Scleral Lenses for Corneal Dystrophies

Scleral Lenses for Corneal Dystrophies

Scleral lenses have emerged as a highly beneficial treatment option for individuals with corneal dystrophies, offering a multitude of advantages in vision correction and comfort. Unlike traditional contact lenses, these custom-designed lenses rest on the conjunctiva overlying the sclera, providing a smooth optical surface that compensates for the irregularities caused by the dystrophy. By vaulting over the cornea and creating a fluid-filled reservoir, scleral lenses improve visual acuity, reduce blurriness and distortions, and offer long-term comfort. Additionally, they protect the cornea, enhance moisture and lubrication, and can be customized to fit each individual’s unique eye shape. With their remarkable ability to address the challenges posed by corneal dystrophies, scleral lenses have become a preferred choice for maximizing visual function and improving the quality of life for those affected by these conditions.


What are Corneal Dystrophies?

Corneal dystrophies are a group of genetic disorders that affect the transparent front portion of the eye called the cornea. The cornea plays a crucial role in focusing light onto the retina at the back of the eye, allowing us to have clear vision.

Corneal dystrophies are characterized by the abnormal accumulation of material within the layers of the cornea, leading to structural changes and impaired vision. These dystrophies are typically bilateral, meaning they affect both eyes, although the severity can vary between the two.

There are several types of corneal dystrophies, each with distinct characteristics:


  • Epithelial Basement Membrane Dystrophy (EBMD): This dystrophy involves irregularities in the outermost layer of the cornea, known as the epithelium. It can cause recurrent corneal erosions, where the surface of the cornea becomes painful and may lead to blurry vision.
  • Fuchs’ Endothelial Dystrophy: This dystrophy affects the innermost layer of the cornea, called the endothelium. It leads to the gradual loss of endothelial cells, causing fluid buildup in the cornea and resulting in blurred or hazy vision, particularly in the morning.
  • Lattice Dystrophy: Lattice dystrophy is characterized by the deposition of abnormal protein fibers, forming a lattice-like pattern within the cornea. It can lead to recurrent corneal erosions, blurry vision, and in advanced stages, corneal scarring.
  • Macular Dystrophy: Macular dystrophy primarily affects the middle layer of the cornea, called the stroma. It leads to the buildup of cloudy material within the stroma, causing vision problems such as blurred or distorted vision.
  • Granular Dystrophy: Granular dystrophy involves the accumulation of small, white deposits called granules within the cornea. These granules can progressively affect vision, causing blurry or hazy vision.


Corneal dystrophies are usually inherited in an autosomal dominant pattern, meaning that a child has a 50% chance of inheriting the condition if one of their parents carries the gene mutation. However, the age of onset and disease progression can vary widely among individuals.


Why are Scleral Lenses the Best Treatment Option for Corneal Dystrophies?

Scleral lenses are often considered an excellent treatment option for corneal dystrophies due to several reasons:

  • Vision Improvement: Scleral lenses can significantly improve visual acuity in patients with corneal dystrophies. These lenses vault over the entire cornea and rest on the sclera (the white part of the eye), creating a reservoir of fluid between the lens and the cornea. This fluid-filled space helps to provide a smooth and regular optical surface, compensating for the irregularities caused by the dystrophy. As a result, vision can be significantly enhanced, reducing blurriness, distortion, and other visual symptoms.
  • Corneal Protection: Scleral lenses provide a protective barrier over the cornea, shielding it from external irritants and reducing the risk of corneal erosions or abrasions. In conditions like epithelial basement membrane dystrophy (EBMD) or recurrent corneal erosions associated with dystrophies, the smooth and stable surface of the lens can help prevent the painful erosions by minimizing friction between the eyelids and the cornea.
  • Long-Term Comfort: Scleral lenses are designed to rest on the sclera, which is less sensitive than the cornea. This feature often leads to increased comfort compared to traditional contact lenses. The lenses are also larger in diameter, covering a larger area of the eye, which can enhance comfort by distributing the lens weight more evenly.
  • Moisture and Lubrication: The fluid reservoir created by the scleral lens acts as a moisturizing chamber, providing continuous lubrication and hydration to the cornea throughout the day. This can be particularly beneficial for corneal dystrophies that involve dryness or compromised tear film, such as Fuchs’ endothelial dystrophy.
  • Customization: Scleral lenses are custom-designed and fitted for each individual’s unique corneal shape and condition. This customization ensures a precise fit, optimal vision correction, and maximum comfort. The lenses are typically made of highly breathable materials, allowing for adequate oxygen permeability to the cornea.


While scleral lenses offer many advantages, it is important to note that their fitting and management require expertise from an eye care professional experienced in specialty contact lenses. Regular follow-up visits are necessary to monitor the condition, assess the fit of the lenses, and make any necessary adjustments to ensure optimal vision and comfort.


What You Can Expect Wearing Scleral Lenses If You Have a Corneal Dystrophy

If you have a corneal dystrophy and are considering wearing scleral lenses, here are some things you can expect:

  • Improved Vision: Scleral lenses can significantly improve your visual acuity by providing a smooth and regular optical surface. You can expect clearer and sharper vision, reducing blurriness and distortions caused by the corneal dystrophy.
  • Comfortable Wear: Scleral lenses are designed for comfort. Although there may be an adjustment period initially, most people find them comfortable to wear once they are properly fitted. The lenses rest on the sclera, which is less sensitive than the cornea, leading to increased comfort compared to traditional contact lenses.
  • Customized Fit: Scleral lenses are custom-made to fit your eyes precisely. During the fitting process, your eye care professional will take detailed measurements of your eye’s shape and size. This ensures that the lenses sit properly on your eyes and provide optimal vision correction.
  • Moisturized and Protected Cornea: The space between the back surface of the lens and the cornea acts as a reservoir for a saline solution. This provides continuous moisture and lubrication to the cornea, which can be beneficial if you have dryness or a compromised tear film due to your corneal dystrophy. Additionally, the lens offers protection to the cornea by acting as a barrier against external irritants and reducing the risk of corneal erosions.
  • Longer Wear Time: Scleral lenses have a larger diameter compared to traditional contact lenses, and they vault over the cornea, resting on the sclera. This design allows for enhanced stability and a more secure fit, enabling longer wear times without discomfort. However, the specific wear time will be determined by your eye care professional based on your individual needs.
  • Ongoing Care and Monitoring: Wearing scleral lenses requires ongoing care and regular follow-up visits with your eye care professional. Our team will monitor the condition of your cornea, assess the fit of the lenses, and make any necessary adjustments to ensure optimal vision and comfort. We can also provide guidance on lens insertion, removal, and proper cleaning and maintenance.

At WCLI, you can rest assured that our team will provide you with the personalized experience and treatment that you need if you need scleral lenses as a result of your corneal dystrophy. To learn more about whether scleral lenses are a viable option for you, get in touch with us today.


en English