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Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the entire corneal surface and rest on the "white" of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by keratoconusand other corneal irregularities.

Scleral lenses may be used to improve vision and reduce pain and light sensitivity for people suffering from a growing number of disorders or injuries to the eye, such as severe dry eye syndrome, microphthalmia, keratoconus, corneal ectasia, Stevens–Johnson syndrome, Sjogren's syndrome, aniridia, neurotrophic keratitis (aneasthetic corneas), complications post-LASIK, higher order Aberrations of the eye, complications post-corneal transplant and pellucid degeneration. Injuries to the eye such as surgical complications, distorted corneal implants, as well as chemical and burn injuries also may be treated by the use of scleral lenses.

Sclerals may also be used in people with eyes that are too sensitive for other smaller corneal-type lenses, but require a more rigid lens for vision correction conditions such as astigmatism.

Modern scleral lenses are made of a highly oxygen permeable polymer. They are unique in their design in that they fit onto and are supported by the sclera, the white portion of the eye. The cause of this unique positioning is usually relevant to a specific patient, whose cornea may be too sensitive to support the lens directly. In comparison to corneal contact lenses, scleral lenses bulge outward considerably more. The space between the cornea and the lens is filled with artificial tears. The liquid, which is contained in a thin elastic reservoir, conforms to the irregularities of the deformed cornea, allowing vision to be restored comfortably.

  • Comfort:

    Scleral lenses offer unbelievable comfort to the wearer. The large design stays tucked beneath the lids and moves very little. If you were to manufacture a soft lens in an intralimbal design (a diameter that stays inside of the margins of the limbus, usually 11 millimeters or smaller), the wearer would be aware of the edges and would not find it very comfortable to wear. The rigidity of the material has less to do with the comfort than the size and design of the lens.

  • Stability:

    Scleral lenses are very stable on the eye offering consistent stable optics. The lens is unlikely to decenter or to dislodge from the eye during eye movement or activity. This provides many benefits for not only your everyday contact lens wearer, but especially for active contact lens wearers.

  • Consistent Vision:

    Scleral lenses are fit with a tear film between the cornea and the back surface of the contact lens. The cornea remains consistently moist providing vision that does not fluctuate or deteriorate due to dryness. Soft lenses are dependent upon consistent moisture to offer the best optics. The moisture level maintained by the lens can vary based on environmental conditions, medications or patients who just do not produce a sufficient volume or quality of tears. Those patients with the ideal tear film would likely find scleral lenses and soft lenses equally comfortable with similar visual quality. Those without this ideal tear film may find a scleral lens preferable for all day comfort and visual performance. A study that seems to confirm this thought will be presented in this article.

  • Reduced Glare and Starbursts:

    Scleral lenses have very large optic zones that stay centered over the pupil allowing the patient optics without flare and glare. Traditional corneal lenses have smaller optic zones and move quite a bit on the blink which sometimes allows for the peripheral curves to move into the visual axis creating light reflections and starbursts. The larger optical zone is beneficial to everyone, but especially to athletes, patients with large pupils and patients who experience flare and glare at night when the pupils dilate.

  • Reduced Dryness:

    Scleral lenses are fit with a tear layer between the cornea and lens that stays consistent throughout the day. The consistent tear film keeps the surface of the cornea lubricated and allows for the scleral lens to be worn comfortably from the moment of application until the lens is removed. As a person with dry eyes, I have tried every modality available and find my wearing time to be the best with scleral lenses.

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