If you are considering scleral contact lenses in Las Vegas, one of the most common questions patients ask is whether these lenses are actually comfortable. Scleral contact lenses are large, rigid lenses that vault entirely over the cornea and rest on the sclera, the white part of the eye. When properly fitted by an experienced specialist, scleral lenses are remarkably comfortable and should not cause irritation or a sensation of something rubbing the eye. However, if discomfort does occur, it usually signals a fit issue that your doctor can address.
Unlike soft contact lenses, which are flexible and conform to the shape of the cornea, a scleral contact lens is rigid and holds its own shape. This is actually what makes scleral lenses so effective for patients with irregular corneas, severe dry eye, and other complex conditions.
Because the lens does not mold to the eye, it must be precisely fitted so the edges land correctly on the sclera. A well-fitted scleral lens rests gently on the white of the eye, just outside the limbus, which is the border where the cornea meets the sclera. The lens should not press down on the eye but instead align smoothly, allowing a reservoir of preservative-free saline to fill the space between the lens and the cornea.
This fluid reservoir serves two important purposes. First, it continuously bathes the cornea in moisture and nutrients, which is especially beneficial for patients with dry eye conditions. Second, it creates a smooth optical surface that corrects vision even when the cornea itself is irregular.
One of the most significant advantages of scleral lenses is that they actually protect against dryness rather than contributing to it. With soft contact lenses, the lens sits directly on the cornea and can absorb moisture from the tear film, leading to dryness and discomfort, especially later in the day.
Scleral lenses work differently. Because they vault over the cornea without touching it, the saline-filled chamber beneath the lens keeps the corneal surface hydrated throughout the entire wearing period. This makes scleral lenses an excellent option for patients who have been unable to wear other types of contact lenses due to chronic dry eye, Sjogren’s syndrome, or graft-versus-host disease.
Since dryness is rarely an issue with scleral lenses, the most common cause of discomfort is a fitting issue at the edge of the lens, known as edge lift. Edge lift occurs when the edge of the scleral lens is too flat for the curvature of the sclera, causing the edge to lift away from the eye’s surface. An easy way to picture this is placing a paper plate on a basketball. Because the plate’s flat edge does not match the curve of the ball, the edges lift up.
Edge lift can be subtle and difficult to detect, even for experienced practitioners. At Insight Vision Optometry, Las Vegas, our specialists use anterior segment OCT imaging alongside slit lamp evaluation to identify even minor edge lift that might otherwise go unnoticed. When edge lift is present, patients often report discomfort, lens movement during blinking, or air bubbles entering beneath the lens.
The good news is that edge lift is straightforward to correct. By steepening the lens edge in the affected area, the lens can be adjusted for a comfortable, stable fit. Raised areas on the sclera, such as pingueculae, pterygiums, or surgical blebs, can also affect how the lens edge sits. In these cases, the lens design is customized to vault over or accommodate the elevated tissue.
If you experience persistent discomfort, redness, blurred vision, or any sudden change in how your scleral lenses feel, contact your eye doctor promptly. These symptoms may indicate a fit adjustment is needed. If you experience sudden eye pain, significant vision loss, or signs of infection such as discharge or increasing redness, seek immediate care.
Scleral lens fitting requires advanced training and specialized equipment. At Insight Vision Optometry, Dr. Stephanie Woo, OD, FAAO, FSLS, has fitted over 2,000 specialty contact lens patients and is a nationally recognized scleral lens expert and GPLI Practitioner of the Year. Dr. Nathan Schramm, OD, FSLS, FBCLA, organized the first International Congress of Scleral Contacts and has authored textbook chapters on scleral lens fitting. Dr. Thanh Mai, OD, FSLS, brings additional expertise in keratoconus and irregular cornea management. Together, the team uses advanced technology including sMap 3D corneo-scleral topography and anterior segment OCT to ensure every scleral lens is precisely fitted for comfort and optimal vision.
To learn more about whether scleral contact lenses are right for you, call Insight Vision Optometry at 702-747-4070 or visit www.insightvisionlv.com to schedule a consultation.
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