Scleral Lenses for Keratoconus: A Personalized Fit

Keratoconus can make clear, stable vision difficult to achieve with ordinary glasses or soft contact lenses. As the cornea becomes thinner and develops an irregular shape, patients may experience blurry vision, glare, ghost images, or frequent prescription changes.\
 

At League City Eyecare & Eyewear, we provide specialty contact lens care in League City, including customized scleral lenses for patients with keratoconus. A personalized fitting allows us to design the lens around the unique shape and visual needs of your eyes.
 

Why Does Keratoconus Make Vision More Difficult?

The cornea is normally smooth and rounded, helping light focus clearly inside the eye. With keratoconus, the cornea becomes more cone-shaped and irregular.
 

Standard soft contact lenses closely follow the shape of the cornea. If the surface underneath is irregular, conventional lenses may not provide the stable optical surface needed for consistently sharp vision.
 

Glasses may still work for some patients with mild keratoconus, but more advanced irregularity often requires a specialized contact lens approach.
 

How Do Scleral Lenses Work?

Scleral lenses are larger rigid gas permeable lenses designed to vault over the cornea instead of resting directly on it. The lens lands on the sclera, which is the white portion of the eye.
 

Before insertion, a scleral lens is filled with sterile preservative-free saline. This fluid remains between the lens and cornea during wear.
 

Potential advantages for patients with keratoconus include:
 

• A smooth optical surface over an irregular cornea

• More stable vision than some conventional contacts can provide

• Minimal direct contact with the sensitive corneal surface

• A fluid reservoir that remains over the cornea during wear

• A customized design based on individual eye shape
   

Results vary, and scleral lenses are not automatically the best option for every patient with keratoconus.
 

What Happens During a Scleral Lens Fitting?

A specialty contact lens fitting involves more than choosing a lens based on prescription strength. At our League City office, we evaluate your corneal shape, eye health, vision, and previous contact lens experience.
 

A diagnostic scleral lens may be placed on the eye so we can evaluate how well it clears the cornea and rests on the sclera. We also check visual clarity and comfort after the lens has had time to settle.
 

Because scleral lenses are highly customized, adjustments may be needed before the final fit is achieved.
 

Why Is the Fit So Important?

A properly fitted scleral lens needs enough clearance to vault over the cornea while distributing its weight appropriately across the sclera. A lens that does not fit correctly may cause discomfort, redness, unstable vision, or other problems.
 

Follow-up visits allow us to evaluate the fit after you have worn the lenses during normal daily activities. We can also check the cornea and surrounding tissues to make sure your eyes remain healthy.
 

You will also learn how to insert, remove, clean, and fill the lenses safely. Scleral lenses should never be filled or rinsed with tap water. Use only the sterile solutions recommended by your eye doctor.
 

Do Scleral Lenses Stop Keratoconus Progression?

Scleral lenses improve vision but do not stop keratoconus from progressing. If your corneal shape continues to change, additional monitoring or referral for treatments such as corneal cross-linking may be appropriate.
 

Regular eye exams remain important even when your lenses provide excellent vision. If you develop significant pain, redness, light sensitivity, discharge, or sudden changes in vision, remove your contacts and seek prompt eye care.
 

If keratoconus is making glasses or standard contacts less effective, contact League City Eyecare & Eyewear at 3725 E League City Pkwy, Suite 100, League City, TX 77573 by calling (281) 305-1609 to schedule a specialty contact lens evaluation and learn whether scleral lenses may be right for you.