Scleral lenses for keratoconus and irregular corneas
When the cornea becomes too irregular for glasses to correct, a scleral lens bypasses the problem rather than compensating for it. NVISION Eyecare fits scleral and specialty contact lenses from our Rosedale practice near Albany.
Book an appointment
No referral needed, for any appointment — including specialty Ortho-K, dry eye and keratoconus consultations.
Send a messageA smooth optical surface over an irregular cornea
A scleral lens is a rigid gas-permeable lens made much larger than a normal contact lens. Instead of sitting on the cornea, it vaults right over it and rests on the sclera — the white of the eye — which is far less sensitive and far more regular in shape.
The space between the lens and the cornea fills with sterile saline. That fluid reservoir does two things at once: it bathes the cornea all day, and it replaces the eye’s irregular front surface with a smooth optical one. Light then focuses through that smooth surface rather than through the distorted cornea underneath.
This is why sclerals can deliver clear vision in eyes that glasses simply cannot correct. The distortion is not being compensated for — it is being bypassed.
When scleral lenses are the right answer
Keratoconus and corneal ectasia
This is the most common reason our patients are fitted with sclerals. As keratoconus progresses, the cornea thins and steepens into an irregular cone, and a point comes where glasses and soft lenses can no longer produce usable vision. Sclerals are frequently the option that restores it.
Patients who cannot tolerate corneal RGP lenses
Conventional rigid lenses sit directly on the cornea, and many people never adapt to that sensation. Because a scleral lens bears its weight on the sclera instead, patients who gave up on rigid lenses years ago often find sclerals comfortable from the first fitting.
Severe ocular surface disease
The permanent fluid reservoir makes sclerals useful in some severe dry eye and ocular surface cases, where the eye benefits from being continuously bathed rather than intermittently lubricated.
Irregular corneas after surgery or injury
Corneas left irregular by previous surgery, transplant or trauma present the same optical problem as keratoconus, and respond to the same solution.
What the fitting process involves
Scleral lenses are custom-made, so the fitting is a process rather than a single appointment. It generally runs like this:
- Assessment and corneal mapping — corneal topography measures the shape of the front of your eye in detail and establishes whether sclerals are the right option.
- Trial fitting — diagnostic lenses are placed on the eye and assessed for how well they vault the cornea, how they land on the sclera, and what vision they deliver.
- Custom lens ordered — the final lens is made to the measurements taken, and adjusted for your prescription.
- Collection and training — you are taught insertion, removal, filling the lens with saline and the cleaning routine. This takes longer than for soft lenses and is worth not rushing.
- Follow-up reviews — the fit is checked on the eye after wear, and adjustments made. More than one revision is normal and is not a sign anything has gone wrong.
- Ongoing monitoring — corneal health and lens fit are reviewed periodically, and for keratoconus the corneal shape is tracked for progression.
How long adaptation takes varies. Most patients are wearing their lenses through a full day within the first few weeks, but the fitting phase itself depends on how irregular the cornea is.
There is a subsidy pathway for keratoconus
This is worth knowing before you rule sclerals out on cost: NVISION Eyecare holds a contract with the Ministry of Health to administer a subsidy for severe eye conditions requiring contact lens correction, and keratoconus is the most common qualifying condition.
If you have been diagnosed with keratoconus, or corneal mapping here indicates it, ask us whether the subsidy applies to your case. We can also process Southern Cross claims on the spot as an Easy Claim partner.
| Service | Fee |
|---|---|
| Adult soft contact lens fitting packageIncludes eye exam | $235 |
| Soft contact lens fitting package (under 16)Includes eye exam | $205 |
Scleral lenses are custom-made and quoted individually after assessment — they are not covered by the soft lens package above.
Scleral lens questions
Are scleral lenses uncomfortable?
Can I still be fitted if glasses no longer correct my vision?
How long does the fitting take?
Is there funding for scleral lenses?
Do scleral lenses stop keratoconus getting worse?
What do scleral lenses cost?
Book a keratoconus assessment with corneal mapping
Corneal topography tells us whether scleral lenses are the right option before anything is ordered.