Scleral Lenses

How scleral lenses improve vision and comfort

The cornea is the clear front surface of your eye. When its shape becomes irregular, light does not focus evenly, which can cause blurred vision, ghosting, glare, and distortion. Glasses and standard soft contacts may not fully correct these problems.

Scleral lenses hold their shape rather than conforming to the irregular cornea. They arch over the cornea and rest on the tissue covering the sclera, the white portion of the eye. The smooth lens surface and fluid beneath it help compensate for corneal irregularity so light can focus more clearly.

Before insertion, the lens is filled with preservative-free saline. This fluid reservoir keeps the corneal surface bathed during wear and helps protect it from friction caused by blinking. The lens material allows oxygen to pass through, while careful fitting helps support healthy wear.

Because scleral lenses extend beyond the cornea, they generally remain stable on the eye. Comfort and clarity still depend on the individual fit and the health of the eye.

Who may benefit from scleral lenses?

Scleral lenses may be useful when conventional correction does not provide adequate vision or when other contacts are difficult to tolerate. Dr. Sturm evaluates patients with:

• Keratoconus and other corneal ectasias, conditions that alter the cornea’s shape and can cause substantial distortion.
• Corneal irregularities following surgery, including LASIK, radial keratotomy (RK), and corneal transplantation.
• Corneal scarring, when an irregular surface contributes to reduced vision.
• Significant dry eye or ocular surface disease, including selected patients with Sjögren’s syndrome.
• High or complex prescriptions, particularly when standard contacts do not provide satisfactory vision.

The diagnosis alone does not determine whether scleral lenses are the best choice. We also consider corneal health, eyelid anatomy, your visual needs, and your ability to insert, remove, and care for the lenses. Active inflammation or other eye health problems may need treatment before fitting proceeds.

For more information about the underlying condition, visit our keratoconus page. You can also explore other options on our specialty contact lenses page.

What to expect during scleral lens fitting

Evaluating your eyes and current vision

We begin by reviewing your symptoms, medical and surgical history, and experience with glasses or contacts. Dr. Sturm examines the cornea and surrounding tissues and evaluates how well your current prescription corrects your vision.

Corneal and scleral mapping can help guide lens design, while anterior segment OCT provides cross-sectional images to assess clearance between the lens and cornea. These measurements, together with a microscope examination of the lens on your eye, help guide adjustments. Testing is selected according to your needs. Learn more on our technology page.

Assessing the fit and ordering your lenses

During fitting, Dr. Sturm evaluates how the lens clears the cornea, how its edges rest on the eye, and how well you see through it. A lens must provide appropriate support without excessive pressure on the surrounding tissue.

These findings guide the prescription and custom lens design. After your lenses arrive, we reassess vision and fit. Changes to the lens shape or prescription may be needed as the lenses settle during wear and you gain experience using them.

Refining the result

Scleral fitting usually involves multiple visits. Some eyes require relatively few adjustments, while complex corneal shapes or significant surface disease may require repeated modifications over several weeks or months.

You may notice clearer vision during an initial lens assessment, but that does not mean fitting is complete. The final result must also provide a suitable fit, manageable daily wear, and an acceptable response from the eye.

Getting used to your lenses and daily care

We provide instruction in inserting, removing, cleaning, and disinfecting your lenses. Learning to hold the eyelids open and insert a fluid-filled lens without trapping bubbles takes practice. If handling is difficult, we help you work through the technique and appropriate insertion or removal aids.

Your care routine includes filling the lenses with recommended preservative-free saline and using the prescribed cleaning and disinfection system. Saline does not disinfect lenses. Avoid tap water and saliva, and remove your lenses before sleeping unless specifically directed otherwise for a medical reason.

Wearing time is individualized. Some patients build up gradually, and some need to remove, clean, refill, and reinsert their lenses during the day. Persistent discomfort should be evaluated rather than treated as something you need to tolerate.

Follow-up care and realistic expectations

Follow-up visits allow Dr. Sturm to assess your vision, lens condition, fit after settling, and the health of the cornea and surrounding tissues. Your follow-up schedule depends on your condition and how your eyes respond to wear.

Scleral lenses can improve vision caused by corneal irregularity, but they cannot remove a scar or correct every cause of reduced vision. Retinal disease, optic nerve problems, or dense corneal scarring may limit the improvement possible.

For dry eye, scleral lenses may be one part of treatment. They do not necessarily replace care for eyelid inflammation, tear film problems, or the underlying disease. Additional information is available on our dry eye page.

Remove your lenses and seek prompt eye care if you develop eye pain, marked redness, light sensitivity, or a sudden decrease in vision.

Common questions about scleral lenses

Can I wear scleral lenses if other contacts have been uncomfortable?

Possibly. Scleral lenses fit differently from soft lenses and smaller rigid lenses, so previous contact lens intolerance does not automatically rule them out. An evaluation helps determine why earlier lenses were uncomfortable and whether a scleral design is likely to address that problem.

Do scleral lenses stop keratoconus from progressing?

No. Scleral lenses improve vision while you wear them, but they do not strengthen the cornea or stop keratoconus progression. Monitoring remains important even when you see well with your lenses. Corneal cross-linking may be recommended separately when treatment to limit progression is appropriate.

Can scleral lenses be customized for my eyes?

Yes. Scleral lenses are individually designed to account for your eye’s shape and vision needs. Dr. Sturm can adjust the lens diameter, the space over the cornea, the edges where the lens rests, and the prescription. Follow-up visits help refine these features to support clear vision and comfortable wear.

How often will I need new lenses?

Replacement depends on lens condition, changes in your prescription or corneal shape, and how well the lenses continue to fit. Scratches, deposits, damage, or changes in vision can make replacement necessary. We assess these factors during follow-up care.

Book a scleral lens evaluation in Cibolo

InSight EyeCare offers scleral lens evaluations and fitting in Cibolo for patients from Schertz, Converse, Universal City, Selma, Garden Ridge, Marion, Santa Clara, New Braunfels, Live Oak, Windcrest, Kirby, St. Hedwig, Seguin, and northeast San Antonio, including military families at Joint Base San Antonio-Randolph (Randolph AFB).

If your glasses or current contacts do not provide satisfactory vision or comfort, book an exam with Dr. Sturm or call (210) 659-3937 for more information.