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Contact Lenses for Dry Eye: Scleral Lenses

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A close up of a woman putting a scleral contact lens in her eye to benefit her severe dry eye symptoms.

Contact lenses can be difficult to wear if you suffer from dry eyes, a condition an estimated 16 million Americans have. However, some contact lenses can be comfortable and even beneficial if you have dry eyes. Your eye doctor might recommend scleral contact lenses if you are a good candidate.

Continue reading to learn more about scleral lenses, including how they benefit patients with dry eyes. 

What Is Dry Eye? 

Dry eye is a common condition where your tears cannot effectively lubricate your eyes, leading to irritation. Tears typically spread across your eye’s surface, hydrating and protecting it. When your tears are not balanced, they cannot function as effectively, leading to dry eyes. 

Dry eyes can lead to several uncomfortable symptoms, including: 

  • Eyes that sting, burn, or feel scratchy 
  • Stringy mucus in or around the eyes
  • Light sensitivity 
  • Eye redness
  • Foreign object sensation 
  • Difficulty wearing contact lenses
  • Watery eyes
  • Blurred vision
  • Eye fatigue 

The cause of dry eyes can vary from medical conditions and medications, to age and allergies.  

What Causes Dry Eye? 

While dry eyes can happen for many reasons, the cause is related to the homeostasis or balance of the tear film

Your tear film has 3 layers (mucus, water, and oil) that work together to keep your eyes healthy. Each layer has a different function, keeping tears stable on your eye, hydrating and protecting the eye, and preventing tear evaporation. 

Depending on the tear film’s instability, you may experience decreased tear production, increased tear evaporation, or a combination of these problems. 

Decreased Tear Production

Decreased tear production occurs when your body doesn’t make enough tears. Your lacrimal (tear) glands don’t produce enough water to hydrate your eyes, leading to dry eye symptoms. 

It’s common for tear production to slow down with age, but other factors can contribute, including: 

Increased Tear Evaporation 

Increased tear evaporation happens when your tears lack the oil needed on the surface to prevent evaporation. Dry eyes typically occur due to issues with the meibomian glands in the lids, which provide the oil in your tear film. When problems arise in the oily layer of the tear film, it leads to dry eye symptoms. 

Common causes of increased tear evaporation include: 

  • Meibomian gland dysfunction
  • Rosacea or inflammation of the skin and eyelids
  • Infrequent blinking commonly caused by computer or screen use
  • Eyelid problems like entropion & ectropion 
  • Eye allergies
  • Preservatives in over-the-counter eye drops
  • Wind, smoke, or dry air
  • Work environment
  • Vitamin A deficiency  

You may have trouble wearing contact lenses when your eyes lack enough moisture for any reason above. Thankfully, you can enjoy comfortable vision with the help of scleral lenses. 

A hand placing a a customized scleral contact lenses on their finger tip to help achieve more comfortable and clear vision

What Are Scleral Lenses?

Scleral lenses are specialty contact lenses that cover your entire corneal surface. Unlike traditional lenses that rest on your cornea, scleral lenses vault over it, resting on the sclera (the white of your eye). Scleral lenses are beneficial if you have an irregular cornea or hard-to-fit eyes. 

Scleral lenses are larger and firmer than conventional contact lenses. These contacts are similar to rigid gas permeable lenses, offering: 

  • Easy handling
  • Greater durability
  • Clear, sharper vision 

Additionally, scleral lenses are less likely to dislodge because of their size. The lens’s design helps an irregular cornea become a smooth optical surface. The large-diameter lens makes scleral lenses comfortable to wear. 

Dry Eye Benefits

Scleral lenses can help you enjoy clear, comfortable vision if you have dry eyes because of the fluid reservoir between the eye surface and the back of the lens.  This reservoir constantly washes over your eye, keeping it hydrated and relieving dry eye symptoms. 

These lenses won’t permanently fix dry eye, but they can improve your quality of life. Research shows they can help patients with severe dry eye symptoms

Scleral lenses have several benefits, including being fully customizable to irregular eyes. 

Customized Scleral Lenses: sMap3D Technology

Custom scleral contact lenses can give you a personalized, comfortable fit. Your eye doctor uses specialized technology, like the sMap3D, to scan and map your eye. This technology measures thousands of different areas of the cornea and sclera, helping your doctor design a pair of lenses that fit your unique eyes. 

You’ll have a trial period after your eye doctor fits you in your custom lenses. You and your eye doctor will work together to ensure your new lenses fit comfortably, and you need no further adjustments. Once the fitting process is complete, you can enjoy clear, comfortable vision. 

Enjoy Comfortable Contact Lenses

You deserve to enjoy clear, comfortable vision in contact lenses. While dry eyes use to prevent this, scleral contact lenses are becoming a readily available option for those who suffer from dry eye syndrome. Contact your eye doctor at Heartland Eye Consultants if you’re interested in scleral contact lenses and get the vision and comfort you are looking for from a fully customizable contact lens.

Written by Dr. Holly Ternus

Dr. Holly Ternus is originally from Torrington, Wyoming, and graduated from the University of Nebraska-Lincoln with a degree in biological sciences. She graduated with Honors from The New England College of Optometry and completed internships with Honors at South Boston Community Health Center with an emphasis in glaucoma and narrow-angle glaucoma, Togus Veterans Affairs Medical Center with an emphasis in ocular disease, Lifetime Eyecare in Houston fitting specialty contact lenses, and Brooke Army Medical Center in San Antonio.

Dr. Ternus practiced with ophthalmology in the Dallas/Fort Worth area, specializing in ocular disease, dry eye disease, and emergency care. She then transitioned into primary care, fitting specialty contacts for keratoconus, post-RK, corneal ectasia, and irregular corneas.

Dr. Ternus is an active member of the Nebraska Optometric Association, American Optometry Association, and American Academy of Optometry. She received her fellowship with the American Academy of Optometry in 2018 and is a graduate of the Nebraska Optometric Association’s Leadership Institute. She also received her fellowship in the Scleral Lens Education Society and is the first in Nebraska to have completed this honor.

Outside of work, Dr. Ternus enjoys spending time with her husband and 2 children, snowboarding, skiing, water sports, watching Husker football, and everything that involves being outdoors.

More Articles By Dr. Holly Ternus

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