Traditional Scleral Lenses

• The most common mode of fitting, sometimes referred to as a “diagnostic” fitting

• The least expensive type of scleral lens

Traditional scleral lenses are fitted using a pre-manufactured fitting set. Based on certain measurements, the fitter will select a lens from their fitting set and evaluate it on a patient’s eye. They will then order an initial lens based on their observations. Once that initial lens arrives, the fitter will again observe it on the eye and potentially order a further adjusted lens. Subsequent adjustments are performed the same way, through trial and error, until the fitter reaches a lens design they are satisfied with.

Good for: regular corneas, dry eye, mild-to-moderately irregular corneas and relatively symmetrical corneas & scleras

Common brands include (but are not limited to): Custom Stable, ZenLens, Atlantis, Jupiter, Europa, OneFit, SynergEyes VS, BostonSight scleral

Scan-Based Scleral Lenses

• Lenses are designed using technology, sometimes referred to as “empirical” fitting

• The most popular option at my office

Scan-based scleral lenses are manufactured based on the results of a profilometry scan that measures the exact contours of both the cornea and sclera. You and your doctor will likely reach an optimal fit faster with this method. Due to the more intricate, contoured fit, patients tend to experience less fogging and more comfort.

There are two types of scan-based lenses. One is what I call a freeform lens - this is a true 3D printed scleral lens. The other is a super-customized “standard” lens that more closely matches the contour of the eye with additional customization that only a scan provide. My office can use any of the standard designs that are integrated with the Eaglet ESP profilometer to create a scan-based lens.

Good for: large degrees of corneal & scleral irregularity, asymmetric & advanced keratoconus, conjunctival irregularity, and anyone who has “failed” with traditional lenses

Free-form brands include: Gaudi, Boston 360, Maxim3D, ScanFit, Latitude

Impression-Based Scleral Lenses

• Lenses are designed using a mold of the eye

• Typically the most expensive option

An impression-mold is taken of the cornea and sclera for a super-customized and specific scleral lens. The impression takes a few minutes and the resulting lens is much more likely to fit optimally on the first attempt.

Good for: highly irregular scleras, large pingueculas, post-surgical eyes (especially post-glaucoma surgery), anyone who is difficult to scan, those who have “failed” with other types of scleral lenses due to discomfort, are difficult to scan and those who need prism correction in their lenses

Brands include: EyeFit, EyePrintPro