Expert Scleral Lens Fitting the Key to Good Vision and Comfort for Patients with Keratoconus

Keratoconus patients that have received a scleral lens fitting conducted by a keratoconus specialist report better comfort and vision than they experienced with their previous form of keratoconus treatment. Keratoconus experts agree scleral contact lenses are the treatment of choice for keratoconus.

Dr. Richard Driscoll is a keratoconus specialist at Total Eye Care. Scleral contact lenses are the most effective treatment for patients with keratoconus. Scleral contact lenses are more comfortable and provide better vision than other keratoconus treatments.

What is Involved in Fitting  Scleral Contact Lenses?

A scleral lens fitting begins with a comprehensive eye exam. At the scleral lens fitting, we will evaluate your eyes with special instruments. By using high technology diagnostic instruments we can evaluate and monitor the health and shape of your cornea. With this new information, your keratoconus specialist will select an initial diagnostic lens.¹

Once the diagnostic lens has settled on your eye the doctor will evaluate the fit of the lens. Then our scleral lens specialist will determine what lens power will provide the best visual acuity. This information will allow your contact lens specialist to design a lens that is customized to the shape of your eye. Scleral contact lenses almost always allow a patient to achieve better visual acuity than they were able to achieve with glasses. We can maximize your visual acuity and comfort by customizing the lens according to the shape of your eye.²

Your new lenses will arrive approximately two weeks later. When you pick up your lenses will show you how to insert, remove, and care for them. We will schedule an appointment to see how your eyes are adapting to the new lenses. This visit will also allow us to see if any modifications will improve your fit, vision, and comfort.

How Long Does a Scleral Lens Fitting Take?

A scleral contact lens fitting typically takes about 2 hours. Approximately half of that time will be spent “test driving” a scleral contact lens. You will actually be able to experience the vision and comfort your customized scleral contacts will provide. The remainder of the time is used for measuring your eye for your initial diagnostic lens and evaluating the lens on your eye.

What Conditions are Treated with Scleral Contact Lenses?

Scleral contacts are not just for patients with keratoconus or pellucid marginal degeneration. Prescription scleral contacts can also help patients that have irregular astigmatism after corneal surgery. Common surgeries where post-surgical complications may require scleral contacts are;³

• Penetrating keratoplasty (corneal transplant)⁴
• LASIK⁵
• RK (radial keratotomy)
• Dry Eye Syndrome^6,7
• Sjogren’s Syndrome
• Corneal Scarring
• Irregular Astigmatism
• High Refractive Error

Does Insurance Cover a Keratoconus Scleral Lens Fitting?

Your medical insurance will not cover a scleral lens fitting; however, most vision plans do cover scleral lens fittings for certain conditions. Vision plans call this coverage medically necessary contact lens or visually necessary contact lens coverage.

How Do I Learn More?

We offer complimentary keratoconus treatment consults to help patients decide if they may benefit from scleral contacts. You can schedule your free consultation online with Dr. Driscoll at either our Colleyville or Keller/Southlake location. We can also schedule your appointment by calling 817.416.0333.

About Dr. Richard Driscoll

Dr. Driscoll is a therapeutic optometrist and scleral lens specialist at Total Eye Care in Colleyville, Texas. A 1988 Graduate of the Illinois College, Dr. Driscoll has been treating patients with keratoconus for over 30 years. Following Dr. Driscoll’s Graduation from the Illinois College of Optometry, he joined the residency program at the Tuscaloosa VA Medical Center in Tuscaloosa, Alabama. Dr. Driscoll likes to write. He wrote An Eye Doctor Answers: Explanations To Hundreds Of The Most Common Questions Patients Wish They Had Asked, available on Amazon.com, and The Patient’s Guide to Keratoconus which you can download here.

References

¹Schornack MM. Scleral lenses: a literature review. Eye Contact Lens. 2015;41:3–11. [PubMed]

²Harthan J, Nau CB, Barr J, Nau A, Shorter E, Chimato NT, Hodge DO, Schornack MM. Scleral Lens Prescription and Management Practices: The SCOPE Study. Eye Contact Lens. 2018 Sep;44 Suppl 1:S228-S232.  [PubMed]

³Jennifer S Harthan JS, Shorter E. Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations. Clin Optom (Auckl). 2018; 10: 65–74. [PubMed]

⁴Barnett M, Lien V, Li JY, Durbin-Johnson B, Mannis MJ. Use of scleral lenses and miniscleral lenses after penetrating keratoplasty. Eye Contact Lens. 2016;42:185–189. [PubMed]

⁵Kramer EG, Boshnick EL. Scleral lenses in the treatment of post-LASIK ectasia and superficial neovascularization of intrastromal corneal ring segments. Cont Lens Anterior Eye. 2015 Aug;38(4):298-303.  [PubMed]

⁶Bavinger JC1, DeLoss K, Mian SI. Scleral lens use in dry eye syndrome. Curr Opin Ophthalmol. 2015 Jul;26(4):319-24. [PubMed]

⁷Kok JH1, Visser R. Treatment of ocular surface disorders and dry eyes with high gas-permeable scleral lenses. Cornea. 1992 Nov;11(6):518-22. [PubMed]