Summary: Are Scleral Lenses Right for You?
Scleral lenses are advanced specialty contact lenses designed to provide exceptional comfort and vision correction for a variety of eye conditions. Whether you have dry eyes, irregular corneas, or simply struggle with standard contact lenses, scleral lenses offer a unique solution by vaulting over the cornea and resting gently on the sclera.
Traditional treatments for dry eye syndrome, such as lubricant drops and other therapies, often fail to provide lasting relief. Scleral lenses are typically considered after insufficient response to these initial treatments.
Scleral Lens Center of Hawaii specializes in custom scleral lens fitting, serving patients across Honolulu, Oahu, the neighbor islands, and visitors seeking expert scleral contact lens care.
At a Glance:
- Scleral lenses create a fluid reservoir that cushions the eye, enhancing comfort and protecting the ocular surface
- They are ideal for patients with irregular corneas, post-surgical eyes, or those who cannot tolerate traditional contact lenses
- Scleral lenses are especially beneficial for patients with severe dry eye, including those with autoimmune disease such as Sjögren’s syndrome, rheumatoid arthritis, or lupus
- Each lens is custom-fit by a scleral lens specialist in Hawaii using advanced diagnostic imaging
Introduction: Specialty Contact Lenses in Honolulu
Living in Hawaii offers many visual delights but can also present challenges for those with unique eye conditions. Environmental factors such as trade winds, intense UV exposure, and salt air can affect eye comfort, while frequent transitions between outdoor heat and indoor air conditioning may impact vision clarity. Whether you experience discomfort with traditional contact lenses, have irregular corneas, or require precise vision correction, scleral lenses offer a specialized solution.
Scleral lenses are large diameter, custom lenses that rest gently on the sclera—the white of the eye—and vault over the cornea without touching it. The space between the lens and corneal surface is filled with sterile saline solution, creating a protective fluid environment that cushions and protects the eye throughout the day.
At Scleral Lens Center of Hawaii, we focus on complex cases involving ocular surface challenges, irregular corneas, and post-surgical eyes that have not responded well to routine care. Patients are evaluated and treated through Kahala Eye Clinic in Honolulu, where we provide integrated specialty services for those seeking advanced vision care.
Understanding Common Eye Challenges
Many people experience visual challenges that are not easily addressed by glasses or standard contact lenses. Issues such as irregular corneas (keratoconus, post-transplant changes), post-surgical eyes (LASIK, cataract surgery), or sensitivity to traditional contact lenses can affect vision quality and comfort. Dry eye disease, including cases caused by meibomian gland dysfunction, can lead to significant discomfort and vision problems.
Common Symptoms Include:
- Blurred or fluctuating vision
- Glare at night
- Discomfort or irritation with standard contact lens wear
- Sensitivity to environmental factors like wind, dust, or air conditioning
- Difficulty achieving stable, sharp vision with glasses
Untreated or severe dry eye disease can result in corneal damage, which may cause visual impairment.
Factors That May Affect Eye Comfort and Vision:
- Corneal irregularities or scarring
- Post-surgical changes to the eye surface
- Environmental conditions such as salt air, UV exposure, and trade winds
- Prolonged screen time or visual demands
Scleral lenses offer a unique approach by creating a smooth optical surface and a protective fluid reservoir that cushions the eye, improving both comfort and visual clarity. Scleral lenses can help stabilize the tear film, reducing the rapid evaporation of natural tears, which is a common issue in dry eye disease.
What Are Scleral Lenses and How Do They Help?
Scleral contact lenses are specialty lenses designed for both therapeutic and optical purposes. Unlike regular or soft contact lenses that rest directly on the cornea, scleral contact lenses vault over the cornea and rest on the less sensitive sclera. This design creates a fluid-filled chamber between the lens and the eye. Scleral contact lenses are large-diameter, rigid gas permeable contact lenses that vault over the cornea and rest on the sclera, creating a protective fluid-filled chamber over the cornea.
Key Design Features:
- Diameter typically 15–20 mm, significantly larger than standard contact lenses
- Made from rigid, highly oxygen-permeable materials designed for extended daily wear
- Custom-shaped based on precise measurements of each patient’s corneal and scleral anatomy
- Fully customizable
Scleral lenses have been utilized for some time, but their use has increased over the past 2 decades due to modern advances in materials and manufacturing.
How Scleral Lenses Work:
The filled lens is inserted with preservative-free saline solution. This fluid reservoir cushions the corneal surface throughout the day, providing protection from environmental irritants like wind, dust, and air conditioning. The lens also creates a smooth optical surface, improving vision for patients with irregular corneas or post-surgical eyes.
Scleral lenses can address both comfort and vision correction simultaneously. For patients who cannot tolerate traditional contact lenses or who have complex corneal conditions, scleral lenses offer enhanced comfort and sharper vision that other options cannot match. Advances in lens surface technology have further improved comfort, wettability, and resistance to deposits, optimizing the lens’s interaction with the eye surface.
Scleral lenses are FDA-recognized for dry eye treatment. While scleral lenses do not cure underlying eye conditions, they provide significant relief, protect the eye surface, and improve visual function in many patients.
Who Is a Good Candidate for Scleral Lenses?
At Scleral Lens Center of Hawaii, candidates are carefully evaluated to ensure scleral lenses are appropriate, safe, and likely to provide meaningful benefit.
Typical Candidate Groups:
- Patients with irregular corneas such as keratoconus, post-transplant, or post-radial keratotomy
- Patients experiencing blurry vision despite wearing glasses or contact lenses
- Patients suffering from dry eye disease
- Individuals with post-surgical eyes after LASIK, PRK, cataract surgery, or corneal transplants
- Patients with post LASIK complications
- Those who experience discomfort or poor vision with standard or soft contact lenses
- People exposed to challenging environments including wind, salt air, and air conditioning
- Patients needing precise vision correction that glasses or regular contacts cannot provide
A thorough examination rules out conditions that may limit scleral lens wear, such as active eye infections or severe eyelid disease. If you have struggled with vision or comfort issues despite trying other options, a consultation with a scleral lens specialist in Hawaii may be the appropriate next step.
Scleral Lenses vs. Other Vision and Comfort Solutions
Scleral lenses are typically considered when basic vision correction or lens options prove insufficient or when the eye requires additional protection and comfort.
Standard Vision and Comfort Solutions:
- Glasses and standard contact lenses
- Soft contact lenses for daily or extended wear
- Eye drops and lubricating gels
- Environmental modifications such as humidifiers or protective eyewear
How Scleral Lenses Compare:
Standard lenses may sit directly on the cornea, sometimes causing discomfort or inadequate vision correction for irregular corneas. Scleral lenses vault over the cornea, resting on the sclera, and provide a fluid reservoir that cushions the eye and stabilizes the tear film.
Scleral lenses offer both continuous protection and improved optical quality during wear—typically 8–14 hours daily—without frequent intervention. They can be particularly helpful for patients with irregular corneas, post-surgical eyes, or those who have struggled with traditional lenses.
Scleral Lens Fitting Process in Hawaii
Scleral lens fitting is a detailed medical process, typically requiring 2–4 visits. At Scleral Lens Center of Hawaii, all fitting scleral lenses appointments are conducted at Kahala Eye Clinic in Honolulu.
The Fitting Process Includes:
Step | Description |
|---|---|
Comprehensive Evaluation | Full ocular and medical history, vision assessment, corneal health examination |
Advanced Imaging | Corneal topography and scleral mapping to guide custom lens design |
Diagnostic Lens Trial | In-office trial lenses to evaluate vault, comfort, and vision at the slit lamp |
Customization | Ordering standard scleral lenses or custom lenses tailored to individual anatomy |
What to Expect at Your First Fitting Visit:
You will receive instruction on inserting and removing lenses using a small plunger device. You will learn to fill the lens bowl with preservative-free saline solution and check for air bubbles that can cause midday fogging. After 20–30 minutes of initial wear, your eye doctor will assess comfort, visual clarity, and lens fit.
Most patients require 1–3 follow-up visits in the first few months for fine-tuning lens parameters and addressing any handling challenges. As a scleral lens fitting Hawaii specialty center, we routinely manage complex cases referred from across Oahu, the neighbor islands, and the mainland.
Living with Scleral Lenses: Comfort, Care, and Expectations
Most patients adjust well to scleral lens wear, though successful use requires consistent hygiene and realistic expectations about adaptation.
Typical Daily Routine:
- Morning: Clean hands thoroughly, fill each lens with preservative-free saline, insert carefully while avoiding air bubbles
- During the Day: Usually no drops needed under the lens; some patients use lubricating drops on top as advised
- Evening: Remove lenses with a small plunger, clean with approved solutions, store in disinfecting solution overnight
What to Expect During Adaptation:
Many patients notice significant relief within the first week. Some may experience initial lens awareness, handling challenges, or vision fluctuation that improves with technique refinement or lens adjustments. Typical daily wear time ranges from 8–14 hours depending on individual tolerance and your eye specialist’s guidance.
Important Care Considerations:
- Strict hand hygiene is essential to prevent eye infections
- Avoid tap water contact with lenses or lens-related surfaces
- Overnight wear is not recommended unless specifically prescribed
- Scleral lenses are a long-term management tool, not a permanent cure for underlying eye conditions
Regular follow-ups are scheduled at intervals to monitor eye health, lens fit, and vision stability.
Risks, Limitations, and When Scleral Lenses May Not Be Enough
While scleral lenses improve vision and comfort for many patients, they are not appropriate for everyone.
Potential Limitations:
- Time investment and learning curve for insertion, removal, and cleaning
- Higher cost compared with standard contact lenses or glasses
- Need for specialized follow-up care and periodic lens replacement
- Possible issues including midday fogging, lens awareness, or handling difficulty
Medical Considerations:
- Increased infection risk if hygiene is poor or lenses are overworn
- Possible hypoxia or redness if lens fit or wear schedule is inappropriate
- Potential symptom worsening during active infection or severe allergy flares
Some patients with complex systemic or ocular conditions may still require additional therapies—such as prescription drops, anti-inflammatory treatments, or prosthetic replacement of the ocular surface ecosystem (PROSE) devices—alongside scleral lenses.
At Scleral Lens Center of Hawaii, each case is evaluated individually. We recommend scleral lenses only when expected benefits clearly outweigh the risks and when the patient is prepared for the commitment that successful wear scleral lenses requires.
Common Questions
When considering scleral lenses for dry eye or other ocular surface conditions, it’s natural to have questions about how these specialized contact lenses work, who can benefit, and what to expect. Here are answers to some of the most frequently asked questions about scleral lenses and their role in vision correction and eye comfort:
1. What are scleral lenses, and how do they differ from standard contact lenses? Scleral lenses are advanced, specialized contact lenses designed to vault over the entire corneal surface and rest on the sclera—the white part of your eye. Unlike standard contact lenses, which sit directly on the sensitive cornea, scleral lenses create a fluid reservoir between the lens and the eye. This constant hydration helps protect the ocular surface, making scleral lenses especially beneficial for dry eye patients and those with irregular corneas.
2. Can scleral lenses correct vision problems, or are they solely for dry eye treatment?Scleral lenses are not just for dry eye—they also provide excellent vision correction for nearsightedness, farsightedness, astigmatism, and presbyopia. For patients with irregular corneas or corneal scarring, scleral lenses offer a smooth optical surface, resulting in sharper vision than many other options. Your prescription and lens design will be customized during the fitting process.
3. How do scleral lenses improve dry eye symptoms, and what are their benefits over traditional contact lenses? Scleral lenses improve dry eye symptoms by creating a protective, fluid-filled chamber over the cornea, delivering continuous hydration throughout the day. This design reduces irritation, light sensitivity, and blurry vision often associated with dry eye. Compared to traditional contact lenses, scleral lenses offer longer-lasting comfort, sharper vision, and better protection for the ocular surface—especially for those with corneal scarring or irregularities.
4. What is the fitting process for scleral lenses, and how does it differ from fitting traditional contact lenses? Fitting scleral lenses is a more detailed process than fitting regular contact lenses. It involves advanced imaging, corneal mapping, and careful evaluation of the tear film and ocular surface. Several visits may be needed to fine-tune the lens fit, ensuring optimal comfort and vision correction. This personalized approach is essential for patients.
5. Can scleral lenses be used in conjunction with other dry eye treatments, such as artificial tears or prescription medications? Yes, scleral lenses can be combined with other treatments like artificial tears, prescription medications, or autologous serum tears. Many patients find they need fewer drops or less frequent use of other therapies once they start wearing scleral lenses, but it’s important to coordinate all treatments with your eye doctor to promote healing and maintain a healthy ocular surface ecosystem.
6. How do I care for my scleral lenses to ensure they remain clean and effective?Proper care is crucial for safe and effective scleral lens wear. Clean your lenses daily with approved solutions, store them in a clean case, and always use fresh saline solution to fill the lens before insertion. Avoid exposing your lenses to tap water or swimming while wearing them, as this can increase the risk of eye infections. Follow your eye doctor’s instructions and attend regular follow-up visits to keep your lenses and eyes healthy.
7. Are scleral lenses comfortable to wear, and is there an adaptation period?Most patients find scleral lenses comfortable after a short adaptation period. Initially, you may notice the sensation of the lens, but as you become accustomed to the fit and handling, comfort typically improves. A proper lens fit, guided by an experienced eye specialist, is key to long-term comfort and successful scleral lens wear.
8. How long can I wear scleral lenses, and are they suitable for overnight wear? Most patients can comfortably wear scleral lenses for 12 to 16 hours each day. However, overnight wear is generally not recommended due to the increased risk of eye infections.
9. Are scleral lenses covered by insurance, and what is the cost? Insurance coverage for scleral lenses varies and is often very limited. Many medical insurance plans provide partial coverage when scleral lenses are medically necessary for severe dry eye, keratoconus, or other corneal conditions. It’s best to check with your insurance provider and discuss costs with your eye doctor to understand your options.
If you have additional questions about scleral lenses, schedule an appointment a personalized consultation. Our team is dedicated to helping you achieve lasting comfort, sharper vision, and improved eye health with the right specialty contact lens solution.
Scleral Lens Center of Hawaii is a premium specialty service focused on complex eye conditions and specialty contact lenses Hawaii patients need for advanced vision care.
What Sets Us Apart:
- Dedicated focus on scleral lenses and advanced vision management
- Extensive experience with post-surgical, irregular corneas, and ocular surface disease patients
- Modern diagnostic technology for precise scleral lens fitting Hawaii standards demand
- Integrated care delivered throughKahala Eye Clinic, an established Honolulu practice
Who We Serve:
- Local residents of Honolulu, East Oahu (Hawaii Kai, Kahala, Manoa), and surrounding communities
- Patients referred from Maui, Kauai, the Big Island, and other neighbor islands
- Individuals traveling from the mainland U.S. and internationally seeking specialized care
Our patient-centered approach emphasizes thorough education on options and realistic outcomes, collaborative care with referring optometrists and ophthalmologists, and ongoing support for long-term vision management.
Schedule a Scleral Lens Consultation
If you experience vision challenges, discomfort with standard contact lenses, or complex corneal conditions that have not responded to standard treatments, we encourage you to schedule a consultation.
All appointments for Scleral Lens Center of Hawaii are booked and provided through Kahala Eye Clinic in Honolulu. We welcome patients from across Oahu, the neighbor islands, and those traveling to Hawaii for specialty care.
Next Steps:
- Call the clinic to schedule an evaluation for scleral lenses
- Request a referral from your current eye doctor if applicable
- Bring prior records, medication lists, and documentation of previous eye treatments to your first visit
Many patients who have struggled with vision or comfort issues find meaningful relief and eye protection with properly fit scleral lenses.
Legal and Clinical Notice: Scleral lens services referenced on this page are provided exclusively through Kahala Eye Clinic, a licensed eye clinic in Honolulu, Hawaii. “Scleral Lens Center of Hawaii” is a descriptive service name used for patient education and informational purposes and is not a separate legal medical entity.
All examinations, treatment, fitting, and follow-up care are performed under the clinical supervision of licensed eye doctors at Kahala Eye Clinic.