Search every guide, condition page, and common question.

    Finding care

    Can scleral lens care be done by telehealth?

    Video calls and photos can save you a trip for some questions. But checking how a scleral lens sits, and how healthy your cornea is under it, still needs you in the chair. Here's where remote care helps and where it doesn't.

    By the Scleral Lens Team · Updated October 5, 2026 · 3 published sources cited

    The short answer

    Partly. Telehealth works for symptom check-ins, handling and care questions, reviewing photos of redness or a lens problem, and deciding whether you need to come in. It can't replace in-person visits for the fitting itself, follow-up fit checks, or eye health exams, because those need a slit lamp microscope and often imaging such as OCT. Telehealth rules and coverage vary by state and plan, so ask your practice what it offers and whether your insurance pays for it.

    Key points

    • Good for: symptom check-ins, handling questions, photo review, triage.
    • Needs in person: fitting, fit checks after settling, eye health exams.
    • Photos help when labeled clearly and taken in good light.
    • Telehealth rules and coverage vary by state and plan. Ask.
    • Urgent symptoms need same-day, in-person care.

    What telehealth can do

    Remote contact, by video, phone, photo or portal message, can be genuinely useful between visits:

    • Symptom check-ins. “My left eye is red at the end of the day” or “my vision is foggier than last week” can often be talked through, and your fitter can decide whether it can wait for your next visit.
    • Handling and care questions. Insertion technique, bubbles, which solution to use, and what to do if you dropped a lens can often be coached over video.
    • Photo review. A clear photo of redness, a mark after removal, a lens chip, or deposits can help your fitter judge urgency.
    • Planning. Deciding whether to reorder, scheduling, records, and insurance questions.
    • Triage while traveling. If you’re far from home, a quick call can help decide whether you need a local eye doctor today.

    What needs an in-person visit

    A scleral lens is checked on the eye with a slit lamp microscope, and often with imaging such as anterior segment OCT, which shows the fluid layer between the lens and the cornea. None of that can be done well through a phone camera. In-person visits are needed for:

    • The fitting itself. Under the federal Contact Lens Rule, a contact lens fitting can include an examination to determine lens specifications and, for a new prescription, an evaluation of the fit of the lens on the eye.[2]
    • Fit checks after settling. A scleral lens settles onto the eye over hours, and the fitter checks how much clearance is left over the cornea and how the edge sits after wear. See what is vault or clearance?
    • Eye health exams. Looking at the cornea and conjunctiva with the lens out, checking eye pressure if needed, and monitoring your underlying condition.
    • Regular monitoring. A 2026 case series on complications from poorly fitted scleral lenses concluded that both the lens fit and the underlying disease should be assessed at regularly scheduled intervals in all wearers.[1]
    • Anything urgent. Pain, light sensitivity, discharge, or sudden blur.

    Rules and coverage

    Telehealth rules for eye care, including which services can be done remotely and whether a doctor can see you across state lines, vary by state and have changed over time. Insurance coverage for virtual visits also varies by plan. Ask the practice what it offers where you live, and ask your plan whether it covers virtual visits with that provider.

    How to take useful eye photos

    Wearers and fitters share some practical tips:

    • Use good, even light, such as near a window. Avoid the flash if it washes out redness.
    • Turn off any mirror or selfie flip, so left and right aren’t reversed.
    • Include a little of the nose in the frame, and label which eye it is.
    • Take a few: looking straight ahead, up, down, left and right.
    • Note the time, and how long after removal (or how long into wear) the photo was taken.
    • If you’re showing a mark or redness after removal, take photos at intervals to show whether it fades.

    Questions to ask your practice

    • Do you offer video visits or photo review through a portal?
    • Which problems can be handled remotely, and which need a visit?
    • Who reviews messages, and how quickly?
    • Is there a charge for virtual visits, and does insurance cover them?
    • What should I do if I’m traveling and something goes wrong?

    What wearers say

    Many wearers say sending a photo through the portal saved them an unnecessary trip, or got them seen the same day when it mattered. Others describe frustration when a new, clearly uncomfortable fit was reviewed only by phone and weeks went by before anyone looked at the lens. The common view is that remote contact is a helpful extra, not a substitute for seeing the fitter.

    Finding a practice

    For where to look, see how do I find a good scleral lens specialist? If you live far from a fitter, see is it worth traveling for a scleral lens fitting?

    Common questions

    Can I be fitted for scleral lenses by video?

    No. Fitting a scleral lens needs measurements of your eye and an in-person look at how a lens sits, how much fluid is under it, and where the edge lands. That takes a microscope and often imaging in the office.

    Can my follow-up visit be done by phone?

    A quick phone or video check can help between visits, but a fit check needs you in the office, ideally after you've worn the lenses for some hours so the fitter can see them settled. Wearers report problems were missed when new fits were reviewed only by phone.

    Can I send my fitter a photo of my red eye?

    Many practices welcome photos through a patient portal. They help decide how urgent a problem is. But if you have pain, light sensitivity, discharge or blurred vision, remove the lens and get seen in person the same day.

    Does insurance cover scleral lens telehealth visits?

    It depends on your plan and state. Some plans cover virtual visits and some don't, and rules have changed over time. Ask your plan and the practice before the visit.

    Can a fitter in another state see me by telehealth?

    Licensing rules for telehealth across state lines vary. Ask the practice whether they can offer virtual visits where you live.

    Keep reading

    Is it worth traveling for a scleral lens fitting?

    It can be, especially if your eyes are complex or earlier fittings near home haven't worked. But a scleral lens fitting usually takes several visits, and you'll need check-ups and the occasional urgent visit afterward, so distance has a real cost. Before you commit, ask the distant practice how many trips to expect, whether they can compress visits into a few days, and whether a local eye doctor can handle routine care and emergencies in between.

    How often should you see your scleral lens fitter?

    As often as your fitter recommends: there's no one schedule for everyone. Expect several visits during the fitting itself, then regular check-ups once your lenses are settled. Keep them even when your lenses feel fine, because some problems, like corneal swelling, can develop without symptoms. Book sooner if your vision, comfort, or the look of your eye changes, and call the same day for pain, worsening redness, light sensitivity, or vision that doesn't clear.

    What are the red flags when choosing a scleral lens practice?

    Be cautious if a practice won't explain its fees or remake policy, asks you to prepay without a written estimate, has no plan for follow-up or for problems after hours, promises perfect results, or gives care advice that goes against basic contact lens safety, such as rinsing lenses with tap water or sleeping in them. One red flag isn't always a reason to leave, but ask about it directly. A good practice will give you a clear, specific answer.

    What is scleral lens vault, or clearance?

    Vault, also called clearance, is the gap between the back of a scleral lens and the front of your cornea, filled with saline. Too little and the lens can touch the cornea as it settles; too much and less oxygen reaches the cornea and vision can be affected. Published reviews cite targets of roughly 100 to 200 or 100 to 300 microns after the lens settles, but they also stress that the right vault is whatever keeps your vision clear, your eye comfortable, and your cornea healthy.

    Sources

    1. Nau CB, Nau AC, Fogt JS, Shorter ES, Harthan JS, Schornack MM. Complications of poorly fitted scleral lenses and approaches to continued wear. Eye Contact Lens. 2026;52(10):432-435. doi:10.1097/ICL.0000000000001306 pubmed.ncbi.nlm.nih.gov
    2. Federal Trade Commission. Contact Lens Rule: Definitions. 16 CFR § 315.2. ecfr.gov
    3. U.S. Food and Drug Administration. Contact Lens Risks. Content current as of September 4, 2018. fda.gov

    Last updated October 5, 2026. Found an error or a newer study? Let us know and we'll correct the page.