If your doctor has recommended scleral lenses, you may be wondering what the fitting process actually looks like. Scleral lenses are large-diameter gas permeable contact lenses that vault over the entire cornea and rest on the white part of your eye, called the sclera. They are one of the most effective solutions for patients with keratoconus, irregular corneas, severe dry eye, and other complex vision conditions. Because they are designed to match the unique shape of your eyes, the fitting process is highly customized and involves careful precision at every step.
At Insight Vision Optometry in Las Vegas, our specialty contact lens team includes Dr. Stephanie Woo, Dr. Nathan Schramm, and Dr. Thanh Mai, all of whom are Fellows of the Scleral Lens Society. Together, they have fitted thousands of patients with scleral lenses and bring nationally recognized expertise to every fitting appointment. Here is what you can expect during your scleral lens fitting journey.
The first thing to understand is that scleral lens fitting is not a one-size-fits-all process. Every patient is different, and every eye is different. Your fitting may require several visits to our office, and it is important to be patient as your doctor works through each step. Your practitioner must dedicate significant time and attention to your specialized needs, carefully evaluating how each lens interacts with your unique eye shape.
During the fitting, your doctor will try different scleral lenses on your eyes to find the best possible fit. The number of trial lenses varies from patient to patient. Some patients may only need one or two lenses tried on each eye, while others may require ten or more. If your practitioner uses advanced technology to assist with the fitting, such as sMap 3D corneo-scleral topography or anterior segment OCT imaging, you may need fewer trial lenses. Insight Vision Optometry is the only clinic in Nevada equipped with sMap 3D technology, which helps map the detailed surface of both the cornea and sclera for a more precise starting point.
When you arrive for your fitting appointment, your practitioner will start by getting you comfortable. You will be set up with some paper towels and an apron or dental bib to protect your clothing. This is because the fitting process involves saline solution and special dyes that can drip during lens insertion and removal. It is completely normal and nothing to worry about.
Your doctor will then select a diagnostic lens, clean it, and prepare it for placement on your eye. The lens is filled with a non-preserved saline solution before it is applied. In many cases, a yellow fluorescein dye is also placed in the bowl of the lens. This dye is a valuable tool that helps your doctor assess the fit by making it easier to see how the lens sits on your eye and how the fluid layer beneath the lens is distributed.
Scleral lens insertion requires a specific technique, and your practitioner will guide you through every step. Most practitioners will ask you to look down at the ground during insertion. You will hold down your lower eyelid while your doctor controls your upper lid. While you maintain your downward gaze, the practitioner will place the scleral lens on your eye with a smooth, quick motion. The saline-filled lens creates a fluid reservoir between the lens and your cornea, which is one of the reasons scleral lenses are so comfortable for patients with dry eye and corneal irregularities.
If you feel nervous about this part, know that our team performs this process daily and will walk you through it at a pace that feels comfortable for you.
After the lens is placed on your eye, your doctor will carefully evaluate the fit using a slit lamp microscope and other instruments. They will look at several factors, including how the lens vaults over the cornea, how it lands on the sclera, and whether the fluid reservoir beneath the lens is appropriate.
If adjustments are needed, your doctor may remove the lens and try a different one. This trial-and-error process is a normal and expected part of the fitting. Once your practitioner is satisfied with the overall fit, they may perform additional tests using specialized instruments to evaluate the fit at the highest level. It is very common to wait 20 to 30 minutes before these additional tests to allow the lens to settle into its final position on your eye.
If the scleral lens is being used to correct your vision, your doctor will also determine what prescription power needs to be incorporated into the lens. Before removing the lens, the practitioner may do one final check to confirm whether any small adjustments should be made to the order.
After the diagnostic fitting is complete, your practitioner will contact a specialized laboratory to order your custom scleral lenses. Because these lenses are manufactured specifically for your eyes, fabrication time can range from one to four weeks, depending on the complexity of the lens design and the laboratory. More complex prescriptions or advanced lens designs, such as wavefront-guided lenses or channeled scleral lenses, may take longer to produce.
When your custom lenses arrive, you will return to our office for a dispense visit. During this appointment, your practitioner will insert the new lenses, evaluate the fit on your eyes, and check your vision. If the fit and prescription meet the expected standards, you will move forward with training. If any changes are needed, your doctor can reorder the lenses at that time.
Our team will spend as much time as you need to make sure you feel confident handling your lenses at home. Many patients are surprised by how quickly they become comfortable with insertion and removal after a thorough training session.
Insight Vision Optometry in Las Vegas was originally founded as a specialty contact lens clinic and remains one of the most recognized scleral lens practices in the country. Dr. Stephanie Woo, the founder, is a recipient of both the GPLI Practitioner of the Year and Scleral Lens Practitioner of the Year awards. She is also the only practitioner in Nevada certified to fit EyePrintPro custom scleral lenses for the most complex cases.
Our practice draws patients from across Nevada and from around the country who need expert-level scleral lens care. Whether you are dealing with keratoconus, post-surgical complications, severe dry eye, or another corneal condition, our team is here to help you see clearly and comfortably. To schedule a scleral lens consultation, contact our office at 702-747-4070 or visit www.insightvisionlv.com to book an appointment online.
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