptionally well because they fit securely and provide stable vision during movement. If you participate in water sports, discuss protective eyewear options with us, and consider using daily disposable soft lenses for those specific activities if appropriate.
Contact our office as soon as possible so we can order a replacement lens. Because specialty lenses are custom-made, we keep your parameters on file and can reorder the exact same lens. If you have a backup pair, you can wear those while waiting for the replacement. Inspect your lenses regularly for chips, cracks, or warping, and handle them carefully to avoid accidental damage.
Specialty lenses often provide better vision quality than glasses for people with irregular corneas or high astigmatism because they create a smooth front optical surface. Laser surgery is not an option for many conditions that require specialty lenses, such as keratoconus or severe dry eye. For appropriate candidates, we discuss all vision correction options and help you choose the approach that best fits your lifestyle, eye health, and visual goals.
Getting Help for Specialty Contact Lenses
If you struggle with standard contact lenses or have an eye condition that makes vision correction challenging, specialty contact lenses may offer an excellent solution. Our eye doctor will evaluate your individual needs and recommend the lens design that provides the best combination of vision, comfort, and eye health. Schedule a consultation with us to explore your options and start your journey to better vision.