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Scleral contact lenses are unique, differing from other lenses due to their large size and design, which covers the cornea entirely before resting on the sclera, hence the name. While conventional lenses float on the cornea, scleral lenses vault over it and rest on the eye's white part. Because of this unique feature, they suit people with irregular corneas and some eye conditions, providing a smooth optical surface that can correct vision better than other lens types. They are also great for people with dry eyes because the space between the lens and the eye fills with saline, keeping the eyes moisturized for longer than standard lenses.
The following are the different types of scleral contacts available:
Postoperative Scleral Contacts
These specific lenses are designed to help patients who need vision correction after eye surgery or transplant. They help by ensuring the cornea maintains a stable and normal shape as it heals, improving vision during recovery. These lenses also reduce discomfort and shield the delicate surface of the eye from the environment while protecting it from injury during the healing process. These lenses are custom-made to fit the unique contours of the eye after surgery, allowing for an improved optical surface that enhances vision. Through the use of these comfy and protective lenses, one can enjoy a smoother recovery and better visual results.
Scleral Contacts for Astigmatism
Specially designed to correct astigmatism, these toric scleral lenses provide clear vision, even for those with irregular astigmatism. They combine the strength of scleral lenses with the precision required for astigmatism. Toric scleral lenses are unique because they use two different powers and orientations for vision at varying distances. Scleral lenses astigmatism patients use also leverage the eye's shape to enhance stability and precision. Unlike generic toric lenses, these custom lenses are shaped to fit the unique contours of an irregular cornea, providing a smooth optical surface that corrects astigmatism.
Orthokeratology Scleral Contacts
These lenses, worn overnight, gently reshape the cornea so that during the day, without needing them, the wearer has clear vision. Perfect for nearsightedness, they mold the eye to reduce myopia over time, teaching the eye a new shape. This effect is temporary, and the lenses need to be worn regularly for the best results. Contact lenses for myopia control are a modern, non-surgical solution that is gaining popularity among children and teens, as they slow down the progression of nearsightedness. This safe, non-invasive system minimizes the need for glasses or regular contacts during the day and lowers the risk of worsening vision over time.
Scleral Contacts for Keratoconus
These are specially made for people with keratoconus, a condition that causes the cornea to become misshaped and cone-like. Scleral lenses for keratoconus patients are larger than regular lenses and are designed to sit on the white part of the eye, the sclera, completely vaulting over the cornea. This creates a continuous optical surface that helps improve vision by allowing light to enter the eye more evenly onto the retina. Scleral contacts for keratoconus offer deeper comfort and clarity than other corrective options; they minimize distortion and give a more accurate focus.
Hybrid Scleral Contacts
These spectactcles combine the best features of different lenses by integrating a rigid gas-permeable (RGP) center with a soft,elastic skirt surrounding it. This design provides the clear, crisp vision typically found in RGP lenses while retaining the comfort associated with softer lenses. They are especially useful for people with iris flat, allowing for a comfortable fit and clear vision, even with challenging prescriptions. For those seeking clarity and comfort, hybrid lenses are an excellent halfway house, providing the sharper vision of scleral lenses with the softer feel of traditional contacts.
The design of scleral lenses is a key factor in their functionality and ability to improve vision for people with irregular corneas or specific eye conditions. Unlike standard contact lenses, these have a unique shape and structure. Because of their larger diameter, they rest on the white part of the eye, known as the sclera, instead of sitting on the cornea. This feature allows them to vault over the entire corneal surface, creating a smooth optical zone that improves the way light focuses on the retina and thus enhancing vision. The space between the back of the lens and the cornea is filled with a special solution, which eliminates dry eye discomfort for longer periods of wear.
The following elements are among the key features of the design of sclera contacts:
Optical Zone
This part of the lens helps give clear vision by making an even, smooth, and flat surface where light focuses properly on the retina. The size and shape of this zone differ from person to person, depending on how their eyes are shaped. For people with irregular corneas, like those with keratoconus or other conditions, designing an optical zone that matches their unique eye shape is important to correct their distorted vision. When put on the eye, the lens turns due to the shape of the optical zone, helping light focus in the right spot. This special design is made to enhance comfort while giving clearer vision.
Gas Permeable Material
Scleral lenses need to be made from a special material called gas permeable or GP, which allows oxygen to easily flow through the lens to the eye. This keeps the eye healthy and moisturized, even when the lens is worn for a long time. GP materials also help the lens hold its unique shape, which is necessary to get the correct vision. Unlike soft lenses that may change shape, GP lenses stay stable, letting light focus perfectly on the retina to improve clarity. Because of how they are made, these lenses are good for reshaping the cornea, making them useful for people with irregular eye shapes who need extra help seeing clearly.
Scleral Lens Vaulting
The unique shape, called vaulting, allows this lens to sit above the cornea and rest on the scleral surface. This design works well for eyes with keratoconus, post-surgery, or previous injuries. Multi vaulting can help someone with different areas of their eye needing separate shapes. This technique also gives a channel between the lens and cornea for fluid, helping keep dry eyes away. It allows for the right amount of oxygen to get through while giving patients a smooth, comfortable fit with better vision correction.
Edge Design
The outer sides, or edges, of these lenses must be shaped carefully for them to fit well and be comfortable, even if they are larger. This special shape helps the lens sit correctly on the white part of the eye and not rub or irritate the surrounding tissues. Tapered edges create a smooth surface that tracks well as people move their eyes. Thickened or different styles may strengthen the lens for better vision. The way the edge is designed ensures the lens stays in the proper place without discomfort while allowing for clear sight.
Scleral lenses are designed to improve vision and comfort for people with various eye conditions or irregular cornea shapes. These larger-diameter lenses rest on the white part of the eye and vault over the cornea. This design allows them to create a smooth optical surface that improves vision while also providing comfort for dry or sensitive eyes.
Keratoconus
This eye disease makes the cornea bulge out in a cone shape, which warps vision. Scleral lenses can help flatten this surface so that light focuses better on the retina and vision becomes clearer. Because these lenses are larger, they vault over the irregular cornea and provide an even, smooth surface for better sight.
Dry Eye Syndrome
Dry eye disease occurs when the eyes never feel moist enough and can become irritated. Scleral lenses create a pocket of fluid between the lens and the cornea that keeps the eyes wet for hours and lessens irritation, allowing people with dry eyes to have comfort.
Post-Surgical Patients
After cataract or corneal transplant surgery, the shape of the eye may not be normal anymore. Scleral lenses can help make the healing process smoother by providing a well-fitting surface that aids in vision correction while protecting delicate surgical areas.
Irregular Corneas
Other reasons for unusual cornea shapes include eye injuries, diseases like Pellucid marginal degeneration, or previous surgeries. Scleral lenses help make vision clearer by providing a smooth surface regardless of how the cornea differs from the usual shape.
Astigmatism
For people with high levels of astigmatism, regular soft or toric lenses may not give clear vision. Special-design scleral lenses for astigmatism can help light focus properly on the retina and improve blurred or distorted sight, even if the astigmatism is very severe.
Several key features and requirements allow scleral lenses to provide optimal correction and comfort for challenging vision needs. They also require proper handling, cleaning, and storage to remain safe and effective.
Lens Material
Scleral lenses come in various gas-permeable materials, each with different levels of oxygen flow to keep the eye healthy. Common choices include Boston XO and Menicon Z, which provide high oxygen levels for comfort, even during extended wear. These specially formulated plastics help the lens maintain a smooth surface for vision correction while allowing ample oxygen to nourish the eye.
Diameter and Vaulting
Scleral lenses are larger than typical contacts, with diameters usually between 14.5 mm and 20 mm, and are tailored to each person's unique eye shapes and sizes. The vaulting, or curvature of the lens that arches over the cornea, is also custom-designed to fit perfectly over the individual cornea and rest on the white part of the eye, creating a smooth optical surface that improves sight.
Prescription Parameters
Each lens's prescription includes key measurements, such as the lens powers, which correct nearsightedness or farsightedness and astigmatism, and the special curvatures that make the lens fit the eye properly. These parameters ensure the lens provides the right optical correction for clear vision and the proper alignment on the eye for comfort and optimal performance.
Sterilization
Cleaning and caring for scleral lenses starts with sanitation. They should always be rinsed with a sterile lens solution, never tap water, which could cause infection.
Storage
For each nighttime wear, the lenses must be stored in fresh, sterile saline or a specially formulated storage solution to keep them moist and maintain their shape. This environment protects against drying or warping of the lens material.
Lens Case
Using a designated case with separate compartments for each lens is important. This keeps the lenses clean and helps them retain their shape by preventing contact between them.
Avoiding Damage
Care must be taken to prevent harming the sensitive lens material. Contacts should always be handled with clean hands, and protective measures should be taken to prevent exposure to harsh elements or traumatic injury to the lenses.
A1: Scleral contact lenses are larger-than-usual lenses that vault over the cornea to rest on the white part of the eye, known as the sclera. This design enables them to provide a smooth optical surface and correct vision for people with irregular corneas or other eye conditions.
A2: People with keratoconus, irregular corneas, dry eyes, or those who had eye surgery often find relief from wearing scleral lenses. These lenses give comfort and improved vision for challenging prescriptions.
A3: While regular lenses rest directly on the cornea, scleral lenses are made to fit over the entire eye. They are larger and specifically shaped for those with unique eye profiles, giving them a smoother surface to enhance clarity of vision.
A4: Scleral lenses create a pocket of fluid between the lens and the eye, keeping it hydrated for longer and reducing the discomfort associated with dry eye syndrome. This feature makes them very comfortable for people with persistently dry eyes.
A5: Proper maintenance includes cleaning them with a sterile solution, storing them in fresh saline, and using special lens cases. Bacteria won't harm them if handled correctly, and they'll last a long time with good hygiene.
