Can you buy scleral lenses online?

Contact lenses are prescription medical devices

In the US, contact lenses are medical devices that require a prescription. The FDA warns against buying them from any seller not authorized by law to dispense them.^[4] The FDA oversees the lenses themselves, and the Federal Trade Commission enforces the rules about prescriptions and sales.^[1]

Why scleral lenses are different from soft lenses

Soft lenses come in standard parameters from a box, so a prescription can be filled by many sellers. Scleral lenses are usually designed for your eye during a fitting, and it often takes more than one order to get right.

In an international survey of fitters, a fitting involved an average of 2.4 lenses ordered over 3.8 visits, with some patients needing as many as 16 lenses over 18 visits.^[5] Lens edges are often shaped to match the eye: 36% of the lenses in that survey had toric, quadrant-specific, or custom landing zones rather than simple round ones.^[5] In a large Dutch practice, toric landing zones were used in 99.8% of lenses.^[6] That level of customization is why reorders normally go back through the fitter, who works with the lab that made the design.

Your right to your prescription

Under the FTC’s Contact Lens Rule, your eye care provider must give you a copy of your contact lens prescription when the fitting is complete, even if you don’t ask for it.^[2] The rule defines a contact lens fitting as the process that ends when a successful fit has been achieved, and it can include medically necessary follow-up examinations.^[3]

A valid prescription includes, among other things, your name, the exam date, issue and expiration dates, the prescriber’s details, the lens power, material or manufacturer, base curve, and diameter when appropriate.^[2] Expiration is set by your state, commonly one or two years; where the state hasn’t set one, federal regulation sets one year unless your eye care professional has a medical reason for less.^[1]

If you do order lenses from someone else

The FDA’s advice for buying any contact lenses applies:^[1]

• Use a current, valid prescription. Don’t stock up just before it expires.
• Order from a supplier you know is reliable.
• Check that what arrives matches exactly: brand, lens name, power, diameter, base curve, and peripheral curves.
• Don’t accept a substitution unless your eye care professional approves it.
• If you think you’ve received the wrong lens, check with your eye care professional.

Buying contact lenses online has been linked to infection risk in the past. A large Australian study of contact lens infections across lens types listed internet purchase of lenses among the risk factors it identified.^[7] That doesn’t mean every online order is risky, but it’s a reason to keep your fitter involved.

Buying supplies online

Saline, cleaners, disinfecting solutions, cases, and plungers are a different matter. Many wearers buy these online. The rules:

• Buy the exact product your fitter recommends. Solutions aren’t interchangeable. See saline and solutions.
• Fill lenses only with sterile saline, preferably single-use vials.^[9]
• Check seals and expiration dates when the package arrives.
• Never use homemade saline or tap water.^[8]

What to ask your fitter

• “When will you consider my fit complete, and can I have a copy of my prescription then?”
• “How do I order a replacement or spare lens, and how long does it take?”
• “Which care products should I buy, and is it fine to order them online?”