All About Scleral Contact Lenses

What Are Scleral Contact Lenses?

Scleral lenses are large-diameter, custom-designed contact lenses that vault over the cornea and rest gently on the white part of the eye (the sclera).

Unlike standard contact lenses, scleral lenses create a fluid reservoir between the lens and the eye. This layer of sterile saline:

• Smooths irregular corneas
• Protects fragile ocular surfaces
• Provides constant hydration
• Dramatically improves vision in complex cases

They are one of the most transformative tools in modern specialty contact lens practice.

At Illume Eye Care in Ponsonby, we fit scleral lenses for patients across Auckland who have been told they are “hard to fit” or who thought contact lenses were no longer an option.

Who Are Scleral Lenses For?

Scleral lenses are often recommended for:

• Keratoconus
• Post-LASIK or post-corneal graft irregularity
• Severe dry eye disease
• Ocular surface disease (including Sjögren’s)
• Corneal scarring
• High or irregular astigmatism
• Failed soft or RGP lens wear

They are especially powerful when vision and comfort both need to be restored.

Why Are They Different?

Traditional lenses sit directly on the cornea. Scleral lenses:

✔ Vault over the cornea
✔ Rest on insensitive scleral tissue
✔ Create a protective tear reservoir
✔ Provide exceptional optical quality

For many patients, vision becomes sharper and more stable than glasses, even in complex corneal conditions.

Scleral Lenses for Dry Eye

Scleral lenses can act like a liquid bandage for the eye. The fluid reservoir:

• Shields the cornea from friction
• Reduces evaporation
• Improves comfort in moderate to severe dry eye
• Supports healing of the ocular surface

For patients with advanced dry eye who haven’t responded to drops alone, scleral lenses can be life-changing.

The Fitting Process

Scleral lenses are fully customised. At Illume, your fitting includes:

• Corneal topography and ocular surface assessment
• Trial lens fitting
• OCT and slit lamp evaluation of vault and landing zone
• Fine-tuning for comfort and vision
• Training in insertion and removal

It may take multiple visits to achieve optimal results but the outcome is worth it.

Are They Comfortable?

Yes, when properly fitted. Although they look large, they are often more comfortable than small rigid lenses, because they rest on less sensitive tissue.

Most patients adapt well with guidance and support.

Why Choose Illume for Scleral Lenses?

Scleral lens fitting is a subspecialty skill.

At Illume Eye Care, we:

• Focus on complex contact lens fitting
• Manage keratoconus and irregular corneas
• Co-manage with ophthalmologists and fellow optometrists
• Combine scleral lenses with dry eye therapy when needed

If you’ve been told “nothing else will work”, we’d love to reassess.