Scleral Contact Lenses in Orange County — When Nothing Else Works
Irregular corneas need extraordinary lenses. We've fitted scleral lenses for 35+ years — from keratoconus to post-LASIK complications to radial keratotomy.
When glasses blur and standard contact lenses fail, scleral lenses vault over the entire corneal surface and create a smooth optical surface from saline — correcting vision that was uncorrectable any other way.
Who Scleral Lenses Help
Scleral lenses succeed in conditions where every other optical solution has fallen short. If you've been told "there's nothing more we can do," we may disagree.
Keratoconus & Corneal Ectasia
The irregular, cone-shaped cornea creates distortion that glasses and soft lenses cannot neutralize. Scleral lenses vault over the irregular surface entirely, creating a perfect optical sphere from the fluid reservoir.
Post-LASIK Complications & Corneal Irregularity
LASIK can leave behind optical zone irregularities, regression, or ectasia. Scleral lenses correct the remaining refractive error without removing more corneal tissue — protecting a cornea that has already been altered.
Radial Keratotomy (RK) — Fluctuating Vision & Hyperopic Shift
RK incisions from the 1980s and 90s often cause vision that fluctuates dramatically from morning to evening. Scleral lenses provide stable, consistent correction throughout the day regardless of the incision geometry.
Severe Dry Eye Disease
The saline-filled reservoir between a scleral lens and the cornea never evaporates, never dries, and never creates the friction that makes conventional contact lenses unbearable. Many severe dry eye patients finally achieve comfortable full-day wear.
Irregular Astigmatism from Any Cause
Standard glasses lenses can only correct regular, symmetric astigmatism. Scleral lenses correct any shape of irregular astigmatism — post-surgical, traumatic, degenerative — by replacing the irregular corneal surface with a smooth saline layer.
Post-Corneal Transplant (PKP / DSAEK / DMEK)
Corneal transplants, even successful ones, frequently leave irregular astigmatism that glasses cannot fully correct. Scleral lenses are the first-line specialty lens option after keratoplasty for achieving best-corrected vision.
What Are Scleral Lenses?
Scleral lenses are large-diameter rigid gas-permeable contact lenses — typically 14 to 22 millimeters across — that vault completely over the entire corneal surface and land gently on the white of the eye (the sclera), which is far less sensitive than the cornea.
Before inserting a scleral lens, you fill the bowl of the lens with sterile saline solution. When placed on the eye, this creates a smooth, liquid optical surface in front of the cornea. No matter how irregular your cornea is underneath — whether it's cone-shaped from keratoconus, flattened from LASIK, scarred from incisions, or simply distorted in a way no one can fully explain — the saline layer corrects it perfectly.
That same fluid reservoir is why scleral lenses are so comfortable for dry eye patients. The eye stays bathed in saline throughout the day, never drying out, never losing moisture to evaporation.
Scleral lenses are made from highly oxygen-permeable materials, so your cornea breathes normally despite the lens covering it. This makes them safe for extended daily wear — most patients wear their lenses 12 to 16 hours without issue.
How Scleral Lenses Compare
Scleral Ortho-K: The Next Frontier for RK, Post-LASIK & Myopia Patients
Standard orthokeratology uses small rigid lenses worn overnight to gently reshape the cornea, allowing you to remove the lenses in the morning and see clearly without correction for 12–16 hours. It works beautifully for patients with regular corneas and moderate myopia.
But patients with RK scarring, post-LASIK flattening, or highly irregular corneas often cannot fit standard ortho-k lenses — the cornea is too flat, too irregular, or the optical zone too small for conventional reverse-geometry designs.
Scleral ortho-K applies reverse-geometry design principles to full scleral-diameter lenses. Worn overnight, they reshape the cornea gently across a wider zone, providing improved unaided vision during the day — often when standard ortho-k simply cannot fit.
Who Benefits Most from Scleral Ortho-K
"When standard ortho-K doesn't fit because the cornea is too flat or too irregular, scleral ortho-K often succeeds where nothing else has."
Doctor's Insight: Scleral Lenses
Direct Answers from Dr. Bonakdar
Can scleral lenses correct keratoconus?
Yes. Scleral lenses are among the most effective optical treatments for keratoconus. Because the lens vaults completely over the irregular, cone-shaped cornea and fills the space with saline, the fluid layer creates a perfectly smooth refracting surface regardless of how distorted the cornea is underneath. Many keratoconus patients who cannot wear glasses or soft lenses achieve excellent functional vision with sclerals — and may avoid or delay corneal transplantation.
Are scleral lenses a good option after LASIK complications?
Scleral lenses are often the best non-surgical option for post-LASIK patients with residual irregular astigmatism, ectasia, halos, or regression. Unlike LASIK enhancement surgery — which removes more tissue from an already-thinned cornea and increases ectasia risk — scleral lenses correct vision without touching the cornea at all. Many post-LASIK patients who had given up on clear vision are surprised by how well-corrected they can be with a properly fitted scleral lens.
How are scleral lenses fitted for irregular corneas?
Scleral fitting for irregular corneas requires a multi-step process using corneal topography, OCT imaging, and a series of diagnostic trial lenses. We evaluate vault over the corneal apex, clearance at the limbus, and the landing zone on the sclera — all three zones must be optimized simultaneously. For complex corneas, fitting may require 3–5 appointments and multiple lens modifications before achieving the ideal fit.
The Fitting Process
Scleral lens fitting is a specialty process that typically takes 2–3 appointments. Here's what to expect from start to finish.
Comprehensive Corneal Mapping
We perform detailed corneal topography and OCT imaging to map every contour of your corneal surface. This data drives lens parameter selection. For irregular corneas — keratoconus, post-LASIK, post-RK — this mapping is the foundation of the entire fitting.
Trial Lens Selection Based on Vault Requirements
Using your topography data, we select a trial lens family and initial parameters. The goal is a lens that clears the corneal apex by 200–400 microns, clears the limbus, and lands symmetrically on the sclera. The first trial lens rarely achieves all three simultaneously — that's expected.
Slit-Lamp Fitting Assessment + Visual Acuity Testing
With the trial lens on the eye, we evaluate fit at the slit lamp using fluorescein dye to visualize the fluid reservoir. We assess all three landing zones and verify the refraction over the trial lens to determine your final prescription.
Final Lens Delivery, Training + 1-Week Follow-Up
When the final lenses arrive, we provide in-office insertion and removal training until you are fully comfortable and independent. A 1-week follow-up appointment confirms corneal health, fit stability, and vision quality. Additional follow-ups are scheduled as needed.
Insurance Coverage for Scleral Lenses
When scleral lenses are medically necessary — keratoconus, post-LASIK ectasia, post-RK complications, severe dry eye disease — they are typically covered under medical insurance rather than vision plans. This distinction matters: medical coverage often provides substantially higher benefits for specialty lens fitting, materials, and follow-up care.
We handle the prior authorization process and submit claims under appropriate medical billing codes. Insurance plans we commonly bill include VSP (medical exception claims), EyeMed, Medicare Part B, and most major medical insurance carriers.
Frequently Asked Questions
Straight answers to the questions patients ask us most before their scleral lens consultation.
Are scleral lenses hard to put in?
There is a learning curve of 1–2 weeks, but most patients master insertion with our in-office training. Counterintuitively, the larger size that seems daunting at first actually makes placement easier than small lenses — you fill the lens with saline, place it flat on the eye, and there is much more surface area to work with than a tiny soft or rigid lens.
How long can I wear scleral lenses each day?
Most patients wear scleral lenses 12–16 hours comfortably. The fluid-filled saline reservoir between the lens and your cornea keeps the eye consistently moist throughout the day, eliminating the dryness and discomfort that often limits wear time with standard contact lenses.
Will insurance cover scleral lenses?
When medically necessary — keratoconus, post-LASIK ectasia, radial keratotomy complications, severe dry eye — scleral lenses are typically covered under medical insurance, not just vision plans. We handle the prior authorization process and submit under medical billing codes to maximize your benefits.
Can I wear scleral lenses if I have severe dry eye?
Yes — scleral lenses are actually one of the most effective treatments for severe dry eye disease. The saline reservoir completely eliminates lens-to-cornea friction that irritates the ocular surface with standard lenses. Many patients with chronic dry eye who previously could not tolerate any contact lens wear extremely comfortably in sclerals for full workdays.
How is scleral lens fitting different from a regular contact lens fitting?
A scleral fitting typically requires 2–3 appointments and relies on advanced corneal topography and OCT imaging. We evaluate corneal vault clearance, limbal zone clearance, and the landing zone on the sclera simultaneously — all three must be optimized for the lens to work correctly. This is a specialty skill that requires advanced training and years of fitting experience. Dr. Bonakdar has fitted over 500 scleral lenses and serves as a referral center for complex cases.
Your Scleral Lens Specialist
Dr. Alexander Bonakdar, O.D. has spent 35+ years specializing in complex specialty contact lens fitting — a focus he has maintained since establishing EyeCare Center OC in 1991. Scleral lens fitting is one of his primary clinical areas, and he has personally fitted over 500 patients with scleral lenses across the full spectrum of corneal conditions.
EyeCare Center OC serves as a referral destination for complex corneal cases from UCI Medical Center and CHOC Children's Hospital — cases that other practitioners have not been able to correct with conventional methods. Patients travel from throughout Southern California for scleral lens evaluations.
Dr. Bonakdar is trained in advanced scleral fitting techniques including front-surface toricity, multi-zone custom designs, and scleral orthokeratology for post-surgical patients. His diagnostic approach begins with thorough topography and OCT imaging before a single trial lens is placed.
Patient Stories
Real outcomes from patients who found answers here.
"I have keratoconus and had been wearing RGP lenses for years, but my vision kept getting worse and the discomfort was unbearable. Dr. Bonakdar fitted me with sclerals and I was blown away — the sharpness was unlike anything I'd had since before my diagnosis. I wear them 14 hours a day without any issues."
— Michael T., Irvine, CA
"I have severe dry eye disease from Sjogren's syndrome and hadn't worn contact lenses in six years. Every lens I tried lasted two hours before my eyes were on fire. The sclerals Dr. Bonakdar fitted me with changed everything — I wear them to work every day and forget I have them in."
— Sandra K., Newport Beach, CA
Request a Scleral Lens Consultation
Tell us about your situation and we'll connect you with Dr. Bonakdar's team. Same-week appointments are typically available for new specialty lens consultations.
Related Services & Information
Ready to See What Scleral Lenses Can Do?
If you've been told glasses and standard contacts are the only option — get a second opinion. We've helped hundreds of patients who were told the same thing.