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Q & A with Dr. Barbara Marcussen on Scleral Lenses

Specialty sceleral contact for dry eyes

We sat down with Dr. Barbara Marcussen in Charlotte, NC and discussed the intricate workings of scleral contact lenses and the benefit of these lenses to all of her patients.

Here’s what we found out:

What are scleral lenses?

Scleral lenses are contact lenses that are about the size of a soft contact lens.  They fit on the conjunctiva, or white part of the eye, so they are very comfortable just like a soft contact lens.  A scleral contact lens is more rigid than a soft contact lens which allows it to give very clear vision by correcting for astigmatism.  Scleral contact lenses give the benefits of a rigid surface that corrects for astigmatism with the comfort of a soft contact lens since it sits on the less sensitive conjunctiva of the eye.

For whom are Scleral Lenses intended?

Scleral lenses used to only be used for people with corneal disorders or diseases such as keratoconus, post refractive surgery such as LASIK or penetrating keratoplasty, R-K surgery, post-corneal transplant patients, Stevens-Johnson Syndrome, trauma to the cornea, corneal ectasia, and others.  Now, however, there has been such tremendous benefits of scleral contact lenses to correct for higher amounts of astigmatism and irregular astigmatism that they are also being used for patients who do not have diseased corneas.

Scleral contact lenses are very stable contacts and because they are rigid, they correct for astigmatism which allows for excellent vision even for people with high amounts of astigmatism.

Which conditions do you treat with these Scleral Contact Lenses?

At Complete Eye Care near Charlotte, NC we can treat the following conditions with sclerals:

  • Keratoconus
  • Corneal transplant patients
  • Corneal ectasia
  • Post radial keratology or R-K surgery patients
  • Post LASIK patients
  • Corneal trauma patients
  • People with high amounts of astigmatism
  • People with severe dry eyes

What are the main benefits of wearing scleral lenses?

They give excellent vision and are safe for all types of corneal issues or diseases.  They provide good comfort by vaulting the cornea and only touching the sclera of the eye.  They also are the most stable way to correct for astigmatism.  They can even correct for irregular astigmatism.  Scleral lenses are also an excellent contact lens option for people with dry eyes.

Can Scleral Lenses be used if you have dry eyes?

Scleral contact lenses can be used if you have dry eyes.  They actually are an excellent choice for our Charlotte dry eye patients.  Before the scleral contact lenses is inserted into the eye, a preservative-free artificial tear is placed into the contact lens.  The artificial tears stay in the bowl of the scleral contact lens while it is being worn which allows the cornea to be covered in tears while the lens is worn.  This means the cornea is bathed in a gentle tear which is an excellent treatment for dry eyes.  People with dry eye issues find that they can wear their scleral contacts all day without any issues with comfort.

How should Sclerals be inserted and removed?

Scleral contact lenses are inserted similar to soft contact lenses except they are first filled with a gentle non-preserved artificial tear solution.  This makes these lenses safe for people who have issues with contacts drying out during the day.  Because scleral contact lenses are more rigid, many people find them much easier to handle than soft contact lenses.

How long can you use the same pair of scleral contact lenses?

The same pair of scleral contact lenses will last for one year.  If they are properly cleaned at night, they will only need to be replaced yearly and this can be done at Complete Eye Care in Belmont, NC.

Can you wear scleral contact lenses if you need bifocals?

Yes, bifocal scleral contact lenses are an excellent solution for people who need bifocals.  Because they are stable lenses, they can be a good option for people who need correction at both distance and near due to presbyopia.

Are there any limits to the amounts of prescription scleral contact lenses can correct?

No, there is no limit on the amount of astigmatism scleral contacts can correct.  Scleral contacts are an excellent option for people who have higher amounts of nearsightedness, farsightedness, or astigmatism.  They can also be made as bifocal contact lenses.  Because scleral contacts are stable on the eye and do not move as soft contact lenses do, they work well as bifocal contact lenses.

Is there a difference in the way scleral contact lenses are fit for the eye?

Yes, the most accurate way to fit scleral contact lenses is to specifically design them for each individual cornea on each patient.  A certified WAVE designer can take a reading map of the cornea called a corneal topography.  They then use that reading of over 11,000 individual points on the cornea to custom create the perfect lens to allow the best possible vision no matter what the prescription is in either eye and to add bifocals if needed.  Then a special instrument, called an OCT, maps the alignment across the eye to ensure proper fit and alignment down to levels smaller than the thickness of a human hair.

Would you recommend scleral contact lenses?

Yes! Scleral contact lenses have provided so many people with keratoconus or corneal transplants with the sharp, clear vision they have not had in years.  Scleral contacts have been an excellent solution to those needing to correct for higher amounts of nearsightedness, farsightedness, or astigmatism as well as those needing bifocal contact lenses.  They are also an excellent solution for people with dry eyes who have been unable to wear contact lenses due to their dry eyes.  They have truly changed the lives of many patients by giving them clearer, more comfortable vision.

Call our office at  704-271-5544 for more information. For patients from Charlotte NC, we are conveniently located near Charlotte in Belmont, just west of I-485 on I-85.

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