What the lens covers, and what it doesn’t
A scleral lens vaults over your cornea and rests on the white of the eye, holding a reservoir of fluid against the cornea.[1] Everything under the lens is bathed in that fluid. Everything outside the edge is not:
- The corners of the eye, near your nose and toward your temple.
- The white of the eye beyond the lens edge, especially in the area that shows between your lids.
- The inside of your eyelids, which wipe over the lens with every blink.
These areas are covered by the conjunctiva, the thin clear membrane over the white of the eye, and they rely on your own tears as they always did. When your eyes are dry, or the air is, they can sting, burn, look red or feel gritty even while the middle of the eye feels fine.
Common reasons it happens
What wearers and the eye doctors who answer them most often describe:
- Exposure. Dryness and redness on the exposed white of the eye, often on the side toward the temple, late in the day. It’s typically worse with wind, fans, heating, air conditioning and screens. See scleral lenses in wind and air conditioning.
- Lens size and shape. A smaller lens leaves more of a dry eye exposed. Round lenses can miss part of an eye that isn’t round.
- Allergy. Wearers who wear a lens in one eye only notice that pollen or irritants bother mainly the uncovered eye, and many find their itchy, burning corners calm with allergy treatment. See scleral lenses and allergies.
- Solution residue. Multipurpose or cleaning solution not rinsed off can sting the eye around the lens, not just under it.
- The fit. Pain, redness or a ring right where the edge sits, or pain in one corner, often means the edge needs adjusting. See red ring after removal.
- Something on the white of the eye, such as a pinguecula or loose conjunctiva, rubbing at the edge.
What fitters can change
Size. A review of scleral lens complications notes that, for problems with the conjunctiva at the lens edge, fitters can consider a large-diameter lens to cover the affected tissue or a small-diameter lens to avoid it.[1] Wearers report both working. Some found relief only after moving up through several sizes. Others with lid friction or loose conjunctiva did better smaller. An eye doctor answering wearers’ questions has called “bigger is always better” a myth: it depends on the eye.
Shape. Impression-based and scan-based designs can be oval or follow the eye’s shape more closely, and several wearers say an oval lens finally covered a dry corner. See impression-based scleral lenses and toric landing zones.
Edge changes. Flattening or lifting the edge, or adding a small gap in one area, reduced corner redness for some wearers.
For how lens sizes are described, see what are mini-scleral lenses.
What you can do
- Use preservative-free drops over the lens for the exposed areas, as your fitter approves. See eye drops with scleral lenses.
- Rinse well with fresh preservative-free saline after any multipurpose or peroxide solution, and change one product at a time if something stings.
- Shield your eyes from moving air with wraparound or sealed glasses. See moisture chamber glasses.
- Keep treating dry eye and lids. The lens doesn’t fix the tear film the exposed areas depend on. See scleral lenses for severe dry eye.
What wearers say
Mild dryness at the corners late in the day is something many dry-eye wearers live with and manage with drops. Some wearers say it eased over the first months, or after tear duct plugs. People who found it went beyond a nuisance usually got relief from a size or shape change, an allergy routine, or a different solution. A few, especially with very dry eyes, still have some burning outside the lens and see the lens as a big improvement rather than a complete fix.
What to ask your fitter
- Is this exposure, allergy, solution, or the lens edge?
- Would a larger, smaller or differently shaped lens help my eye?
- Is anything on the white of my eye, like a pinguecula, in the way?
- Which drops can I use over the lens, and how often?
Common questions
Will a bigger lens fix my dry corners?
It helps some people. Wearers report that moving to a larger, or more oval, lens covered a dry area a round lens missed. Others found a larger lens rubbed more, especially with loose conjunctiva, and did better smaller. Your fitter weighs your lid shape, the surface of the white of your eye and handling before changing size.
Can I put drops on the exposed part of my eye while the lens is in?
Yes, preservative-free drops your fitter approves can go over the lens and onto the surrounding eye. Wearers often prefer a medium-thickness drop that doesn't feel gummy. See our eye drops page for what goes where.
My inner corners itch more than burn. Is that dryness?
It might be, but wearers also report allergy, solution left on the lens after a multipurpose soak, or makeup as causes. Rinsing well with fresh preservative-free saline and treating allergies helped some. If it persists, tell your fitter.
There's a red ring or redness right at the lens edge. Is that dryness too?
Usually that's worth a fit check rather than more drops. A lens that presses or settles too much can cause redness at the edge. See the red ring guide and tell your fitter.