Why there’s no single price
Scleral lenses are custom medical devices. Your fitter measures your eye, orders a lens, checks how it sits, and often changes the design and reorders until the fit is right. Two people with the same diagnosis can need very different amounts of work.
That’s why practices rarely publish one price, and why very little cost data appears in the medical literature. What you can learn, before you commit, is how the bill is built and what is included.
The two main parts of the bill
The professional fitting. This covers the exams, corneal measurements, trial lenses, the visit where you receive your lenses and learn to handle them, and follow-up visits to check the fit. Some practices charge one global fee for a set period. Others bill visit by visit.
The lenses. Each lens is made to order. The lens cost depends on the design and material, and you usually need one per eye.
Some practices also charge separately for the care supplies (preservative-free saline, cleaner, a storage case, and an inserter and remover), or include a starter kit.
What drives the total up or down
How many visits and remakes you need. A survey of fitting practices covering 259 patients found that practitioners ordered an average of 2.4 lenses per eye over 3.8 visits before reaching a final fit, but the range ran from 1 to 16 lenses and 1 to 18 visits.[3] If your fitting fee is per visit, or doesn’t cover remakes, the high end of that range costs more.
How complex your eyes are. Advanced keratoconus, corneal transplants, very irregular sclerae, and severe ocular surface disease can need more customized designs and more adjustment. Ask your fitter how complicated they expect your fit to be.
Replacements over time. Lenses get lost, scratched, and broken. In one study of 157 keratoconus eyes that had worn scleral lenses successfully for at least a year, 26.1% of eyes had a broken lens at some point.[4] Lenses are also replaced as they age or as your eyes change. Plan for replacement costs, not just the first pair.
Your coverage. The same fitting can cost you very different amounts depending on whether your medical plan, your vision plan, or neither one pays. For example, one large insurer’s published policy treats the evaluation and fitting for keratoconus as medically necessary, but says that plans excluding contact lenses don’t cover the lenses themselves for that purpose; those are left to the member’s vision plan.[6] Your plan may be different, so check.
Published figures we could verify
Reliable published price data for scleral lenses in the US is scarce. These are the two sources we found that report dollar amounts. Neither is a price list, and your costs could be higher or lower.
- One academic health system’s charges. A 2026 study of a program that pays for specialty eye care for low-income patients at a San Francisco safety-net hospital estimated, based on UCSF Health charges, about $550 to $650 per eye for scleral lenses and $688 to $810 for a typical initial fitting.[1] That’s one institution’s pricing, used to estimate program costs, not a national average.
- What keratoconus patients report spending. In a 2016 to 2017 online survey distributed by the National Keratoconus Foundation, 41% of people wearing scleral lenses in both eyes said their annual out-of-pocket costs were under $1,000, compared with 60% of those wearing corneal gas permeable lenses.[2] That survey had 76 bilateral scleral wearers, and the costs were self-reported.
We did not find a published national average we could verify, so we don’t print one. Be cautious of any single number you see online without a source.
What to ask the practice before you start
- What does the fitting fee include, and for how long? Does it cover follow-up visits and lens remakes?
- How many visits do you expect for someone with my eyes?
- Are the lenses priced separately from the fitting? Is that per lens or per pair?
- Is there a warranty or exchange period if a lens doesn’t work out?
- What does a replacement lens cost later, if I lose or break one?
- Are care supplies included, or do I buy them separately? Which ones do you recommend?
- Do you bill my medical plan, my vision plan, or neither? If neither, can you give me paperwork to submit myself?
- Can I get a written estimate?
What to ask your plan
Call the member services number on your card. Ask whether contact lenses are excluded under your medical plan, whether your vision plan has a “medically necessary” or “visually required” contact lens benefit, and whether either one needs prior authorization. If you have a health savings account or flexible spending account, IRS Publication 502 counts contact lenses needed for medical reasons, and supplies such as saline, as medical expenses.[7] The guides below walk through each step.
Common questions
Why is a scleral lens so much more expensive than a regular contact lens?
Each scleral lens is custom made to the shape of your eye, and fitting one takes specialized measurements, trial lenses, and several visits. Regular soft lenses are mass produced in standard sizes. Much of what you pay for with a scleral lens is the fitter's time and the remakes needed to get the fit right.
Does the price include replacement lenses?
Usually not, unless the practice says so. A fitting fee often covers adjustments for a set period, but a lens you break or lose after that is normally a separate charge. Ask about the warranty or replacement policy before you order.
Will my insurance pay for scleral lenses?
Sometimes, in part. It depends on your diagnosis and on whether the lenses fall under your medical plan, your vision plan, or neither. Start with the guides on medical versus vision insurance and on medically necessary contact lenses, then call your plan with the questions they list.
Can I use my HSA or FSA?
IRS Publication 502 lists contact lenses needed for medical reasons, and supplies like saline, as medical expenses, which generally makes them eligible for HSA and FSA funds. Check with your account administrator about their documentation rules.
Is it cheaper to get scleral lenses online?
Scleral lenses can't be bought off the shelf. They are made to a fitter's specifications after measuring your eye, so the cost of the fitting and follow-up comes with them wherever you get them.