Custom Scleral Lenses

There are currently five practices in the world who have access to truly customized scleral prosthetics. A customized scleral prosthetic is a process whereby a mold, similar to molds taken for orthodontics, is taken of the shape of the eye. The mold is sent to a laboratory who scans the mold and inputs the scan into a computer aided design (CAD). A scleral prosthetic is built from the CAD file and manufactured. This is the ultimate in scleral lens technology. For those who have failed with traditional sclerals or for whom traditional sclerals are not an option, this technology is sight saving. There are pros and cons with this technology:


  • The best comfort- because the custom scleral prosthetic contours the shape of the sclera exactly, there is no contact lens available that is more comfortable.  This holds true for patients with elevations on the sclera, such as pingueculae and pterygiae.
  • The best optics- because custom scleral prosthetics fit lock and key with the scleral shape, they are rotationally stable.  This allows extremely precise optics to be built into the lenses, and no rotation to worry about.
  • Ease of fit- The molding and fitting process is painless and very quick since there is no need for revisions to the fit.  Custom scleral prosthetics can typically be completed in 2-3 visits depending on the complexity of the eye.


  • Cost- the reason we do not fit everyone with this device is that with any new technology, the cost is greater.  This is not a process that is billable to insurances.  Given this, the procedure is significantly less expensive than the Boston Foundation for Sight lenses, even though the technology is far superior. For what reason, we are unsure. 

Additional information