Ocular surface diseases such as severe dry eye, keratoconjunctivitis sicca, Stevens-Johnson syndrome, graft-versus-host disease, and exposure keratopathy can cause chronic discomfort, fluctuating vision, and significant visual disability. These conditions often are recalcitrant to conventional therapies, leaving patients with persistent symptoms that affect their daily functioning and emotional well-being.
Scleral lenses have emerged as a transformative solution in the management of ocular surface disease. Bandage contact lenses can dry out and dislodge in dry eyes. Unlike bandage contact lenses, scleral lenses vault entirely over the cornea and rest on the white part of the eye (sclera), creating a fluid-filled reservoir or “liquid bandage” that bathes the ocular surface in saline throughout the day. This constant hydration and mechanical protection promote corneal healing.
Impact on Quality of Life
The benefits of scleral lenses go far beyond vision correction. For many patients with ocular surface disease, scleral lenses restore a sense of normalcy:
- Pain Relief: Chronic burning, grittiness, and photophobia are significantly reduced or eliminated, allowing patients to resume activities like reading, computer work, and being outdoors without discomfort. In a study examining patients with ocular graft-versus-host disease, 92% reported an improvement in pain.1
- Visual Improvement: The smooth optical surface of the lens improves distorted or fluctuating vision that can result from unstable epithelium and/or breakdown. Nearly 88% of patients with corneal decompensation from severe ocular surface disease seen in a tertiary care setting experienced at least one line or better in visual acuity when wearing a scleral lens.2
- Psychosocial Well-Being: Chronic eye pain and vision loss can lead to social withdrawal, depression, and loss of independence. Patients often report dramatic improvements in mood, confidence, and quality of life after being fit with scleral lenses.3
- Functional Gains: Many patients return to work or hobbies they had abandoned. Activities such as driving at night, applying makeup, or using digital devices become possible again.4
A Personalized Therapeutic Tool
Each scleral lens is custom designed to fit the unique shape of the eye. The versatility of scleral lenses also makes them suitable for a wide range of underlying conditions, even in cases where conventional treatments have failed.
A Restorative Approach, Not Just a Device
In severe dry eye and ocular surface disease, scleral lenses serve a therapeutic role that goes beyond vision correction. Rather than viewing them merely as specialty contact lenses, clinicians should recognize scleral lenses as a form of treatment. The emphasis should shift from “fitting” scleral lenses to managing ocular surface disease with scleral lenses as a key therapeutic modality. For patients with complex ocular surface disease, scleral lenses often represent the first meaningful step toward healing—not just of the eyes, but of overall quality of life.
To learn more about Visionary Optics scleral lenses, connect with our team.
1. Bligdon, S. M., Colarusso, B. A., Ganjei, A. Y., Kwok, A., Luo, Z. K., & Brocks, D. (2021). Scleral Lens and Prosthetic Replacement of the Ocular Surface Ecosystem Utilization in Ocular Graft-versus-Host Disease: A Survey Study. Clinical ophthalmology (Auckland, N.Z.), 15, 4829–4838. https://doi.org/10.2147/OPTH.S337824
2. Chahal, H. S., Estrada, M., Sindt, C. W., Boehme, J. A., Greiner, M. A., Nerad, J. A., Carter, K. D., Allen, R. C., & Shriver, E. M. (2018). Scleral Contact Lenses in an Academic Oculoplastics Clinic: Epidemiology and Emerging Considerations. Ophthalmic plastic and reconstructive surgery, 34(3), 231–236. https://doi.org/10.1097/IOP.0000000000000929
3. Villani, E., Barabino, S., Giannaccare, G., Di Zazzo, A., Aragona, P., & Rolando, M. (2025). From Symptoms to Satisfaction: Optimizing Patient-Centered Care in Dry Eye Disease. Journal of clinical medicine, 14(1), 196. https://doi.org/10.3390/jcm14010196
4. Takahide, K., Parker, P. M., Wu, M., Hwang, W. Y., Carpenter, P. A., Moravec, C., Stehr, B., Martin, P. J., Rosenthal, P., Forman, S. J., & Flowers, M. E. (2007). Use of fluid-ventilated, gas-permeable scleral lens for management of severe keratoconjunctivitis sicca secondary to chronic graft-versus-host disease. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 13(9), 1016–1021. https://doi.org/10.1016/j.bbmt.2007.05.006
