What the first visit is for
The first appointment is mostly about measuring your eyes and deciding whether scleral lenses are the right next step. Expect a history, a vision check, an eye health exam with a microscope, maps or scans of your eye, and usually one or more trial lenses. Your own lenses are made to order afterward. A fitting is a series of visits: in an international survey describing 259 patients, fits took an average of 3.8 visits.[2] See what a scleral lens fitting involves for every stage.
What to bring
- Your glasses, including any old pairs you still use, and sunglasses for after.
- Your current contact lenses in their case, and the lens boxes or details if you have them. The fitter may want to see how they fit or check your vision through them.
- A list of every eye drop and medicine you use, including over-the-counter drops, ointments, and allergy medicines, plus any allergies.
- Both insurance cards, medical and vision, and photo ID. See medical vs vision insurance.
- Records from your cornea surgeon or other eye doctors: your diagnosis, transplant or surgery reports, corneal maps, and any past contact lens specifications. Sending them ahead is even better.
- A referral, if your plan or the practice needs one. See do you need a referral?
- Your written list (below).
The FDA advises contact lens wearers to always have a backup pair of glasses with a current prescription.[3] If yours are out of date, mention it.
Your written list
Write down, in a few lines each:
- What you’ve tried before (glasses, soft lenses, rigid lenses, other scleral lenses) and why each didn’t work
- What bothers you most now: blur, ghosting, glare at night, pain, dryness, light sensitivity
- What you most want to see or do: driving, reading, screens, work, sports
- How many hours a day you’d like to wear lenses
- Your questions
How long it may take
Plan for a long appointment. In a survey of 423 fitters who fit scleral lenses for keratoconus, the median time for the initial evaluation was 30 minutes,[1] but that’s the fitting evaluation alone. A first visit that also includes your history, an eye health exam, dilation and paperwork often runs longer. Ask the office when you book, and don’t schedule anything tight afterward.
Dilation and driving
Your fitter may dilate your pupils to examine the inside of the eye. Dilation can leave your vision blurry and light-sensitive for some hours, and putting your lenses back in won’t undo that. Ask ahead whether dilation is likely, bring sunglasses, and arrange a ride. See can you wear scleral lenses after eye dilation?
Lenses in or out beforehand?
Ask the office. Some fitters want your current contact lenses out for a time before they measure your cornea. Others want to see your lenses on your eye. If you can’t see well enough to get there without lenses, ask how to handle that.
Questions to ask at the visit
Use two lists:
- Before booking, practical questions for the office about wait times, fees, insurance and what to bring: see what to ask before booking a fitting.
- At the visit, clinical questions for the fitter, such as whether scleral lenses are the right option for you, what you can realistically expect, and how they’ll fit you: see questions to ask a scleral lens fitter.
Before you leave, make sure you know:
- What happens next, and when your next visit is
- What the fitting fee covers, and the remake window (see what’s included in a fitting fee)
- Whether anything needs insurance approval before lenses are ordered
- How to reach the office between visits
What wearers say
Many wearers say the first visit felt long and a little overwhelming, and that trial lenses didn’t feel like the final lenses would. People who brought a list of past lenses and symptoms say it made the visit more productive. Several recommend a driver or rideshare, and bringing someone to take notes. Many were surprised they didn’t leave with lenses, so it helps to know that ahead of time.
Finding a practice
If you haven’t chosen a practice yet, see how do I find a good scleral lens specialist? and the checklist for choosing a specialist.
Common questions
Will I leave with scleral lenses on the first day?
Usually not. Each lens is custom-made, so the first visit is mostly measurements and trial lenses, and your lenses are ordered afterward. Some specialty programs that make lenses on site are an exception.
Should I wear my current contact lenses to the appointment?
Ask the office when you book. Some fitters want your eyes lens-free for a time before measuring the cornea; others want to see your current lenses on the eye. If you rely on lenses to see, ask how to manage the time without them.
Can I drive home after the first visit?
If your eyes are dilated, plan not to. Ask the office whether dilation is likely and arrange a ride. Many wearers use a rideshare or bring someone along.
How long does the first appointment take?
Plan for a long visit. In a survey of fitters, the median time for the initial scleral lens evaluation was about half an hour, but a first visit with history, eye health exam, and trial lenses often runs longer. Ask the office what to expect.
What if trial lenses feel uncomfortable?
Say so. Trial lenses are a starting point and often feel different from your final custom lenses. Honest feedback helps the fitter design the right lens.
Should I bring someone with me?
It can help: a second person can take notes, drive if you're dilated, and later learn to help with insertion and removal if you need it.