The cost of distance
A scleral lens fitting is a series of visits. In an international survey describing 259 scleral lens patients, fits took an average of 3.8 visits, with a range from 1 to 18.[1] After the fit is final come routine check-ups (see how often should you see your fitter?), replacement lenses every so often, and now and then an urgent problem.
Every one of those is a trip. Before you choose a distant practice, count them, and count the time off work, travel, lodging, and who drives you if your eyes are dilated.
When traveling tends to make sense
- Complex eyes. Advanced keratoconus, a corneal transplant, eyes after several surgeries, or severe ocular surface disease may need a fitter who sees those cases every week, or tools and designs that aren’t available locally.
- Failed local fittings. If you’ve had many remakes without progress, a fresh look from a more experienced fitter can change the picture. See how to get a second opinion.
- Specific treatments. Some approaches, such as PROSE or certain impression-based lenses, are only offered at some practices.
- No fitter nearby. In some regions, no one fits scleral lenses regularly.
When it may not be needed
Most scleral fitting happens close to home: in a 2020 survey, 76% of scleral fitters worked in community practice rather than academic centers.[2] If an experienced fitter is within reasonable reach and your eyes are fairly straightforward, a closer practice may serve you just as well, with easier follow-up.
How to make a long-distance fitting work
Ask how the practice handles out-of-town patients. Some specialty centers fit over several consecutive days, sometimes with lenses made on site, so most of the work happens in one stay. Others work across separate visits weeks apart while the lab makes each lens. Ask which, and how many trips to plan for.
Plan the trips. Ask whether visits can be grouped, whether you can wear your lenses for some hours before follow-ups so the fitter sees them settled, and whether dilation is likely so you can arrange a driver.
Set up local care. Ask a local optometrist or ophthalmologist whether they’ll see you for eye health checks and emergencies, and ask both doctors to share notes. This shared arrangement is common, and it means someone nearby has seen your eyes before a problem happens.
Know the limits of remote follow-up. Photos, video calls and messages help a fitter triage problems between visits, but checking how the lens sits, the fluid layer under it, and the health of your cornea needs an in-person exam. See scleral lenses and telehealth.
Keep a spare and an emergency kit. Losing or breaking a lens far from your fitter can mean weeks without one. Ask about a spare, and see build an emergency kit.
Who benefits most from a specialty center
People most likely to find the trip worthwhile tend to be those with severe or unusual corneal shapes, ocular surface disease that needs a lens to protect the eye, children with complex needs, and people who’ve tried several lenses without success. Specialty centers often see a high volume of these eyes and may have a wider range of tools and designs. Ask any center how often they fit patients like you.
What wearers say
Wearers who traveled often say it was worth it, especially after several unsuccessful fittings at home. Many describe planning a block of days, sometimes with family, and leaving with lenses. Others describe the strain of repeated long drives for small adjustments, and some long-term wearers later moved their care closer to home once their fit was stable. Several wearers found an excellent fitter nearby after assuming they’d need to travel.
Finding a practice
For where to look, see how do I find a good scleral lens specialist? and use the checklist for choosing a specialist to weigh a distant practice against a closer one.
Common questions
How many trips should I plan for?
Ask the practice, since it depends on your eye and how they work. In an international survey, fittings averaged a little under four visits, with some needing far more. Some specialty centers fit over several consecutive days instead.
Can my local optometrist handle follow-up?
Often for routine eye health checks and emergencies, yes. Adjusting the lens design is usually done by the fitter who designed it. Ask both doctors whether they'll share your care and send each other notes.
What if something goes wrong when I'm far from my fitter?
Remove the lens and contact your fitter, or see a local eye doctor or urgent care the same day if you have pain, redness, light sensitivity or blurred vision. Know before you start who you'll call locally.
Are well-known centers always better than a local specialist?
Not necessarily. Wearers report excellent results both at large centers and with experienced local fitters. What matters is experience with eyes like yours.
Do I need to stay overnight?
For some specialty programs that fit over consecutive days, yes. Ask how many days to plan for and whether you'll be able to drive during the fitting.