Scleral Lenses – Hamilton & Burlington

Corneal Thinning and Scleral lenses

The cornea is the clear, front surface of the eye. Normally, the cornea has a round shape, like a ball, which helps us see clearly. Sometimes, however, the cornea can develop a condition called ectasia.

Ectasia is a progressive thinning and distortion of the cornea. As the cornea thins it becomes weaker, and proceeds to bulge outward in a cone shape. This condition is known as keratoconus. There are many different types of corneal ectasia, with keratoconus being the most common. Keratoconus affects approximately 1 in 2000 people in North America. Corneal thinning or ectasia, can also occur as a complication of refractive surgery (LASIK or PRK).

As a result of corneal irregularity, keratoconus can cause significant glare, halos and blurred vision especially at night. In more moderate to advanced cases these symptoms are typically not fully correctable with glasses or standard soft contact lenses.

When glasses and soft contact lenses fail to provide adequate vision, it may be time to consider scleral lenses. Scleral contact lenses are rigid, oxygen permeable lenses that cover the entire cornea (like a bridge) without touching it, and sit on the white part of the eye (the sclera). Scleral lenses are very stable on the eye, and they do not move around or pop out like some smaller RGP lenses. The smooth dome shape of scleral lenses functionally replaces the existing irregular cornea. This allows the lens to correct a large amount of irregularity/astigmatism in the cornea, thereby providing better quality vision than glasses and soft contacts.


Benefits of Scleral Lenses


Compared to glasses and standard soft contact lenses, they create a more regular smooth front surface that provides clearer and sharper vision with less glare and halos.


Scleral lenses are well know for their comfort. Since they tuck nicely underneath the eye lids and do not touch the sensitive cornea like a soft lens, scleral lenses are often more comfortable than traditional soft contact lenses.


Scleral lenses are designed to vault over the cornea like a bridge, and hold a soothing bath of fluid underneath that serves to hydrate the front surface of your eye. This provides excellent relief from the constant redness, burning and irritation associated with chronically dry eyes.

Scleral contact lenses are custom made to fit the unique contours of your eye. As a result, fitting this type of specialty lens requires a specific expertise and involves a greater amount of time than standard smaller gas permeables (RGPs) and soft contact lenses.

Given the highly customized nature of scleral lenses and the increased time required to fit them, scleral lenses tend to be more expensive then standard soft and smaller RGP lenses. Taking this into consideration, scleral lenses are typically the most comfortable way to wear contacts and in many cases, are the only option for those suffering from severe dry eye, keratoconus and other similar irregularities of the cornea.


What are Scleral Lenses used For?

Irregular shaped corneas

Scleral contact lenses have become a comfortable and effective means of correcting vision for a wide variety of corneal irregularities. They have played important roles in the rehabilitation of damaged corneas from scarring, injury and severe dryness. For patients suffering from debilitating glare and halos in their vision, especially at night, scleral lenses can improve vision and overall quality of life.

Severe dry eye

Patients with chronic dry eye typically present with red eyes as well as burning, stinging and irritation. At times these symptoms can be debilitating, making it difficult to work and affecting quality of life. Dry eye can be more severe in patients with an underlying inflammatory condition like Sjogrens syndrome or rheumatoid arthritis. Scleral lenses create a space between the contact lens and your cornea, and this space contains a hydrating fluid that serves to bathe the front of your eye . When conventional therapies fail to provide relief, scleral contact lenses can provide outstanding all day comfort and clear vision.

Soft contact lens/RGP intolerance

Having a corneal health problem is not a requirement for scleral lenses. For patients who have struggled to successfully wear soft contact lenses or smaller RGPs due to excessive discomfort, reduced vision or poor fit (lens dislodging or popping out), scleral lenses are a great alternative. The combination of lens stability, superior comfort and clear vision has made scleral lenses a great choice for anyone looking to reduce their dependency on glasses.

Scleral contact lenses are used to improve vision and manage day to day comfort in a broad range of corneal conditions including;

Irregular corneas

  • Keratoconus
  • Radial keratotomy (RK)
  • Post LASIK ectasia
  • Post-corneal transplant
  • Pellucid marginal degeneration
  • Terrien’s marginal degeneration

Severe dry eye

  • Sjögren’s syndrome
  • Graft versus host disease
  • Stevens-Johnson syndrome
  • Ocular cicatricial pemphigoid



Persistant corneal defect/scarring

  • Post herpetic scarring
  • Neurotrophic keratopathy/persistent ulcer
  • Limbal stem cell deficiency
  • Scarring from injury

High prescriptions

  • High nearsightedness (myopia)
  • High astigmatism


Why Choose Spectrum for your Specialty Contact Lens Fitting?

Over the past decade, Spectrum Family Eye Care and its team of board certified Optometrists and technicians have developed a reputation for delivering quality eye care and superior service. We are constantly striving to keep our practice current by investing in the latest technology. This ensures that our patients are always receiving the best eye health examination possible. This philosophy carries over into our specialty contact lens services as well. This is how our technology helps our patients receive the healthiest specialty lens possible for their eye, while maintaining clear vision throughout the entire day;

Using our Medmont e300 corneal topographer, our doctors are able to capture detailed color coded maps of the surface of your eye (the cornea) to better visualize the irregular areas that are making your vision blurry. This information will aid your eye doctor in customizing a scleral lens specific to the shape of your eye so that you receive the healthiest scleral lens possible.

Our Topcon Maestro technology allows our doctors to take high resolution ultrasound images of the front surface of your eye (the cornea), with and without the contact lens in place. This is very important information as it serves to ensure that the healthiest fit possible is achieved, so that you are always seeing your best. This technology is also used on follow up visits to ensure your lens is fitting your eye properly.

Using our Cirrus 4000 high definition optical coherence tomography (OCT) we are able to capture corneal thickness measurements (also known as pachymetry readings) over the entire surface of your cornea. Once you have been successfully fit into scleral lenses, it becomes very important to monitor your corneal thickness measurements to ensure your are maintaining the healthiest fit possible. The Cirrus 400-HD OCT also allows your doctor to visualize how the scleral lens interacts or “lands” on the white part of your eye (the sclera). This aids in making appropriate adjustments to the lens so that you receive the healthiest and most comfortable lens wearing experience possible, with clear vision throughout the day.

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