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A scleral contact lens is a lens design that actually dates back to the early to mid 1880s. Originally these lenses were designed by taking a cast of the eye. Large diameter, corneal vaulting lenses would then be shaped to conform to the measured shape, initially using an artisan glass blower to custom make them and then eventually grinding the power directly into the glass blank much like how eyeglass lenses were made in the late 1920s. After World War II a plastic polymer called PMMA (polymethyl methacrylate) was attempted to be used due to its decreased cost but because PMMA has virtually no gas permeability much like glass, early scleral contacts were not oxygen permeable enough for full day wear, which severely restricted the effectiveness of them as a realistic patient solution. As such, early lenses fell into disuse until a relatively recent resurgence in the 1990s.

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Scleral lens production increased again after more highly oxygen permeable materials, at the time routinely used in rigid gas permeable (RGP) lenses, became available for other uses. The mold based fitting philosophy was replaced the use of diagnostic kits, in which a patient wears a series of lenses over a prescribed period in order to find the best fit. The recent development of digital imaging techniques and topography guided design has allowed some providers to evaluate and correct fit with much greater accuracy. A number of scleral contact producers have also made lenses with customizable parameters available, so that each lens can be fabricated via a computerized lathe to better match the unique scleral shapes of each individual eye.

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Recent developments at our clinic include utilizing a scleral lens design called KeratoCAD, where a three dimensional digital scan is taken of the cornea with our proprietary topography software. This scan is calculated via this software and our lab designs a lens to fit properly over every area of the that specific cornea. Upcoming exciting advances on the horizon include experimental wavefront correction and decentered optics that can be incorporated into scleral contacts which can further correct the vision to "super vision" levels that can further correct higher order aberrations. Most scleral lenses without any additional optical enhancements can correct up to 80% or more of higher order aberrations (HOA's) depending on the specific circumstances and corneal shape of each patient. 

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Scleral contacts can be used for many reasons such as to improve vision, promote healing, reduce discomfort and mitigate photosensitivity issues for people suffering from a growing number of medical problems affecting the eye, such as:

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• Severe dry eye syndrome/Keratoconjunctivitis sicca (KCS)

• Microphthalmia (A misformed eye from birth that is much smaller than normal)

• Keratoconus/ Pellucid marginal degeneration

• Stevens–Johnson syndrome (An inflammatory condition that can cause eye inflammation)

• Sjögren's syndrome (An autoimmune disease that often results in severe dry eyes)

• Aniridia (poorly formed or absent iris of the eye)

• Neurotrophic keratitis (A corneal disorder caused by damage to the corneal nerves)

• Post-LASIK ectasia (thinning of the cornea)

• Higher order aberrations of the eye

• Complications post-corneal transplantation

• Surgical complications or eye injury and,

• Chemical or burn injuries 

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Scleral contacts can also be employed in people with more benign eye conditions such as high myopia, high astigmatism and even prebyopia (the inability to read close things after age 45) but are intolerant to other smaller diameter corneal RGP lenses, but still require a more rigid contact lens for vision correction. This can include conditions such as irregular astigmatism.