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    Question

    Can scleral lenses help macular degeneration?

    Scleral lenses fix problems at the front of the eye. Macular degeneration is at the back. Here's why that matters, and the narrower cases where a scleral lens can still be worth it.

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

    The short answer

    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.

    Key points

    • Macular degeneration affects the center of the retina, which handles reading and fine detail.
    • No contact lens can restore vision lost in the retina.
    • If blur also comes from the cornea or a dry surface, a scleral lens can address that part.
    • Low vision rehabilitation has been shown to improve reading speed in AMD.

    Why a scleral lens can’t fix macular degeneration

    Age-related macular degeneration (AMD) damages the macula, the central part of the retina at the back of the eye. It affects central vision, which makes reading and driving difficult. It’s the most common cause of blindness in developed countries, especially in people over 60.[1]

    A scleral lens works at the opposite end of the eye. It vaults over the cornea, the clear front window, and its smooth front surface replaces an irregular or damaged corneal surface. That’s why it helps with conditions such as keratoconus and corneal scarring. It can’t do anything about light-sensing cells at the back of the eye that have stopped working. The same is true of other retinal and optic nerve conditions, such as diabetic retinopathy and glaucoma.

    One simple clinical test shows the difference. If blurry or doubled vision clears when you look through a pinhole, the cause is usually optical, from something like the cornea, tear film, or the eye’s lens. Distortion caused by disease of the macula persists when you look through a pinhole.[2] Your eye doctor will use this and other tests to work out how much of your blur has an optical cause.

    When a scleral lens may still help

    Many people have more than one thing going on. A scleral lens can be worth considering if, alongside AMD, you have:

    • An irregular cornea, from keratoconus, a corneal transplant, scarring, or earlier eye surgery. The lens can correct the part of your blur that comes from the cornea, so you see as well as your macula allows.
    • Severe dry eye or another ocular surface disease. Scleral lenses keep the cornea bathed in fluid. In one clinic’s patients using a scleral device called PROSE, symptom scores improved by an average of 54.7% among the 43 who completed follow-up surveys, and the improvement didn’t differ significantly by age.[4] Those 43 were out of 134 people who completed the first survey, so the results may not reflect everyone who tried the device.

    In both cases, the honest expectation is “the best your retina allows,” not a return to sharp central vision. Ask your fitter to explain what improvement is realistic before you start. The vision expectations page covers this in more detail.

    Handling lenses with low vision

    Reduced vision makes lens care harder. A 2025 review notes that poor vision during insertion can increase the chance of mixing up care products, such as cleaners, filling solution and disinfectants. It describes tools that help, including an inserter with a built-in light that is useful for people with low vision.[3]

    Practical guides that help:

    What helps the macular part

    For vision lost to AMD, low vision rehabilitation is the main tool: magnifiers, reading aids, lighting, and training in using the parts of vision that still work. A review of 9 studies with 885 people with AMD found low vision rehabilitation improved reading speed. It did not significantly improve depression scores.[5] Ask your retina specialist or optometrist about a referral to a low vision service. Medical treatment of AMD itself is a matter for your retina specialist.

    Common questions

    I have keratoconus and macular degeneration. Is a scleral lens worth it?

    It can be. The scleral lens can only correct the keratoconus part of your blur, so your vision with the lens will be limited by the macula. Ask your fitter to estimate how much of your blur comes from each problem before you commit, and ask what result would make the lens worth the daily routine for you.

    Will a scleral lens make my central blind spot or distortion go away?

    No. Distortion and blank areas from macular disease come from the retina. A lens on the front of the eye can't change them.

    My vision is poor. Can I still put scleral lenses in myself?

    Many people with reduced vision manage, but it takes adaptations: good lighting, a lighted inserter or stand, and a fixed routine so care products don't get mixed up. Some people need help from a family member. Ask your fitter to train you, and anyone helping you, at the dispensing visit.

    Keep reading

    What is PROSE treatment?

    PROSE is a customized scleral lens treatment from BostonSight, based in Needham, Massachusetts. The device itself is a scleral lens: a gas permeable dome filled with saline that vaults over the cornea and rests on the white of the eye. What sets PROSE apart is its proprietary design software and a structured treatment program with intensive training. It's mainly used for people with severe ocular surface disease or irregular corneas who haven't done well with other options.

    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 have diabetes?

    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.

    Can scleral lenses fix double vision?

    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.

    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.

    Sources

    1. Ruia S, Kaufman EJ. Macular Degeneration. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. pubmed.ncbi.nlm.nih.gov
    2. Tan A, Faridah H. The two-minute approach to monocular diplopia. Malays Fam Physician. 2010;5(3):115-118. pubmed.ncbi.nlm.nih.gov
    3. 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
    4. Asghari B, Brocks D, Carrasquillo KG, Crowley E. OSDI outcomes based on patient demographic and wear patterns in prosthetic replacement of the ocular surface ecosystem. Clin Optom (Auckl). 2022;14:1-12. doi:10.2147/OPTO.S337920 pubmed.ncbi.nlm.nih.gov
    5. Hamade N, Hodge WG, Rakibuz-Zaman M, Malvankar-Mehta MS. The effects of low-vision rehabilitation on reading speed and depression in age related macular degeneration: a meta-analysis. PLoS One. 2016;11(7):e0159254. doi:10.1371/journal.pone.0159254 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.