If you have dry eye syndrome, keratoconus, a history of corneal transplant, or simply find conventional contact lenses uncomfortable, scleral contact lenses may be the answer. At Insight Vision Optometry in Las Vegas, our specialty contact lens team fits scleral lenses for patients who have not found success with standard soft or gas permeable lenses.
Standard soft contact lenses are designed for eyes with a relatively regular corneal shape. If your cornea is irregularly shaped or your eyes are chronically dry, conventional lenses may not fit properly, may shift when you blink, or may worsen your symptoms. Common conditions that can make standard contact lens wear a struggle include:
Scleral lenses are large-diameter gas permeable lenses that are custom-designed to fit each patient’s unique eye shape. Unlike standard contacts that sit directly on the cornea, scleral lenses vault over the entire corneal surface and rest on the sclera. This design provides several key advantages.
A fluid reservoir of preservative-free saline fills the space between the lens and the cornea. This reservoir continuously hydrates the eye throughout the day, making scleral lenses especially beneficial for patients with dry eye, Sjogren’s syndrome, or graft-versus-host disease. The saline layer also optically neutralizes corneal irregularities, providing clear, sharp vision even for patients with keratoconus, corneal scarring, or post-surgical complications.
Because the lens does not touch the cornea, there is no friction or pressure on the sensitive corneal surface. This makes scleral lenses significantly more comfortable than smaller gas permeable lenses for most patients.
Standard soft contact lenses typically measure around 14mm in diameter, while conventional gas permeable lenses are about 9mm. Scleral lenses range from approximately 14.5mm to 24mm in diameter. This larger size allows the lens to form a protective dome over the entire cornea, creating a cushion of tears between the lens and the eye. The larger diameter also provides excellent stability, meaning the lens does not shift or pop out during normal activities.
A scleral lens fitting begins with detailed measurements of your cornea and sclera. At Insight Vision Optometry, Las Vegas, our doctors use advanced corneal topography and sMap 3D corneo-scleral imaging to capture a precise map of your eye’s surface. This imaging technology, available at only a few clinics in Nevada, ensures that your custom scleral lenses match your unique corneal curves and scleral contours for optimal comfort, vision, and all-day hydration.
During the fitting appointment, diagnostic lenses are placed on your eyes to evaluate the fit and determine your prescription. The doctor then works with the laboratory to design your personalized lenses. Once the custom lenses arrive, you will return for a dispensing visit where the fit and vision are verified, and you are trained on lens insertion, removal, and care.
While scleral lenses do not cure keratoconus, they are one of the most effective ways to correct the vision problems it causes. Because keratoconus creates an irregular, cone-shaped cornea, glasses and standard contact lenses often cannot provide adequate correction. Scleral lenses vault over the cone without touching it, delivering clear vision while being comfortable for most patients. For patients with advanced keratoconus, custom-designed scleral lenses using 3D imaging offer the best results.
Corneal transplants have a high success rate, but the eye often develops irregular astigmatism or nearsightedness as it heals, which can take a year or longer. Scleral lenses are an excellent option for achieving clear, comfortable vision after a corneal graft, since they conform to the new corneal shape without putting pressure on the healing tissue.
If you experience sudden vision loss, severe eye pain, new flashing lights or floaters, or a red and painful eye, contact your eye doctor immediately or visit an emergency room. These symptoms may indicate a serious condition that requires prompt treatment.
If standard contact lenses are not working for you, scleral lenses may provide the comfort and clarity you have been looking for. Dr. Stephanie Woo, OD, FAAO, FSLS, Dr. Nathan Schramm, OD, FSLS, FBCLA, and Dr. Thanh Mai, OD, FSLS are nationally recognized scleral lens specialists at Insight Vision Optometry. Call 702-747-4070 or visit www.insightvisionlv.com to schedule your scleral lens consultation.
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