SCLERAL LENSES

Prelude-A brief classification of Contact Lenses:

Contact lenses are categorised into two main groups: soft & hard.
Soft contact lenses are an alternative to spectacles, are mass produced and have more or less a one-size-fits-all design. They provide excellent vision providing the cornea (the most front surface of the eye), is healthy & smooth.
Hard lenses are custom made for each individual eye and are used when soft lenses & spectacles do not improve the vision. Examples include cases of a high spectacle script or an irregular corneal shape. Hard lenses are more breathable than soft lenses, but are initially more uncomfortable, are affected by dry eyes and can dislodge easily. They are generally < 10mm in diameter and are called RGP (for rigid gas permeable).

Advantages of Scleral Lenses over RGP’s:

Scleral lenses are also both hard & custom made, but larger in size than RGP’s.
They tackle the three main downsides of the traditional RGP lenses by offering high comfort, remaining stable without moving out of place, and not being impacted by dry eyes. In fact, they frequently alleviate the symptoms of dry eyes.

For Whom Are Sclerals Intended?

Irregular corneal shapes, such as those found in Keratoconus or Corneal Transplants. The majority of cases in our practice involve individuals belonging to this category.

Severe dry eye syndrome.
High spectacle script where soft contact lenses are not available in these high powers or spectacles will be too thick & heavy.
Individuals who experience discomfort with conventional contact lenses.
Patients requiring visual correction subsequent to eye surgical procedures.
Those affected by complications arising from eye injuries or specific conditions like Stevens-Johnson syndrome.

HOW DO SCLERALS WORK?

Scleral lenses work by creating a vaulted space between the lens and the cornea and resting on the white part of the eye (sclera). This vaulted space gets filled with sterile saline solution, which helps in several ways:
1. Corneal Protection: By vaulting over the cornea, the lens prevents direct contact with the sensitive corneal surface. This helps in cases of post-surgical procedures or with corneal injuries.
2. Smooth Vision Correction: The space between the lens and the cornea masks irregularities on the corneal surface. This is possible as the layer of saline between the lens and the cornea is a liquid, which fills all the gaps of the irregular cornea, essentially smoothing out the corneal surface. This results in clearer and sharper vision, particularly for individuals with conditions like keratoconus or irregular astigmatism.
3. Constant Moisture: The vaulted space filled with saline solution acts as a reservoir, ensuring a continuous and consistent supply of moisture to the cornea. This can be highly beneficial for people experiencing severe dry eye.
4. Stability and Comfort: The vaulting design of scleral lenses, coupled with their larger size and custom-fit nature, contributes to better stability and comfort.
In essence, the vaulting of scleral lenses offers protection, enhanced vision correction, continuous moisture, and increased comfort, making them a valuable option for various eye conditions and improving overall eye health.

OUR SCLERAL LENSES.

Our scleral lenses are custom designed for each individual eye. We prefer a full scleral design which ranges from 16.5mm in diameter to 18.5mm. This as opposed to a smaller (15.5Mmm) mini-scleral design, which often does not have limbal clearance. Limbal clearance is vital for the medium to long term oxygen supply to the cornea.

We have been fitting scleral lenses since 2013. The fitting process does take a few appointments to finalise, but the results have been very successful due to the comfort and superior vision offered by sclerals over the alternatives. If you are not succeeding with your current contact lenses, either due to poor vision, poor comfort, dry eye, or a combination of the above, give our scleral lenses a chance.