Scleral Lens Clinic San Diego
The Scleral Contact Lens Clinic at ReVision Optometry serves patients with unusual eye diseases and conditions, including keratoconus, pellucid marginal degeneration (a variant of keratoconus), post-LASIK corneal ectasia (iatrogenic keratectasia), corneal transplantation, irregular astigmatism, and corneal scarring from trauma, previous corneal eye infection, and poor corneal surgery outcomes. While scleral lenses are most frequently prescribed to restore vision, they also have a role for providing comfort and protecting the sensitive cornea for extreme dry eye disease, including Sjögren’s syndrome and graft-versus-host disease (GVHD).
Our Scleral Contact Lens Clinic is directed by Brian Chou, OD, FAAO, FSLS, the first in San Diego County to earn Fellowship in the Scleral Lens Education Society. In addition to serving on the editorial review board for Review of Cornea & Contact Lenses, Dr. Chou often leads corporate-sponsored scleral contact lens workshops to share the art and science of scleral contact lens prescribing to other eye doctors. He is part of a start-up venture to develop a contact lens for underwater vision, using a scleral lens platform.
What are Scleral Contact Lenses?
Scleral lenses are large contact lenses which rest on the white part of the eye, creating a fluid-filled reservoir over the front eyeball surface. Scleral lenses effectively restore vision for a variety of eye conditions that otherwise respond poorly to conventional treatment.
These medical devices are approximately the size of a penny, designed to rest on the tough outer white coat, or sclera, of the human eye. When appropriately prescribed, they not only provide rigid-quality vision, but they afford the wearing comfort close to a soft disposable contact lens. The comfort of scleral lenses owes from these lenses vaulting over the sensitive cornea of the eye, the most sensitive part of the body. Due to their relatively large diameter, they are stable on the eye and do not dislodge nor eject, even in extreme fields of gaze. This makes them ideal for sports and aquatic activities, along with general activities of daily living. Scleral lenses also trap moisture against the sensitive cornea making them an effective treatment for extreme dry eye disease. Still, scleral lenses are most commonly prescribed for patients with an irregular cornea, where the surface of the eye is not smooth – whether keratoconus, poor outcomes after radial keratotomy and LASIK, previous corneal infection or trauma, or after corneal transplantation.
Why is the Prescribing Doctor Important?
Unlike most soft disposable contact lenses, success with scleral lenses is determined by the expertise and experience of the prescribing doctor, along with the clinic’s technological and staffing resources. Scleral lens prescribing for corneal disease is non-routine and requires complex critical thinking, creative problem solving, and social intelligence.
What do Scleral Lenses Feel Like?
When prescribed appropriately, scleral lenses approach the comfort of soft disposable contact lenses. Although this sounds remarkable, it is due to the scleral lenses resting on the relatively insensitive white part of the eye while vaulting over the highly sensitive cornea. Scleral lenses hold a reservoir of non-preserved saline against the eye surface, protecting the delicate underlying tissue from drying out and rubbing against the lens. Of course, there are variable outcomes from person to person.
How Much do Scleral Lenses Cost?
The total out-of-pocket cost of professional services and a pair of scleral lenses may range from as low as a $0 co-payment with vision plans that deem the contact lenses as “medically necessary,” to under $3,000 for self-paying patients. The cost also depends on the amount of professional time needed to bring you a desirable outcome, including if treatment is required for co-existing eye conditions that may impact successful contact lens wear. Your best approach is generally to schedule an examination at ReVision Optometry, and at this initial appointment, if you qualify for scleral lenses, you will receive an estimate of out-of-pocket costs before any prescribing services begin. The services and lenses are eligible for health savings accounts (HSAs) and flexible spending accounts (FSAs).
For many, there is no price too great to regain your independence, without incurring the cost, risk, variability, and permanence of surgery. Delayed treatment can cause lost productivity, missed opportunities, and reduced quality of life. Our scleral lens patients often mention that they wish they had sought out our clinic sooner. Take the next step by scheduling your appointment at ReVision Optometry today!