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    Question

    Can I wear scleral lenses with conjunctivochalasis?

    Conjunctivochalasis means loose folds in the thin membrane over the white of the eye. Many people with it wear scleral lenses. It can also make the lens edge rub, or the folds bunch under the lens.

    By the Scleral Lens Team · Last reviewed October 2, 2026 · 3 published sources cited

    The short answer

    Often, yes. Wearers with mild conjunctivochalasis commonly say it doesn't get in the way, and fitters can adjust the lens size or edge to reduce rubbing. When the folds are more pronounced they can cause foreign-body feeling, catch at the lens edge, or get drawn up under it. Some people have the folds treated, with medication or a minor surgery, before a fitting or refit. Ask your eye doctor whether treatment first makes sense for you.

    Key points

    • Conjunctivochalasis is loose, redundant conjunctiva, most often along the lower part of the eye.
    • Mild cases often cause no problems with scleral lenses.
    • A different lens size or edge can reduce rubbing. Smaller sometimes works better than bigger.
    • Pronounced folds may need treatment before a fitting or refit.

    What conjunctivochalasis is

    The conjunctiva is the thin, clear membrane over the white of your eye. In conjunctivochalasis it becomes loose and redundant, forming folds that typically sit on the lower part of the white of the eye. It’s common and often goes undiagnosed.[1]

    Symptoms range from mild discomfort in early stages to blocked tear drainage in moderate stages. In severe stages it can lead to exposure damage to the cornea and loss of vision.[1]

    How it affects a scleral lens

    A scleral lens rests on the conjunctiva over the white of the eye. Loose folds can affect it in a few ways that wearers describe:

    • Rubbing at the edge. The folds catch or rub where the lens edge sits, especially along the lower edge, causing a foreign-body feeling.
    • Folds drawn under the edge. Loose tissue can be pulled up under the lens. Wearers sometimes see it as a line or bulge under the lens.
    • Fit readings. Scans of the eye measure the surface of the conjunctiva, and loose or compressed tissue may not reflect the shape of the sclera underneath, one eye doctor explained to a wearer. That can make a scan-based lens harder to get right.
    • Dryness and fogging, since loose folds can disturb the tear film along the lower lid.

    When the conjunctiva is drawn up into the space under the lens, it’s called conjunctival prolapse. Eye doctors can read more about it, and how it’s managed, in our page on conjunctival prolapse and scleral lenses.

    What fitters can change

    A review of scleral lens complications describes options for problems with the conjunctiva at the lens edge, including a large-diameter lens to cover the affected tissue or a small-diameter lens to avoid it.[2]

    Wearers with conjunctivochalasis report:

    • Going smaller. Several found a smaller lens rubbed less than larger ones, even though they’d assumed bigger would be better for their dry eye.
    • Edge adjustments. A small change to the edge or landing area removed irritation and fogging for some.
    • Custom designs. Impression-based or scan-based lenses that follow the eye’s shape more closely. See impression-based scleral lenses.

    Treating the folds first

    The same review notes that anti-inflammatory treatments, such as cyclosporine, lifitegrast, short courses of steroid drops, or amniotic membrane, can help tighten conjunctival tissue, and that in cases of excessive conjunctivochalasis a surgical conjunctivoplasty may be necessary.[2]

    Wearers who had the folds treated describe lenses becoming comfortable afterward. Some were advised to have treatment before starting a fitting, because treating the folds changes the surface the lens rests on, and a few mention that the folds can come back. Ask your eye doctor and fitter to plan the order together.

    Day to day

    • Remove gently. Some wearers worry that tugging during hard removals stretches loose tissue further. Breaking the suction at the lower edge before lifting the lens, as your fitter shows you, makes removal easier on the eye. See how to remove a scleral lens.
    • Report a new line, bulge or sore spot under or at the lens edge, rather than waiting for your next visit.
    • Keep treating dry eye. Ask which preservative-free drops you can use over the lens.

    What wearers say

    Most wearers with mild conjunctivochalasis say it hasn’t stopped them wearing scleral lenses. People with more pronounced folds describe a longer fitting, foreign-body feeling, or the folds creeping under the lens edge, and several needed a smaller lens, an edge change or treatment of the folds. Some also note that untreated dry eye seemed harder on their conjunctiva than the lenses were.

    What to ask your fitter

    • Where are my folds, and will they meet the lens edge?
    • Should I have them treated before we fit or refit?
    • Would a smaller lens, a larger lens, or an edge change suit my eye better?
    • Is any tissue being drawn under the lens, and does that matter for my eye?

    Common questions

    Do scleral lenses cause conjunctivochalasis?

    We found no study showing that they do. Long-term wearers in our research mostly say they never developed it, or that mild age-related folds didn't seem to worsen with the lens. Some worry that pulling on the eye during difficult removals could loosen the tissue. If removal is a struggle, ask your fitter to watch your technique and check the fit.

    Would a bigger lens cover the folds and stop the rubbing?

    Sometimes, but wearers with conjunctivochalasis often report the opposite: a smaller lens rubbed less. A review of scleral lens complications mentions both options for conjunctival problems at the edge. Your fitter decides based on where the folds are.

    If I have surgery for it, will I need new lenses?

    Possibly. Treating the folds changes the surface the lens edge rests on, so your fitter may need to check or adjust the fit afterward. Ask both your surgeon and your fitter about timing before you book.

    I can see a line or fold under my lens. Is my lens cracked?

    It could be a strand of mucus, a fold of loose conjunctiva drawn under the lens, or a crack. Take the lens out and look at it. If the lens is fine but the fold or discomfort is still there, or the eye is painful, don't put the lens back in until you've been seen.

    Keep reading

    Conjunctival prolapse and scleral lenses

    Conjunctival prolapse is limbal or perilimbal conjunctiva drawn into the space under a scleral lens. It is common: in an OCT study of 10 healthy adults, 8 showed it at least once during 90 minutes of wear, most often nasally, and its height tracked how far the lens settled at the limbus. Reviews describe it as usually benign but capable of causing discomfort or, if extensive, blocking vision. It is a fit issue to send back to the fitter, who may change the edge, landing zone, or limbal clearance.

    What are mini-scleral lenses?

    A mini-scleral lens is a scleral lens that extends only a little past the edge of your cornea. In the classification most often cited, a mini-scleral lens is up to 6 mm wider than the visible colored part of your eye, and a large scleral lens is more than 6 mm wider. Both vault over the cornea and rest on the white of the eye; they just differ in how far they reach. Your fitter picks the size that suits your eye's shape and your condition.

    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.

    Am I too old for scleral lenses?

    Probably not. In a study of 120 veterans with an average age of 56.7, age didn't differ between people who kept wearing scleral lenses and those who stopped. What does matter is handling: difficulty putting lenses in and taking them out was the most common reason people stopped, and conditions that affect the hands or nervous system made stopping more likely. Your fitter will also check your cornea and the tissue the lens rests on, which change with age.

    Why do the uncovered parts of my eye still feel dry or burn with scleral lenses?

    Because the lens only covers part of the eye. The cornea and a ring of the white of the eye sit under the lens; the corners and the white beyond the lens edge are still exposed to air and your tear film. With dry eye, those areas can still dry, burn or redden. Fitters can change the lens size or shape to cover more, or less, and preservative-free drops over the lens, lid treatment and allergy control help many. Burning or redness at the edge can also be a fit or solution problem, so report it.

    Sources

    1. Yvon C, Patel BC, Malhotra R. Conjunctivochalasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2026. pubmed.ncbi.nlm.nih.gov
    2. Rodriguez-Garcia A, Jimenez-Perez JC, Ruiz-Lozano RE, et al. Scleral lenses and PROSE: indications, complications, and future challenges. Med Hypothesis Discov Innov Ophthalmol. 2025;14(3):73-106. doi:10.51329/mehdiophthal1525 pubmed.ncbi.nlm.nih.gov
    3. 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.