How an eye injury affects your vision
Injuries to the cornea, the clear front window of the eye, range from scratches that heal without a trace to cuts (lacerations) and full-thickness wounds. When the eye wall is cut or ruptured all the way through, doctors call it an open-globe injury. These are among the leading causes of preventable blindness from trauma.[2] Worldwide, eye injury and corneal ulcers together are estimated to cause 1.5 to 2.0 million new cases of blindness in one eye each year, and the authors note both are often underreported.[1]
Serious cuts are closed with fine stitches. Even after a good repair, the cornea usually doesn’t heal back to its original shape. The result can include:
- Scarring, which can cloud vision if it crosses the center of the cornea.
- Irregular astigmatism, an uneven curve that distorts and ghosts images. Glasses can’t correct it.
- Surface problems, such as epithelial defects that are slow to heal.[3]
- Damage elsewhere in the eye, such as loss of the eye’s natural lens or injury to the retina.
How a scleral lens helps
A scleral lens is a large rigid gas-permeable lens. It rests on the sclera (the white of the eye) and arches over the entire cornea without touching it. Before insertion it is filled with sterile saline.
- It replaces the uneven surface optically. Light passes through the smooth front of the lens and the even layer of saline before it reaches the cornea. The saline fills in the irregularities left by the wound and stitches.
- It doesn’t need a regular cornea to sit on. A small rigid lens rests on the cornea and can be hard to center or keep comfortable on a scarred, uneven one. A scleral lens lands on the white of the eye instead.
- It protects a fragile surface. The saline acts as a fluid bandage, shielding the surface from the blinking lid and from drying out.[3]
A 2025 review notes that scleral lenses are not a first-line treatment for a fresh injury. Their role is in rehabilitation, once the eye has been repaired.[3]
What the research shows
The evidence is small but consistent. We found one dedicated study, a pediatric series, a few case reports, and injury cases mixed into larger studies.
- Repaired open-globe injuries. A university clinic in Istanbul reviewed 11 people whose open-globe injuries had been repaired and who couldn’t tolerate corneal rigid lenses. About half had scarring in the center of the cornea and half just off-center. With scleral lenses, median best-corrected vision improved from 0.50 to 0.10 logMAR, roughly from 20/63 to 20/25, over a median follow-up of 22 months.[4]
- Children. In a US series of 18 children fitted with scleral lenses, the lenses meant three eyes with injury scars didn’t need a corneal transplant. 83% of the children were still wearing their lenses at an average of about nine months. One child had a corneal scratch from putting a lens in.[5]
- Lacerations in a mixed group. A Korean study of 62 eyes fitted with scleral lenses included 4 eyes with corneal lacerations. Across all eyes, vision with the lenses was significantly better than with previous correction. Results weren’t reported for the laceration eyes alone.[6]
- Scars in general. In a series of six eyes with central scars, average vision improved from 20/80 in glasses to 20/25 with mini-scleral lenses.[10]
Injuries that reach the white of the eye can need custom designs. A 63-year-old man’s injury left his cornea and sclera irregular where they meet, so standard lenses wouldn’t stay stable. A lens with a different curve in each quarter of its edge gave him better comfort and vision.[7]
A lens can’t fix damage behind the cornea. After a severe blast injury that damaged the retina, a specially designed scleral lens improved one man’s vision from seeing only hand movements to 6/60 (20/200), and magnified near vision. It also eased dryness and improved the eye’s appearance.[8] That was a real gain, but the lens couldn’t restore what the retina had lost.
Other options, compared
| Option | What it does | Typically suited to |
|---|---|---|
| Glasses | Correct regular blur only | Little irregularity |
| Corneal rigid gas-permeable lenses | Give a smooth surface on the cornea | Irregular scars, when the lens centers and is tolerated; studied in children after corneal cuts[9] |
| Hybrid lenses | Rigid center with a soft skirt | People who can’t tolerate a rigid corneal lens |
| Scleral lenses | Vault the cornea over a saline layer | Irregular scars, intolerance of corneal lenses, a fragile surface |
| Custom scleral designs (quadrant-specific or impression-based) | Match an irregular white of the eye | Injuries that extend beyond the cornea |
| Corneal transplant | Replaces scarred tissue | Dense central scars that limit vision despite lenses |
Questions to ask a scleral lens fitter
- Is my eye healed enough for a fitting? Has my surgeon agreed?
- How much of my vision loss comes from the cornea, and how much from the rest of the eye?
- Do I still have stitches in my cornea, and does that matter for the fit?
- Does my injury reach the white of the eye? Will I need a custom design?
- I lost the natural lens of my eye. Can the scleral lens include that correction?
- What signs mean I should remove the lens and call you the same day?
Common questions
How soon after an eye injury can I be fitted?
There's no fixed timeline in the research. Scleral lenses are used once the eye has healed, during rehabilitation, not for a fresh injury. Your surgeon decides when the wound is stable enough.
My vision is still poor even though the injury healed. Will a scleral lens fix it?
It depends on where the damage is. A lens corrects an uneven corneal surface, which is often a big part of the blur. It can't repair a damaged retina, optic nerve, or deep scar. Your eye doctor can estimate how much a lens might help, and a trial lens can show it.
I lost the natural lens of my eye in the injury. Can a scleral lens help?
Yes, this is one of the uses. A contact lens can supply the focusing power the eye lost, and a scleral lens can do that while also correcting an uneven cornea. In one study of repaired open-globe injuries, one person's lens included this correction.
Can children wear scleral lenses after an injury?
Yes. In one pediatric series, scleral lenses helped three children with injury scars avoid a corneal transplant. Ordinary rigid lenses are another option that has been studied in children after corneal cuts.
Can a scleral lens hide a scarred or damaged-looking eye?
Some can. A case report of a severe blast injury describes a custom scleral lens that improved the eye's appearance as well as comfort. Ask your fitter whether a cosmetic design is possible for your eye.