Scleral contact lenses are one of the most transformative technologies in modern optometry, and they remain one of the most underutilized — largely because most patients have never heard of them. At Harnos Optometry in New Paltz, NY, scleral lens fitting is a core specialty, and we've seen what these lenses can do for patients who had resigned themselves to poor vision or chronic discomfort. If you have keratoconus, severe dry eye, an irregular cornea, or a prescription that conventional lenses can't adequately correct, scleral lenses may be exactly what you've been looking for.
What Makes Scleral Lenses Different
A conventional soft contact lens sits directly on the cornea, conforming to its surface. For patients with irregular corneas — whether from keratoconus, corneal scarring, or post-surgical changes — this means the lens surface is also irregular, producing distorted, unstable vision.
A scleral lens is a large-diameter rigid gas-permeable lens that arches completely over the cornea and rests on the sclera — the white of the eye — without touching the corneal surface at all. The space between the back of the lens and the front of the cornea is filled with a sterile saline solution. This creates two profound advantages: the lens surface is perfectly smooth regardless of the corneal shape beneath it (producing dramatically sharper vision), and the fluid reservoir provides continuous moisture to the corneal surface throughout the day (providing extraordinary comfort for dry eye patients).
Conditions Scleral Lenses Address
- ◆Keratoconus — the irregular cone-shaped cornea that makes conventional lens correction inadequate. Scleral lenses vault the irregular surface entirely and provide the clearest, most stable vision available without surgery
- ◆Severe or chronic dry eye disease — the fluid reservoir provides all-day corneal moisture that no artificial tear can match. Many severe dry eye patients wear sclerals for 12–16 hours without discomfort
- ◆Post-surgical corneal irregularities — after LASIK, PKP (corneal transplant), radial keratotomy, or other procedures that alter corneal shape, scleral lenses can provide vision correction that glasses and soft lenses cannot
- ◆High or complex refractive errors — prescriptions outside the range of soft lenses, or complex astigmatism that soft lenses can't fully correct
- ◆Ocular surface disease — conditions like Stevens-Johnson Syndrome or graft-versus-host disease that damage the ocular surface and make conventional lens wear impossible
Our Scleral Lens Fitting Process
With over 30 scleral lens trial designs and partnerships with two independent specialty labs, we have the resources to find the right fit for virtually any eye. We begin with detailed corneal topography mapping and a comprehensive evaluation, then select an appropriate trial lens from our fitting set. Most patients are amazed by how comfortable scleral lenses feel at insertion — because they rest on the insensitive sclera rather than the highly sensitive cornea, they're often more comfortable from the first wearing than any lens they've tried before.
If you've been struggling with vision that glasses can't fully correct, or discomfort that drops and conventional lenses can't resolve, come see us in New Paltz. Scleral lenses may be the answer.