Why Are Scleral Lenses Expensive?

Why Are Scleral Lenses Expensive?

by Brian Chou, OD, FAAO, FSLS

  • June 18, 2023

If you wear scleral lenses, you likely discovered that disposable soft contact lenses will not bring you a satisfactory outcome. Scleral contact lens wearers have unique eye-related requirements where common treatment fails. Scleral lenses are expensive, often approaching $1,000 each. Highly customized scleral lenses like EyePrintPRO can approach $3,000 each. The cost of the lenses excludes the financial obligation for professional evaluation and prescribing services.

You may wonder why a simple-looking plastic polymer commands pricing more befitting an engagement ring. Of course, for patients with keratoconus and other complex eye diseases, scleral lenses are worthwhile. Their value in restoring a normal life is priceless.

High Complexity of Therapeutic Contact Lens Prescribing

Scleral contact lens prescribing for eye disease like keratoconus is the most knowledge- and experience- intensive professional contact lens service. Few eye doctors routinely provide these scleral lens services and do it well. Instead, most conscientious eye doctors refer these patient cases to a specialized practice with specific expertise, equipment, and operational workflow. With significant time and capital investments to properly build a scleral lens referral practice along with specialized training for the eye doctor and their staff, this cost is built into the services as well as the scleral lens cost. These costs go above and beyond the usual overhead costs of a business.

Supply and Demand

Keratoconus affects a minority of the population. The most recent large-scale population study found 1 in 375 with keratoconus. Similarly, other optically complex conditions such as post-LASIK ectasia and corneal scars after microbial keratitis, where scleral contact lenses compellingly restore vision, represent just a small sliver of the mass population even when taken together. This is why only 1.4% of the U.S. contact lens market is represented by scleral contact lenses. Scleral lenses are not a mass-market treatment and as such, the market supply and demand are constrained which elevates cost.

Fortunately, there are increasing efforts to diagnose new cases of keratoconus. In years previous, many cases of keratoconus would go completely undiagnosed. Today, increasing, and improved screening for keratoconus, is growing the number of identified keratoconus. In turn, this incentivizes other specialty laboratories to enter the scleral lens space, increasing the scleral lens capabilities and eventually decreasing the overall cost of these lenses. Just don’t expect this to happen quickly.

Cheap Scleral Lens, Expensive Fabrication

While the gas permeable material of a scleral lens itself is relatively inexpensive, the fabrication of these lenses is not, and nor is the research and development to bring it to regulatory approval. The computer numerical controlled (CNC) lathes for fabrication are half a million dollars and are proportionately expensive to maintain. These lathes use a cutting tool with a diamond tip, so diamonds are consumed in the manufacturing of your scleral lenses. The intellectual property that underlies these proprietary lenses also results in royalty payments that are baked into the cost of the lenses. Because the prescribing of these custom lenses is a process which can involve multiple lens exchanges within a defined service period, the global fee incorporates the manufacturing of multiple lenses. Lastly, reasonable profit in the sale of these lenses allows the specialty laboratories to reinvest into their operations. That way, your scleral lens design is consistently available in the future.

ReVision Optometry is a referral-based practice in San Diego providing scleral contact lens services for patients with keratoconus and other complex eye conditions. To schedule an appointment, request your examination online or call our office at 619.299.6064.