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    Question

    Can scleral lenses fix double vision?

    It depends on which kind of double vision you have. A quick cover test points to the answer, and it also tells you when double vision needs urgent medical attention.

    By the Scleral Lens Team · Last reviewed October 2, 2026 · 6 published sources cited

    The short answer

    If the double or ghost image is in one eye, and it's caused by an irregular cornea such as keratoconus, a scleral lens often reduces or clears it by giving the eye a smooth optical surface. If you see double only with both eyes open, because the eyes aren't lined up, a standard scleral lens won't fix that, though prism can be built into some custom lenses. Double vision that comes on suddenly needs prompt medical assessment, because some causes are serious.

    Key points

    • Cover one eye at a time: double vision that persists with one eye covered comes from the other eye itself.
    • Corneal irregularity is a classic cause of ghost images in one eye, and scleral lenses target it.
    • Double vision only with both eyes open usually comes from eye alignment, nerves or muscles.
    • Custom scleral lenses with prism have helped some people with binocular double vision in case reports.
    • New, sudden double vision needs urgent assessment.

    Start with the cover test

    Double vision comes in two kinds, and they have very different causes. You can get a first clue at home, though only an eye exam can confirm it.

    Look at a single object, such as a light or a line of text, with both eyes open. Then cover your right eye, then your left.

    • The double image goes away when you cover either eye. That’s binocular double vision. Each eye sees one image, but the two eyes aren’t pointing at exactly the same place.[1]
    • The double image stays when you cover your good eye, and goes away when you cover the affected eye. That’s monocular double vision, coming from the affected eye itself.[1]

    If the doubling stays whichever eye you cover, both eyes may be affected, or there may be another cause, and an eye exam is needed.[1]

    Double vision in one eye: where scleral lenses help

    Monocular double vision usually has an optical cause inside that eye. The list includes an abnormally shaped cornea (keratoconus, keratoglobus, after refractive surgery), corneal scars, tear film problems, cataract, and problems with the macula.[1]

    When the cornea is irregular, different parts of it can bend light to slightly different places, forming secondary “ghost” images alongside the main one.[2] A scleral lens covers the irregular cornea with a smooth optical surface, filled with fluid that evens out the bumps underneath. That targets the cause directly:

    • In 157 keratoconus eyes that wore scleral lenses successfully for at least a year, average vision improved from 0.50 logMAR with glasses to 0.08 with scleral lenses.[5]
    • In 35 eyes with irregular corneas after refractive surgery, scleral lenses significantly reduced higher-order aberrations, the irregular distortions that produce ghosting and halos.[4]

    These studies measured sharpness and optical quality rather than ghosting itself, but they show the lens is correcting the irregularity behind it.

    A scleral lens won’t fix monocular double vision from other causes on that list. If the ghosting comes from a cataract or from the macula, the lens can’t help with that part. A pinhole test helps your eye doctor tell them apart: doubling from optical causes clears through a pinhole, while distortion from the macula persists.[1]

    More on the corneal causes: keratoconus, irregular astigmatism, corneal scarring.

    Double vision with both eyes: a different problem

    Binocular double vision usually comes from misalignment of the eyes. Causes include long-standing squints, problems with the nerves that move the eyes, eye socket disease, myasthenia gravis, and conditions in the brain.[3] The first step is always diagnosing and treating the cause. Treatments for the double vision itself include eye muscle surgery, prism glasses, exercises, and botulinum toxin.[3]

    A standard scleral lens doesn’t change eye alignment. Custom lenses can do a little more:

    • Prism scleral lenses. Prism can be built into the optical zone of a scleral lens, up to about 5 prism diopters because thicker lenses reduce oxygen to the cornea. Case reports describe people with vertical or horizontal double vision who regained single vision with custom-shaped scleral lenses carrying prism.[3] These are individual cases, not trials.
    • Blocking lenses. When single vision can’t be restored, an opaque contact lens over one eye can remove the second image. The published examples mostly use soft lenses.[3]

    Common questions

    I have keratoconus and see a shadow or ghost around letters. Is that double vision?

    It's a form of it, often called ghosting or monocular diplopia. The irregular cornea forms a second, fainter image alongside the main one. Correcting the corneal irregularity, which is what a scleral lens does, is the usual way to reduce it.

    I still see some ghosting with my scleral lens. Is the lens wrong?

    Not necessarily. Residual ghosting can come from a lens sitting slightly off-center, from aberrations that remain, or from other causes such as a cataract or tear film problems. Tell your fitter: design changes can help, and it's worth checking for other causes.

    Can a scleral lens with prism fix double vision from misaligned eyes?

    In some people, yes. Case reports describe custom scleral lenses with prism restoring single vision. A review suggests the best candidates have stable, small, consistent misalignment and no other eye disease. Prism in the lens is limited, and the underlying cause must be diagnosed and managed first, usually with a neuro-ophthalmologist or strabismus specialist.

    Keep reading

    What are impression-based scleral lenses?

    An impression-based scleral lens is made from a physical mold of the front of your eye. The mold is scanned in 3D and a lens is cut to match its shape, including bumps or irregular areas on the white of the eye. EyePrintPRO is the best-known example. Studies from a few clinics report better vision and successful wear in many people who couldn't wear standard scleral lenses, though adverse symptoms and refits do occur.

    Can scleral lenses help after LASIK?

    Yes, for some people. LASIK and other laser surgeries can leave the cornea's surface uneven, which causes halos, ghosting, or blur that glasses can't correct, and they can also cause dry eye. A scleral lens covers the uneven surface with a smooth optical one and bathes the cornea in fluid. In a small study of people with irregular corneas after refractive surgery, vision and dry eye symptoms both improved. If your cornea has started to bulge (ectasia), that is a different problem, covered on its own page.

    Can scleral lenses help with light sensitivity?

    Sometimes. If your light sensitivity comes from a damaged, dry, or irregular front surface of the eye, a scleral lens may reduce it by covering and bathing the cornea and by smoothing the glare and halos an irregular cornea causes. A standard scleral lens is clear, though, so it doesn't block light, and it won't help light sensitivity that comes from inside the eye, the nerves, or migraine. New light sensitivity while you're wearing scleral lenses can be a sign of a problem: remove the lens and call your eye doctor.

    Can I wear scleral lenses after cataract surgery?

    Usually, yes, once your surgeon and fitter agree your eye has healed. Cataract surgery replaces the eye's natural lens, but it doesn't smooth an irregular cornea, so people with keratoconus, a corneal transplant, or other corneal irregularity often still need a specialty lens afterward. Scleral lenses are also one option for people who are left without a lens implant. Medicare Part B covers one set of contact lenses after each cataract surgery that implants a lens, with rules that are worth checking.

    Can scleral lenses help macular degeneration?

    Not for the macular degeneration itself. A scleral lens works by replacing an irregular or damaged front surface of the eye, while macular degeneration damages the retina at the back of the eye, so the vision it takes can't be restored by any contact lens. A scleral lens may still help if you also have a front-of-eye problem, such as an irregular cornea or severe dry eye, because it can clear the part of your blur that comes from there. Low vision rehabilitation is the main help for the macular part.

    Sources

    1. Tan A, Faridah H. The two-minute approach to monocular diplopia. Malays Fam Physician. 2010;5(3):115-118. pubmed.ncbi.nlm.nih.gov
    2. Campbell C. Corneal aberrations, monocular diplopia, and ghost images: analysis using corneal topographical data. Optom Vis Sci. 1998;75(3):197-207. doi:10.1097/00006324-199803000-00025 pubmed.ncbi.nlm.nih.gov
    3. Lee SK, Zabrowski C, Lee MS. Management of diplopia using contact lens. Neuroophthalmology. 2025;49(1):11-16. doi:10.1080/01658107.2024.2377173 pubmed.ncbi.nlm.nih.gov
    4. Marty AS, Jurkiewicz T, Mouchel R, Febvay C, Caillat T, Burillon C. Benefits of scleral lens in the management of irregular corneas and dry eye syndrome after refractive surgery. Eye Contact Lens. 2022;48(8):318-321. doi:10.1097/ICL.0000000000000919 pubmed.ncbi.nlm.nih.gov
    5. Fuller DG, Wang Y. Safety and efficacy of scleral lenses for keratoconus. Optom Vis Sci. 2020;97(9):741-748. doi:10.1097/OPX.0000000000001578 pubmed.ncbi.nlm.nih.gov
    6. U.S. Food and Drug Administration. Contact Lens Risks. Content current as of September 4, 2018. fda.gov

    Last updated October 2, 2026. Found an error or a newer study? Let us know and we'll correct the page.