A scleral lens is a specialized contact lens used to manage a variety of eye conditions. It is made of a plastic that is clear and rigid, yet the material allows the eye to breathe, keeping it healthy. A scleral lens is slightly larger than most soft contact lenses and is designed to rest on the white (less sensitive) part of the eye called the sclera. That is why it’s called a scleral lens! This unique design makes the lens very comfortable to wear, all day long.
Dr. Lyons is one of the leading fitters of scleral lenses in the Cincinnati region. He was trained by one of the innovators in scleral lens design in 2006 and hasn’t looked back since. He is a proud member of the Scleral Lens Education Society.
He often is asked to speak on the topic of scleral lenses to his colleagues. If you would like to view a webinar given by Dr. Lyons, click here:
- Scleral Lenses: Fitting Your Not So Average Corneas
Essilor Laboratories Webinar, October 2011
How Does a Scleral Lens Work?
The eye is very similar to a camera – the cornea and lens of the eye (camera lenses) focus light to the retina (the film). In order for your visual system to properly process images, the eye requires a smooth surface – and the smoother the surface, the clearer your vision. Just like smudges on a camera lens, an irregular cornea will negatively impact your vision. A scleral lens is made of a stiff, yet thin, plastic that fits over the cornea, providing a smooth surface for the eye. This allows the eye to focus better, improving your vision. Additionally, a scleral lens is designed to hold a reservoir of fluid against the eye. This provides constant moisture to the ocular surface, making the lens very comfortable to wear. To insert the scleral lens, the cup of the lens is filled with a clear, preservative-free saline (a solution like our own tears). The lens is then applied while looking down. The lens holds the saline against the eye forming a “saline chamber.”
To view a video on the insertion and removal methods of scleral lenses, click here.
Who is a Candidate for Scleral Lenses?
Scleral lenses are generally indicated for patients who have corneal irregularities, dry eyes, or those who cannot comfortably wear traditional contact lenses. Patients of any age can wear scleral lenses.
Your eye doctor may recommend scleral lenses if you are a good candidate and have a condition from this partial list of indications:
- Corneal ectasia such as keratoconus, pellucid marginal degeneration, and keratoglobus
- Corneal deformities following a corneal transplant (keratoplasty) or refractive treatment such as LASIK and radial keratotomy (RK)
- Severe dry eye due to disorders of the lacrimal gland such as keratoconjunctivitis sicca, Sjogren’s syndrome, and graft-versus-host disease
- Corneal surface irregularities due to ocular surface disease, anterior corneal dystrophies, and scars
- Neurotrophic keratitis resulting from herpes simplex or zoster keratitis, diabetes, and other nerve disorders
- Recurrent corneal epithelial erosions due to a fragile epithelium
- Intolerance to traditional contact lenses
Why is a Scleral Lens Right for You?
Vision: Because the scleral lens plastic is stiff, it provides a smooth, clear refracting surface for the eye. This can lead to vision that is much improved, usually better than eyeglasses and traditional contact lenses.
Moisture: A scleral lens holds fluid against the eye acting as a clear “liquid bandage.” This helps to keep the eye moist and can help to heal extremely dry eyes. It is almost like applying an artificial tear or lubricating drop into the eye every minute of every day.
Comfort: Traditional gas permeable lenses are much smaller than scleral lenses. They sit directly on the highly sensitive cornea of the eye and interact with the eyelids during a blink. This can create sensation when traditional lenses are worn, and it can take weeks to months to grow accustomed to these lenses. A scleral lens rests on the less sensitive sclera of the eye and is held in place by the eyelids. This creates a more comfortable wearing experience and allows most people to adapt to them quickly.
How do orthokeratology lenses work?
In the myopic eye (difficulty seeing at a distance), light focuses in front of the retina, making distant objects appear blurry. When eyeglasses or daytime contacts are worn, light is focused on the retina so you can see clearly.
Today, orthokeratology lenses provides a new option for patients with nearsightedness. Orthokeratology lenses correct nearsightedness, with or without low to moderate astigmatism, by gently and safely reshaping the cornea while you sleep. When orthokeratology lenses are removed in the morning, the treated cornea allows light to focus on the retina. The result is clear, natural vision for your waking hours. And yes, if you get up during the night, orthokeratology lenses will enable you to see clearly with the lenses on!
Who is a Candidate for Orthokeratology?
The best feature of orthokeratologly is that it is approved for any age. This means that we can provide vision correction with lenses, without surgery, even in children. The youngest child Dr. Lyons has fit was 7-years old.
There are limitations to the amount of correction that can be obtained with orthokeratology. The highest rate of success is in nearsighted individuals with the power between -0.50 to -4.00 and less than 1.00 diopter of astigmatism.
Rigid gas permeable lenses are still used today because of their superior optical qualities; however, they can be uncomfortable with reduced wearing time for some people. Synergeyes has created a rigid gas permeable center bound to a soft lens skirt to deliver a comfortable lens with great optical qualities.
Synergeyes also has different designs available for your vision needs. The lenses are used to correct near or farsightedness, presbyopia, and corneal deformities, such as keratoconus.
Specialty Contact Lens Labs
Focal Pointe partners with the following specialty contact lens laboratories to provide you with custom, high-quality contact lenses:
Essilor is intensely dedicated to research and innovation. They strive to create the most beautiful, comfortable and durable corrective lens designs in the world. With the tradition of excellence and technological advancement in the optical field, and with a passionate management staff of experienced professionals, Essilor is truly the work of geniuses. And they strive for perfect quality for each and every Essilor customer.