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Scleral Lenses for Astigmatism

Scleral lenses are a great nonsurgical solution that provides exceptional vision correction in patients with astigmatism, whether by birth, due to post-refractive surgery, or other corneal procedures. Astigmatism is a refractive error caused by irregular corneal curvature, resulting in blurred and distorted vision. Scleral lenses allow astigmatic patients to experience improved visual acuity and comfort while keeping eyes hydrated all day.

If you have been told that your astigmatism is too severe to wear contacts, ask Dr. Chris Hiura about scleral contact lenses. At the Drs. Hiura and Hiura Scleral Lens Center in San Francisco, we work hard to give each patient a superior contact lens fit and know that these lenses can truly make a difference in our patients’ lives.

What is Astigmatism

Histoplasmosis Retinopathy ThumbnailAstigmatism is a common type of refractive error caused by an irregularly shaped cornea. The abnormal cornea causes light to enter unequally onto the retina, which results in blurred or distorted vision, eye strain, headaches, squinting and eye irritation. People are either born with this condition or can develop it later in life.

This condition typically occurs with myopia (nearsightedness) or hyperopia (farsightedness) and can be easily diagnosed using a simple eye exam.

Astigmatism falls into three categories:

  • Myopic (nearsighted) astigmatism: For the myopic, light rays focus in front of the retina, leading objects in the distance to appear blurred. Myopic people who have astigmatism experience further blurring and vision distortion due to the refractive error caused by mismatched curvatures of the cornea or lens.
  • Hyperopic (farsighted) astigmatism: For the farsighted, light focuses beyond the retina. Individuals with hyperopia and astigmatism experience blurred and distorted vision and have difficulty focusing on objects that are up close.
  • Mixed astigmatism: In people with mixed astigmatism, one curvature of the cornea or lens focuses light to the front of the retina while the other focuses light to the back of the retina.

Astigmatism falls into the regular or irregular camp:

Most cases of astigmatism are regular, meaning that the front surface of the eye is oval-shaped. Irregular astigmatism is often caused by scarring of the cornea, keratoconus or from certain types of eye surgeries.

Can People With Astigmatism Wear Contact Lenses?

In cases of moderate to severe astigmatism, sometimes the distortion is too severe to be compensated for properly by soft contact lenses, which simply conform to the irregular shape of the cornea. Scleral lenses, on the other hand, sit on the sclera – not the cornea. They are rigid and maintain their shape regardless of the corneal dimensions. This allows the eye to properly focus light and thus ensures the sharp vision and exceptional comfort. The liquid reservoir that gets trapped underneath the scleral lens masks corneal astigmatism and ensures a stable fit.

What are Scleral Lenses?

Scleral lenses get their name from the way they fit on the eye. The sclera is the white part of the eye, and these lenses rest on the sclera while the lens itself vaults over the cornea.

Scleral lenses have become an important therapeutic strategy in the visual rehabilitation of patients with irregular corneas, such as astigmatism. The liquid reservoir between the lens and the cornea neutralizes astigmatism and provides a continuous moist environment that protects the cornea from exposure to air and friction from blinking.

Scleral lenses offer better comfort, breathability and improved visual acuity due to their rigid optical surface and a shape designed specifically for each patient’s eye. We have found that for our patients with astigmatism, scleral lenses have proven to be the best solution in providing sharp and comfortable vision all day long.

eye doctor, scleral lens on the finger

Are Scleral Lenses for Astigmatism Expensive?

Scleral lenses are custom-fit to each eye, and though the fees for fitting scleral and the cost of the lenses are higher than traditional lenses, their life span and benefits offset the costs.

Coverage rates and restrictions vary among providers, and if considered a medical necessity, many insurance companies will cover the cost of scleral lenses. That said, every country and state has its own restrictions and regulations. Consult with our eye care team at the Drs. Hiura and Hiura Scleral Lens Center to discuss your specific payment options and cost of scleral lenses.

Specialized optometrists, such as Dr. Chris Hiura, are trained in fitting scleral lenses for excellent, effective vision correction, and help patients with astigmatism and other corneal irregularities enjoy great vision and comfort with specialty lenses.

TESTIMONIAL:

“ I went to the Drs. Hiura and Hiura Scleral Lens Center for my astigmatism, and I’m so grateful to the staff and doctors for their thorough care! They meticulously fitted me for scleral lenses, and now I can not only see well, but I tend to forget I’m wearing lenses. They’re so very comfortable! “

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Scleral Lenses For Keratoconus And Other Eye Conditions

The cornea, which is the clear tissue on the eye’s outermost surface (covering the pupil and the iris), bends and focuses light going into the eyes. However, for those with irregularly-shaped corneas, the light entering the eye is not properly focused — which results in distorted vision.

Thankfully, scleral lenses offer excellent visual acuity and comfort for those with corneal irregularities, due to their large shape, unique features and customized fit.

Scleral Lenses for Keratoconus

Keratoconus (keh-rah-toe-cone-us) is an eye disorder in which the round dome-shaped cornea progressively thins, causing a cone-like bulge to develop.

Because patients with keratoconus have irregular, cone-shaped corneas, glasses cannot be used to properly correct vision. The ideal solution, therefore, are scleral contact lenses. They sit on the sclera without touching the cornea, while providing sharpness, clarity and comfort.

Scleral Lenses for Severe Dry Eye

People suffering from severe dry eye can find therapeutic benefits from transitioning to custom designed scleral lenses. Scleral lenses tackle three factors simultaneously: they provide vision correction, they protect the eye, and they serve a therapeutic purpose by lubricating the eye.

Scleral lenses also decrease pain, discomfort, eye redness and itchiness in those with dry eyes.

Scleral Lens RA Transplant 1280×853Scleral Contact for Astigmatism

Astigmatism is a refractive error caused by irregular corneal curvature, resulting in blurred and distorted vision. Scleral lenses offer exceptional vision correction in patients with astigmatism, whether by birth, following post-refractive surgery, or due to other corneal procedures. The lenses improve visual acuity and comfort while keeping eyes hydrated all day long.

Scleral Lenses for Myopia and Presbyopia

Scleral contacts are ideal for anyone with severe nearsightedness or farsightedness. For presbyopic patients, scleral contacts can be designed as multifocal contacts to correct nearsightedness and farsightedness simultaneously. Because scleral lenses are firmly positioned on the eye, they provide significantly more comfort when compared to standard multifocal lenses.

Mini Scleral Contacts Vs. Full-Size Scleral Contact Lenses

All scleral lenses rest on the white part of the eye, the sclera. However, Dr. Chris Hiura will customize the scleral lenses by determining the exact diameter and space needed between the cornea and sclera. Certain scleral lenses may have a space of a few millimeters (mini scleral lenses), while standard scleral lenses are larger, full-sized lenses. Larger scleral lenses are typically recommended for highly irregular corneas.

Ask Us About Scleral Lenses

If you struggle with keratoconus, astigmatism, dry eyes or any of the other conditions listed above, ask your Drs. Hiura and Hiura Scleral Lens Center doctor about scleral lenses. Dr. Chris Hiura will patiently assess and explain your condition to you, and will perform a specialized, scleral lens custom-fitting to ensure that you receive the best fit for optimal visual clarity and comfort.

Call the Drs. Hiura and Hiura Scleral Lens Center today to schedule your consultation.

Request An Appointment
Call 415-770-0772

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Specialty Contact Lenses For Presbyopia

As we get older our vision starts to change. Between the ages of 40 and 50, almost all people develop presbyopia (age-related farsightedness), which makes nearby objects appear blurry.

Reading glasses used to be the only option for contact lens wearers with presbyopia who wanted to perform tasks that require good near vision such as reading a book or menu.

Nowadays, several specialty contact lenses offer patients with presbyopia clear near and distance vision for ultimate visual comfort and convenience.

Contact Lenses for the Farsighted

Monovision

This is a vision correction technique in which the contact lens in one eye corrects for distance vision and the other eye for near vision. Basically, each lens has a different prescription.

Scleral Lenses

Scleral contacts are large-diameter gas-permeable contact lenses that vault over the entire corneal surface and rest on the white part of the eye (sclera) instead of the cornea.

Scleral contacts can also be designed as multifocal contacts for presbyopic patients to correct both farsightedness and nearsightedness. When compared to regular multifocal lenses, scleral lenses are firmly positioned on the eye, offering substantially better stability and comfort.

Multifocal

Patients who wear multifocal contact lenses are able to see at all distances without sacrificing depth perception. Those who participate in outdoor activities, use the computer regularly or don’t like using reading glasses to view their smartphone, tablet, or newspaper might consider multifocal contact lenses.

There are two basic types of multifocal contact lenses: simultaneous vision design and segmented vision design.

1. Simultaneous vision design – Concentric rings of distant and near powers encircle a primary viewing zone in the lens’s center. The central viewing zone is typically used to view distant things, although there are also center-near designs. Under other circumstances, the dominant eye is fitted with a center-distance design, whereas the non-dominant eye is fitted with a center-near design. These multifocal contacts are similar to concentric multifocal lenses, but instead of discrete rings of distance and near power encircling the lens’s center, the multifocal lens power gradually changes from distance to near (or near to distant) from the lens’s center to the periphery. Aspheric multifocal contact lenses are similar to progressive eyeglass lenses in this way.

2. Segmented vision designs – Bifocal and trifocal eyeglass lenses have a similar design to segmented multifocal contact lenses. The upper and center zones of the lens feature a zone for distant vision, while the lower half of the lens has a zone for near vision. A noticeable line in the lenses separates the distant and near zones.

These contact lenses are made of rigid gas permeable (GP) contact lens material. These lenses have a smaller diameter than soft contact lenses and rest above the edge of the lower eyelid on a layer of tears. A segmented multifocal contact lens stays in place as your look shifts downward for reading or seeing close objects, allowing you to see through the lower, near-correction part of the lens.

Rigid gas-permeable (RGP)

RGP contact lenses are composed of rigid silicone polymers that allow oxygen to pass through the cornea. Unlike soft contact lenses, they hold their shape and can often provide clearer vision than soft lenses.

Orthokeratology

Orthokeratology, also called ‘ortho-k’ lenses, are lenses that are worn overnight to reshape the cornea. Ortho-k can be used to correct both eyes for distance vision and be used as monovision and multifocal vision.

If you have presbyopia and are looking into your contact lens options, contact Drs. Hiura and Hiura Scleral Lens Center to learn more about which specialty contact lenses are right for you.

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Call 415-770-0772

Learn More About Scleral Lenses

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Succeeding With Sclerals

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Succeeding With Sclerals

Healthy corneas normally bend incoming light toward the retina so we can see clearly. However, certain corneal conditions, such as keratoconus and astigmatism, lead the light’s path to the cornea to diffuse, resulting in reduced and blurred vision.

That’s precisely what happened to three patients: Ben, Georgette and Fred, who have irregular corneas that caused them to struggle with their vision. Thanks to scleral lenses, they and countless other patients with corneal conditions have experienced improved visual clarity, sharper focus and unparalleled comfort. But before we delve into their stories, what are scleral lenses and how exactly do they benefit those with irregular corneas?

Irregular Corneas and Scleral Lenses

Irregularly shaped corneas are most commonly caused by or associated with astigmatism, keratoconus, prior eye surgeries (such as LASIK, cataracts, corneal transplant), trauma, scarring and pellucid marginal degeneration.

Irregular corneas cannot be corrected with eyeglasses or traditional contact lenses. An excellent non-surgical solution is scleral lenses, which provide clear vision and better comfort while keeping your eyes hydrated throughout the day.

The lenses vault over the cornea and rest on the sclera, the white part of the eye, which prevents corneal irritation. The liquid reservoir fills in the surface irregularities of the cornea, restoring vision and enabling the eye to comfortably heal. The smooth optical surface replaces the distorted corneal surface, resulting in dramatically improved vision and comfort.

Read how scleral lenses have helped address Ben’s, Georgette’s and Fred’s irregular corneas, and enabled them to experience improved vision and a higher quality of life.

*These patient testimonials are meant to reflect actual testimonials of patients but not necessarily our patients.

happy man smilingEverything Is Now in Focus for Ben

Ben entered college excited for life’s newest adventure. He made friends and studied hard. But his struggle to read the content on the classroom whiteboard and in his textbooks presented the same challenges he’d experienced for much of his life.

“Here we go again,” Ben thought. Ben had astigmatism, meaning that his corneas were unevenly curved. As a result, images and texts appeared blurry. To see clearly, he resorted to squinting, which, in turn, led to frequent headaches.

Although Ben had regularly been updating his eyeglass prescription over the years, and tried wearing standard contact lenses, he still struggled with his vision. “Enough is enough,” Ben decided. “It’s time to consult a vision expert!”

That’s when Ben went to see his eye doctor, who suggested he wear scleral lenses to help see clearly with his astigmatism.

The scleral lenses worked wonders by allowing Ben’s eyes to properly focus light to the retina. Several appointments with his eye doctorensured that the scleral lenses were fit just right. Ben can now see clearly and effortlessly, read the board and his textbooks, all of which have enabled him to graduate from college with honors.

If you or your child have astigmatism, make your life easier by following in Ben’s steps and ask Dr. Chris Hiura about scleral lenses.

happy woman smilingFor Georgette, Sclerals Are the Perfect Fit

Just imagine how Georgette felt, at age 15, when she was diagnosed with keratoconus.

No one wants to hear that their cornea is thinning and gradually bulging outward into a cone shape. But that’s exactly what happened to Georgette. Because keratoconus causes blurred vision and sensitivity to light, Georgette often found herself squinting to help her see clearly.

That’s when her eye doctor suggested scleral lenses. Having never worn contact lenses, Georgette hesitated, then reconsidered. “Let’s do it,” she concluded.

Georgette left her eye doctor with her new pair of custom fit scleral lenses, fully excited at the prospect of experiencing great vision. Thanks to sclerals, she not only sees clearly, but now finds her eyes to be significantly less sensitive to light, which allows her to enjoy the outdoors during the day.

happy american familyFred Likes What He Sees Following His Corneal Transplant

“It still hurts,” Fred complained as he looked into his eyes in the mirror.

The corneal transplant he underwent 10 months earlier effectively addressed his corneal scars following a workplace accident. Fred recovered as the operation’s physical effects receded. Post-operative medications prevented not only inflammation and infection, but also the rejection of his newly transplanted corneas. However, the standard contact lenses he began using a few months after the transplant were painful to wear, and his irregular astigmatism—far from corrected—continued to cause fluctuating vision.

Imagine Fred’s excitement at learning that scleral lenses enable clear and painless vision for keratoplasty (corneal transplant) patients like himself. He read a 2016 study published in the Eye & Contact Lens journal that found that sclerals in post-keratoplasty patients are safe and effective, with most patients attaining 20/40 vision or better.

How did things turn out? With attentive care, really well. Fortunately, Fred now experiences both comfort and excellent vision with scleral lenses.

REFERENCES

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Treating Ocular Surface Disease with Scleral Lenses

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Treating Ocular Surface Disease with Scleral Lenses

Ocular surface disease (OSD) is not a single disease. It is a group of eye disorders that affect the surface of the eye. It can significantly affect your eyesight and quality of life. Many cases of ocular surface disease are misdiagnosed a simply ‘dry eyes’, so this condition can go undiagnosed and therefore untreated.

Fortunately, scleral lenses, which are custom-fit and lubricate the eye’s surface, can provide the relief and comfort people with OSD seek.

What are the Causes and Symptoms of Ocular Surface Disease?

Your tear film is controlled by various tissues and glands around the surface of your eyes. If there is a problem with those glands or tissues, it can cause your tear film to become unstable, resulting in dry eye syndrome or other types of ocular surface disorders.

A stable tear film keeps eyes moist, protects them against infection and cleans the surface of your cornea.

When your tear film is unstable, symptoms can include:

  • Redness
  • Watery eyes
  • Blurry vision
  • Gritty or scratchy feeling in the eye
  • Itching
  • Pain

Ocular surface disease symptoms are usually worse in the evening. They can also be exacerbated by windy conditions or a dry climate.

Types of Ocular Surface Disease

Some of the most common types of ocular surface disease include:

  • Dry eye syndrome
  • Blepharitis
  • Meibomian gland dysfunction
  • Allergies
  • Keratitis
  • Conjunctivitis
  • Immunological conditions (e.g. Sjogren’s syndrome)
  • Chemical or thermal burns

Treatment With Scleral Lenses

Depending on the type of condition, treatment can range from artificial tears (dry eye) to antihistamines (allergies), but many people continue to experience dry, itchy, irritated eyes. Eventually, many patients with ocular surface disease seek out more durable methods of treatment.

In recent years, scleral lenses have become a preferred treatment option for patients with ocular surface problems.

While they are generally used to treat refractive errors and corneal irregularities, scleral lenses can also provide immense relief to patients with ocular surface disease.

Scleral lenses do three things simultaneously: they protect the eye, they provide vision correction, and they serve a therapeutic purpose by lubricating the eye. Scleral lenses decrease discomfort, pain, itchiness and eye redness while providing sharp, clear vision.

These customized lenses form a dome over the cornea and rest on the sclera (the white part of the eye). The zone between the lens and the cornea provides a continuous moist environment that protects the cornea and provides relief for those with ocular surface disease.

At Drs. Hiura and Hiura Scleral Lens Center, we regularly diagnose, treat and manage the different types of ocular surface disease to help patients experience clear, healthy vision again. Our Dr. Chris Hiura has the experience and proven treatment options you need to find relief from OSD.

If you have OSD and are interested in scleral lenses, Drs. Hiura and Hiura Scleral Lens Center can help. Dr. Chris Hiura is specialized in fitting scleral lenses for dry eyes and other corneal conditions.

Request An Appointment
Call 415-770-0772

Learn More About Scleral Lenses

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Scleral Lenses for Athletes

Clear and comfortable vision is vital in sports—it can make a huge difference to optimizing your game-time performance. Fortunately, scleral lenses offer a way for athletes who need corrective eyewear to achieve their goals, even in contact sports like basketball, football and hockey.

Scleral lenses are custom-fit contact lenses for people with corneal irregularities, hard-to-fit eyes and severe dry eye syndrome, among other conditions. They provide comfort and offer sharp vision on and off the playing field.

Scleral lenses are extremely stable on the eye, as they vault over the cornea and rest on the sclera. Moreover, the reservoir of saline solution between the back surface of the lens and the front of the cornea ensures that the eye remains moist all day long. Furthermore, the lenses’ highly breathable gas permeable material ensures that plenty of oxygen reaches the front of the eye.

What Kind Of Athletes Wear Scleral Lenses?

Scleral lenses benefit athletes who find wearing traditional contact lenses challenging or impossible, and/or who have any of the following eye conditions:

  • Astigmatism
  • Dry eye syndrome
  • Presbyopia
  • Keratoconus
  • Post-refractive surgery (i.e. LASIK, PRK)
  • Giant papillary conjunctivitis (GPC)

Scleral Lenses for Athletes with Keratoconus

Keratoconus is an eye condition in which the cornea thins and weakens over time. This causes a cone-like bulge to develop and an irregular-shaped cornea. Keratoconus can result in increased sensitivity to light, distorted vision, slightly blurred vision and even significant vision loss. Professional athletes diagnosed with keratoconus often worry that the condition could end their career.

Scleral lenses are a long-term solution that helps athletes with keratoconus to continue to perform at their peak with amazing vision. Just ask professional athletes Brandon Williams from the Baltimore Ravens, Steph Curry from the Golden State Warriors, or Diamond DeShields from the Chicago Sky. These star athletes all wear scleral contact lenses and can now show off their true sporting prowess due to their sharp vision.

Do Scleral Lenses Work For All Sports?

When fitted correctly, the edges of these customized lenses fit comfortably under the eyelids, which prevents them from easily falling out. Moreover, because of their stability and extreme comfort, they offer an added advantage for athletes who engage in contact or extreme sports or those with rapid movements, such as in:

  • Basketball
  • Baseball
  • Football
  • Gymnastics
  • Hiking
  • Hockey
  • Rock Climbing
  • Soccer
  • Skiing
  • Tennis

However, scleral lenses are not advised for wrestling, karate, or boxing, other martial arts or any sports where facial injuries are common.

How Can Scleral Lenses Improve An Athlete’s Vision?

Athletes are often exposed to challenging environmental conditions, such as dust, chalk, sand and wind, all of which can lead to discomfort with soft contact lenses. As scleral lenses provide a seal over the eye’s surface, their eyes are much more protected from the elements. Because athletes have demanding visual needs, stable, clear, crisp vision is essential for optimal athletic performance.

To learn more, contact Drs. Hiura and Hiura Scleral Lens Center today.

Request An Appointment
Call 415-770-0772

Learn More About Scleral Lenses

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