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What to Expect at a Scleral Lens Fitting

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A closeup of a scleral lens being held by an applicator.

Designed for those who need that extra bit of care, scleral lenses offer a unique and comfortable solution for a variety of eye conditions. Their specialized design requires a detail-oriented approach to fitting, which is key to unlocking their full potential. 

A scleral lens fitting involves an initial consultation, where your specific vision needs are assessed, followed by a comprehensive eye exam and a series of diagnostic tests. You’ll also undergo a trial fitting, allowing you to try the lenses on and experience how they function in your daily life for 1 to 2 weeks.

Afterwards, any adjustments can be made before the scleral lens measurements are finalized for full-time wear. 

All About Scleral Lenses 

Scleral contact lenses are oversized, specialized hard contact lenses that resemble small, snug bowls that rest on the sclera. 

Unlike traditional contact lenses, which sit on the cornea, scleral lenses vault over it, creating a dome filled with fluid that provides continuous hydration to the eye’s surface. The material of the lens allows oxygen to permeate through the lens, thereby maintaining eye health.  

Scleral lenses create a new, smooth surface that corrects vision issues while protecting the cornea. This unique design allows them to address certain eye conditions while providing clear, comfortable vision, and makes scleral lenses a great option for those who find traditional lenses uncomfortable or ineffective. 

Scleral lenses are particularly beneficial for people with:

  • Severe dry eyes
  • Irregular corneas
  • Keratoconus
  • Post-surgical complications

Their large size and customized fitting process helps ensure a snug fit, making the lenses more stable and reducing their risk of shifting or falling out. 

Importance of Scleral Lens Fittings 

Annual contact lens fittings are necessary for maintaining good lens fit, vision, and overall ocular health. Fittings are even more important for scleral contacts because of their specialized design.

Over time, subtle changes can occur in the shape and health of your eyes, which can affect how your lenses fit and perform. A well-fitted scleral lens is necessary for ideal performance. If a lens is too loose or too tight, it can negatively impact vision and comfort.

Lens fittings allow your optometrist to assess whether adjustments to the lens prescription or shape are needed. 

Plus, these appointments provide an opportunity to check for any signs of complications that may require attention, such as redness, swelling, or dry spots beneath the lenses. This allows your optometrist to ensure that your eyes are healthy enough to continue wearing contacts.

An optometrist explains the details of a scleral lens fitting to their patient.

What to Expect at Your Scleral Lens Fitting

The scleral lens fitting process is a comprehensive and highly personalized experience that helps patients receive lenses tailored to their specific needs. Here’s what you can expect from start to finish: 

  • The Initial Consultation: The appointment begins with an initial consult where your optometrist will review your ocular history. This conversation helps tailor the fitting process to your vision needs.
  • Comprehensive Eye Examination: A routine eye exam is conducted to evaluate the overall health of your eyes, update your vision prescription, and identify any underlying conditions that may affect lens fitting. 
  • Diagnostic Tests: During the ocular health assessment, your optometrist will use tools to assess the state of your cornea, sclera, and tear film. A diagnostic test for dry eye will assess the quality and quantity of the tear film, confirming that the lens can maintain adequate moisture and comfort for all-day wear. 
  • Corneal Topography: This non-invasive imaging technique maps the surface curvature of your cornea, providing a detailed picture of any irregularities. Corneal topography is necessary for creating lenses that offer superior comfort and visual clarity, particularly for patients with conditions like keratoconus or post-surgical corneas.
  • sMap3D Mapping Technology: This mapping technology takes fitting accuracy to the next level. This system captures a 3D image of the ocular surface, accommodating the unique contours of each eye. The measurements gathered by this process allow for customization of the scleral lens, providing an excellent fit that enhances comfort and performance.
  • Lens Trial and Assessment: After mapping, trial lenses are selected based on your eye’s specific measurements. These lenses are worn for a while to assess their fit and visual correction. You’ll have the opportunity to experience how the lenses feel and function in your daily life as you wear them for a week or two.
  • Lens Customization: Based on the trial outcome, your lenses are custom-designed to the specific shape of your eye. This may involve altering the curvature or diameter of the lens to achieve the ideal balance between comfort and vision. 
  • Final Lens Delivery and Education: Once your lenses are ready, you’ll return for a final fitting. During this visit, you’ll receive instructions on inserting, removing, and caring for your scleral lenses. Proper hygiene and handling techniques are discussed to promote lens longevity and eye health.
  • Follow-Up Appointments: Despite the lenses being finalized, these post-fitting, follow-up appointments confirm that your lenses continue to perform well. These check-ups allow for minor adjustments and monitoring of your eyes’ health, providing long-term success with your scleral lenses.

Throughout this process, a personalized approach works hand-in-hand with precision technology to provide the wearer with the most suitable possible vision correction with lasting comfort. 

Schedule Your Scleral Lens Fitting

Scleral contact lenses are often an appealing solution for those seeking improved vision and comfort. To fully reap the benefits of these lenses, contact lens fittings are vital. 

These appointments confirm that your lenses fit correctly while maintaining your ocular health and delivering the most ideal visual outcomes. With the right guidance and care, you can experience the world with clarity and comfort like never before.Connect with our team at Heartland Eye Consultants to schedule a consultation for your scleral lens fitting.

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.

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