Scleral Lenses for Keratoconus: Who Can Benefit?

Scleral lenses are large-diameter rigid gas-permeable contact lenses that rest on the white part of the eye, the sclera, and vault over the cornea without touching it. The space between the lens and the cornea is filled with saline. For people with keratoconus, scleral lenses can provide much clearer and more comfortable vision than glasses or standard contact lenses.

Why Do Glasses Not Work Well in Keratoconus?

Glasses correct regular astigmatism but cannot fix the irregular shape of a keratoconic cornea. As keratoconus progresses, glasses give less clear vision. Rigid lenses help by creating a regular surface over the cornea.

How Are Scleral Lenses Different From Other Lenses?

Soft lenses

Soft lenses mould to the cornea and do not correct irregularity well.

Corneal rigid gas-permeable (RGP) lenses

These sit on the cornea and can provide good vision but may be uncomfortable or unstable on steep cones.

Scleral lenses

These are larger, rest on the sclera, avoid pressure on the cone and keep the cornea bathed in saline, which often improves comfort and stability.

Who Can Benefit?

Scleral lenses can help some patients delay or avoid corneal transplant when vision becomes poor with other corrections.

What Is the Fitting Process?

Fitting is done by a trained specialist using corneal scans and trial lenses. Several visits may be needed to achieve the right vault, landing on the sclera and vision. Custom lenses are then ordered.

How Do You Insert and Remove Them?

Lenses are filled with preservative-free saline and inserted with the head facing down, often using a small plunger. Removal uses a small suction tool or fingers. Training is provided, and most people learn within a few sessions.

How Do You Care for Scleral Lenses?

What Are Possible Problems?

Fogging of vision, discomfort, redness or difficulty inserting lenses can happen. Contact your eye care team for persistent redness, pain, light sensitivity or reduced vision, as these may signal infection or poor fit.

Key Takeaways

Final Thoughts

Scleral lenses can transform vision and comfort for many people with keratoconus. Expert fitting and good care make them safe and effective. Dr. Meeta Mungale and the team at Mungale Eye Hospital in Vadodara provide keratoconus care, including specialty contact lens fitting.

Sources and further reading