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    Question

    Can I wear scleral lenses if I have diabetes?

    Diabetes affects the cornea as well as the retina. That doesn't rule out scleral lenses, but it changes what you and your fitter need to watch for.

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

    The short answer

    Many people with diabetes can wear scleral lenses, but diabetes adds real considerations. It can weaken the cornea's surface, slow healing, reduce corneal feeling, and raise the risk of some eye infections. Fitters are advised to weigh how long you've had diabetes, how well it's controlled, whether you have retinopathy, and your overall health. A scleral lens won't help vision lost to diabetic retinopathy.

    Key points

    • Diabetes can damage corneal nerves, slow surface healing, and reduce corneal sensation.
    • Reduced feeling means pain may not warn you early, so watch your vision and redness too.
    • Evidence on whether diabetes raises contact lens infection risk is mixed, and none of it is scleral-specific.
    • Scleral lenses are sometimes used to treat diabetic corneal damage, under close supervision.
    • They can't help vision lost to diabetic retinopathy.

    How diabetes affects the cornea

    Most people know diabetes can damage the retina. Fewer know it affects the cornea too. A 2019 review describes people with diabetes as commonly having damage to the cornea’s protective surface barrier, abnormal wound healing, a fragile surface layer, loss of corneal nerves and sensitivity, and a higher overall risk of bacterial and fungal infections.[1] An earlier review adds changes in tear chemistry and tear production, and changes to the cornea’s inner cell layer.[2]

    Diabetes is also one of the systemic causes of neurotrophic keratopathy, a condition in which the cornea loses feeling and heals poorly.[3] It’s listed among the systemic risk factors for corneal ulcers as well.[5]

    What that means for scleral lens wear

    Infection risk: the evidence is mixed. One landmark study from 1989 found diabetes was the only systemic disease linked to a higher risk of contact lens-related corneal infection, but later studies have disagreed with each other.[1] The 2019 review concluded there are inherent risks with contact lens wear in diabetes, and that little evidence yet shows how large the added risk is.[1] The 2012 review notes that studies of modern lenses suggest contact lenses can be a workable option for people with diabetes.[2] None of this research was specific to scleral lenses.

    Reduced feeling can hide early warning signs. Pain and discomfort are among the warning signs the FDA lists for contact lens problems.[6] If diabetes has reduced your corneal sensitivity, you may not feel a problem as early. Watch for the other signs on that list too: blurred vision, unusual redness, discharge, and unusual sensitivity to light.[6] If in doubt, take the lens out and call.

    The cornea’s inner layer matters. A 2025 review lists diabetes among the conditions that can lower the number of endothelial cells, the cells that keep the cornea clear, and treats a low count as a relative or absolute reason not to wear a scleral lens, depending on severity.[4] Ask whether your endothelium has been checked before fitting.

    Fitters weigh the whole picture. The 2019 review advises fitters to consider how long you’ve had diabetes, how well it’s controlled, whether you have retinopathy, and your overall health.[1] Bring an up-to-date list of your medications and diagnoses to your fitting.

    Scleral lenses as treatment for diabetic corneal damage

    In some people with diabetic neurotrophic keratopathy, scleral lenses are part of the treatment rather than a risk. A 2025 review describes scleral lenses as having a protective and therapeutic role, including for persistent surface defects, and illustrates it with a patient whose diabetic neurotrophic keratopathy was treated with a scleral lens.[3] That kind of use happens under close medical supervision. See scleral lenses for neurotrophic keratitis.

    Hands and handling

    Peripheral neuropathy is one of the conditions that can make inserting and removing scleral lenses harder.[4] If your fingertips are numb or less precise, these guides may help: shaky hands and inserters and removers.

    Good habits matter more

    Infection prevention habits apply to everyone, but they carry extra weight if your cornea heals slowly. The FDA’s advice includes rubbing and rinsing lenses as directed, never topping off solution, keeping all water away from lenses, and replacing your case regularly.[6] Never sleep in scleral lenses: overnight wear is considered an absolute contraindication.[4] See cleaning and disinfecting and are scleral lenses safe?.

    Common questions

    Does my blood sugar control matter for wearing scleral lenses?

    It's one of the things fitters are advised to consider, along with how long you've had diabetes, whether you have retinopathy, and your general health. Research on exactly how glucose control affects contact lens risk is mixed. Tell your fitter about your diabetes and any changes in your treatment, and keep your diabetes care team informed that you wear lenses.

    Can scleral lenses help diabetic retinopathy or macular edema?

    No. Those affect the retina at the back of the eye. A scleral lens only changes the front surface. Treatment for retinopathy comes from your eye doctor or retina specialist.

    I have neuropathy in my hands. Will that make lenses harder?

    It can. Peripheral neuropathy is one of the conditions known to make inserting and removing scleral lenses harder. Tools such as lighted inserters, stands and one-finger applicators can help, and your fitter can tailor your training.

    Keep reading

    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.

    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.

    Can I wear scleral lenses after a corneal ulcer?

    Often, yes, once the ulcer has fully healed and your eye doctor agrees. A healed ulcer can leave a scar that makes the cornea uneven, and a scleral lens can smooth out that unevenness and improve vision. It can't clear a scar that sits in the center of your vision and blocks light. If the ulcer was linked to contact lens wear, work out with your doctor what went wrong before you go back to any lens, because contact lens use is linked to repeat infections.

    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.

    Can I wear scleral lenses if I've had herpes in my eye?

    Many people can, once the eye is quiet and their eye doctor agrees. Herpes simplex keratitis can scar the cornea and make it uneven, and scleral lenses are one way to restore clearer vision through that kind of scar. The virus stays in the body and can reactivate, and one small study found more frequent recurrences in contact lens wearers. Herpes can also reduce corneal feeling, so you may not feel early warning signs. Plan monitoring, and what to do if symptoms return, with your eye doctor before you start.

    Sources

    1. Bussan KA, Robertson DM. Contact lens wear and the diabetic corneal epithelium: a happy or disastrous marriage? J Diabetes Complications. 2019;33(1):75-83. doi:10.1016/j.jdiacomp.2018.09.015 pubmed.ncbi.nlm.nih.gov
    2. O'Donnell C, Efron N. Diabetes and contact lens wear. Clin Exp Optom. 2012;95(3):328-337. doi:10.1111/j.1444-0938.2012.00738.x pubmed.ncbi.nlm.nih.gov
    3. Font CS, Cortina MS. Neurotrophic keratopathy: update in diagnosis and management. Indian J Ophthalmol. 2025;73(4):483-495. doi:10.4103/IJO.IJO_2963_24 pubmed.ncbi.nlm.nih.gov
    4. Rodriguez-Garcia A, Jimenez-Perez JC, Ruiz-Lozano RE, Bustamante-Arias A, Barcelo-Canton RH. 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
    5. Byrd LB, Gurnani B, Martin N. Corneal Ulcer. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. 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.