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The key difference between scleral lenses and RGP (Rigid Gas Permeable) lenses is where they rest on the eye. RGP lenses sit directly on the cornea, which is the colored part of the eye, while scleral lenses vault over the cornea and rest on the sclera, which is the white part of the eye. This design difference affects comfort, vision stability, and how well the lenses support patients with dry eye.
For patients with irregular corneas or complex eye conditions, specialty contact lenses often outperform glasses because they deliver sharper, more stable vision than glasses. Scleral and RGP lenses are similar in several ways: they are both rigid and gas-permeable. However, determining which is right for you depends on your corneas, comfort, lifestyle, and budget. This guide explains what each lens is, how it works, the differences between them, the lens-fitting process, and how to choose the right lenses for you.
What Are Corneal Rigid Gas Permeable Lenses?
Rigid gas-permeable (RGP) lenses are small-diameter rigid contact lenses that rest directly on the cornea. Unlike soft contact lenses, they maintain their shape on the eye, creating a smooth optical surface that can provide exceptionally crisp vision. Made from oxygen-permeable materials, they allow oxygen to reach the cornea while providing excellent optical quality.
Healthy tear exchange behind the lens helps flush away debris and keep the eye hydrated. Doctors often prescribe RGP lenses for patients with high astigmatism and early keratoconus. RGP lenses are also very durable, cheaper, and easier to handle for those with less contact lens experience.
What Are Scleral Lenses?
Scleral lenses are large-diameter gas-permeable lenses that vault over the cornea, resting only on the sclera. The sclera and conjunctival tissue are far less sensitive than the cornea, so scleral lenses are much more comfortable for patients with irregular or damaged corneas due to the larger diameter and weight distribution.
The defining feature of scleral lenses is the fluid reservoir. Before inserting the lenses, patients fill the reservoir with preservative-free saline. This creates a thin layer of liquid between the lens and the cornea. The fluid bathes the ocular surface, keeping it hydrated, neutralizing corneal irregularity, and shielding the eyes from environmental irritants.
Scleral vs. RGP: 7 Key Differences
1. Where the Lens Rests
RGP lenses rest directly on the cornea, which is the most sensitive tissue in the eye. Scleral lenses vault over the cornea and rest on the white of the eye, which has fewer nerve endings and is significantly less sensitive. Because scleral lenses avoid the cornea completely, they don’t create the pressure and friction that patients can experience with RGP lenses, which rest directly on the cornea.
2. Comfort and Adaptation
Many patients find scleral lenses comfortable shortly after insertion because they rest on the less-sensitive sclera rather than the cornea. RGP lenses generally have an adaptation period of a few days to a couple of weeks, during which the foreign body sensation can be distracting. Despite the shorter adaptation period, scleral lenses do have a steeper learning curve for insertion because of their larger size.
3. Stability and Movement
RGP lenses can move when blinking and can be decentered or ejected during physical activity. Scleral lenses, on the other hand, stay centered due to their large diameter. The stability provides consistent, steady vision that doesn’t become blurry when you blink, move, or exercise. Scleral lenses are often prescribed for very active patients, including children who frequently lose their glasses, because they stay in place better and are less likely to move around on the eye.
4. Dry Eye and Moisture
Scleral lenses are designed to hold moisture against the eye all day, providing continuous hydration while protecting the ocular surface and promoting a more stable tear film throughout the day. RGP lenses, on the other hand, rely on the natural tear film to keep the eye moist. The tear exchange cannot work effectively if another issue already compromises the tear film.
5. Vision Quality and Residual Astigmatism
Both scleral lenses and RGP lenses provide sharp vision by replacing irregular corneas with a smooth refractive surface to correct higher-order aberrations. Scleral lenses can correct residual astigmatism because they are so stable. In contrast, RGP lens wearers with astigmatism may need glasses in addition to their lenses. Furthermore, prolonged RGP lens wear can lead to corneal molding, which causes drifting vision after removal. Scleral lenses don’t touch the cornea at all, reducing the chance of drifting.
6. Handling and Care
RGP lenses are generally easier to insert, remove, and clean because of their smaller size. Their daily care routine is relatively straightforward, making them a good option for many experienced contact lens wearers. Scleral lenses are larger, and the maintenance routine has a few more steps. Scleral lenses must be cleaned and soaked in a specific lens solution overnight, and many wearers need to use a lens plunger to insert and remove them safely. Neither routine is particularly difficult when you get used to it, but both require strict hygiene to prevent infections.
7. Cost and Vision Insurance
RGP lenses are generally the more affordable option to purchase and replace, and they are durable enough to last for much longer than traditional soft lenses. Scleral lenses cost more because they are custom-made for each patient’s eyes, and fitting can take longer due to the extensive measurements needed. Fortunately, many insurance plans cover medically necessary contact lenses. Our team can help determine whether your lenses may qualify as medically necessary under your insurance benefits.
Which Lens Is Right for You?
Scleral lenses are usually better for patients with moderate-to-advanced keratoconus, severe chronic dry eye or ocular surface disease, post-surgical corneas, an active lifestyle, or RGP lens intolerance. The vaulted design and fluid reservoir are an excellent option for patients with challenging corneal conditions. Scleral lenses provide clear vision, comfort, and protection.
RGP lenses are often prescribed for patients with early keratoconus or high astigmatism and otherwise healthy corneas. They are the more budget-friendly option, which is ideal for patients with limited insurance coverage. Some lens wearers also prefer the simplicity of RGP lens wear and care without compromising on vision quality. Neither lens is superior, and candidacy depends on your unique eyes, lens preferences, and budget.
How We Fit Both Lenses at Weston Contact Lens Institute
For RGP lenses, we use corneal topography mapping to measure the precise curvature of your corneas. That way, the lenses match the shape perfectly. For scleral lenses, we use sMap3D scleral topography and EyePrintPRO impressions to build a detailed 3D model of your ocular surface. The information we collect allows us to design custom-fit scleral lenses that vault the cornea correctly and land evenly on the sclera, down to the millimeter. Scleral lens fittings may need multiple follow-up appointments to ensure a precise fit. Advanced imaging technology allows us to customize the fit with exceptional precision, improving comfort, vision, and long-term lens success.
Book a Specialty Lens Consultation in Weston, FL
The best way to determine whether scleral or RGP lenses are right for you is through a specialty contact lens evaluation. We'll assess your eye health, lifestyle, and visual goals before recommending the option that's best suited to your eyes. Contact Weston Contact Lens Institute to arrange an assessment with one of our expert eye care practitioners.
