Why there’s no headcount
We found no registry of scleral lens wearers and no published national count. What exists instead:
- Fitter surveys, such as the SCOPE studies (Scleral Lenses in Current Ophthalmic Practice Evaluation), which ask practitioners about their patients.
- International prescribing surveys, which sample contact lens fits each year across many countries.
- Large practice records, which describe every lens one practice ordered.
Each answers a different question. None of them can be multiplied up into a reliable total, so this page doesn’t try.
Why people wear them
Fitter surveys have asked the same question several times: what are scleral lenses prescribed for?
| Survey | Corneal irregularity | Ocular surface disease | Ordinary refractive error |
|---|---|---|---|
| SCOPE 2015, fitters’ estimate of their practice[3] | 74% | 16% | 10% |
| SCOPE 2020, median across 777 fitters[2] | 84% | 10% | 2% |
| International survey, 259 individual patients[1] | 87% | 9% | 4% |
The first two rows summarize what fitters said about their practices. The third describes one actual patient per fitter. They measure slightly different things but tell the same story: scleral lenses are mainly a medical device for irregular corneas, and their use for ordinary prescriptions has stayed small.
In individual studies, the mix depends on the clinic. In a US veterans’ clinic, 55.8% of 120 patients were fitted for corneal ectasia.[9] In a Portuguese prospective study, 71 of 95 participants had irregular corneas and 24 had regular ones.[10]
How scleral lens use is growing
Worldwide. An annual international survey analyzed 342,500 contact lens fits from 20 countries between 2000 and 2023.[4]
- Rigid lenses (any lens made of rigid material) were 14.2% of all fits in 2000 and 15.2% in 2023, after declining until 2012 and then rising.
- Among 5,994 rigid lens fits from 2019 to 2023, 28% were scleral or corneo-scleral lenses, 30% corneal spherical lenses, 21% myopia control or orthokeratology lenses, and 16% complex corneal designs.
- The authors attribute the recent rise in rigid lens fitting to this “repurposing”: growth in scleral and myopia control lenses replacing conventional corneal lenses.[4]
In keratoconus. At one US academic medical center, none of the keratoconus patients seen in 2010 were using scleral lenses. In 2020, 22% were. Corneal rigid lenses were still the most common at 60%.[6]
Among fitters. More practitioners are fitting scleral lenses, and they’re fitting more of them.
- In the 2015 SCOPE survey, more than 80% of fitters reported fitting their first scleral lens after 2005.[11]
- In 2020, 777 of 922 respondents had completed at least five fits. The median fitter had completed 100 fits, up from 36 in 2015. 63% were in the United States, with 59 other countries represented, and 76% worked in community rather than academic practice.[2]
- In a survey of 778 practitioners who fit scleral lenses, 42% ranked them as their first choice for corneal irregularity, ahead of corneal rigid lenses (20%). For ocular surface disease, they were generally considered after drops, gland treatments, and punctal plugs.[7]
Who the wearers are
There’s no population-wide demographic data, but large practice records give a picture. In a Dutch specialty practice that ordered 27,430 scleral lenses for 6,635 patients between 2016 and 2022:[5]
- The median age at first order was 43, ranging from 3 to 95.
- 53.4% of patients were male.
- People with keratoconus were the youngest group, with a median age of 35.[5]
In the US veterans’ clinic, the average age was 56.7.[9] Different clinics see very different patients.
What lenses they wear
Size. In the international survey, the average lens was 16.2 mm across, ranging from 11.8 to 23.0 mm.[1] In the Dutch practice, 60.8% of lenses were mini-scleral designs and 39.2% large scleral, and for every indication except corneal transplant, the share of mini-scleral designs rose over time (44% in 2016, 74% in 2022).[5]
Shape. In the international survey, landing zones were spherical in 64% of lenses, toric in 26%, quadrant-specific in 7%, and custom in 3%. Optics were spherical in 70%, toric in 27%, and designed to correct higher-order aberrations in 3%. Only 5 lenses had multifocal optics.[1] In the Dutch practice, 99.8% of landing zones were toric, which shows how much practice style varies.[5]
Fitting effort. In the international survey, fits took an average of 2.4 lenses over 3.8 visits.[1] The Dutch practice, which fits from diagnostic trial sets, averaged 1.4 lenses per successful new fit.[5]
Care products. In the international survey, 62% of patients used a daily surfactant cleaner, 47% used hydrogen peroxide disinfection, and 67% used single-use vials of preservative-free saline.[1] The daily routine guide covers what these products are for.
What wearing them is like
A National Keratoconus Foundation survey compared 76 people wearing scleral lenses in both eyes with 75 wearing corneal rigid lenses:[8]
- Satisfaction: scleral wearers rated vision and comfort higher; ease of use was similar.
- Problems: 58% of scleral wearers reported cloudy or foggy vision, 67% lens discomfort, 72% halos, and 63% handling difficulty.
- Time: 45% of scleral wearers spent 6 to 10 minutes a day handling their lenses.
- Cost: 41% of scleral wearers reported annual out-of-pocket costs under $1,000, compared with 60% of corneal rigid lens wearers.
These were self-selected survey respondents with keratoconus, so they may not represent all wearers.
For how wearers fare over time, see scleral lens outcomes research.
Common questions
How many people wear scleral lenses?
Nobody knows exactly. We found no registry or published count of scleral lens wearers. The best available data are surveys of fitters and records from large practices, which show the share of fits and the reasons for them, not a total count.
What is the most common reason people wear scleral lenses?
Corneal irregularity, mostly keratoconus and other ectasias. In an international survey describing 259 individual patients, 87% wore scleral lenses for corneal irregularity, 9% for ocular surface disease, and 4% for ordinary refractive error.
Are scleral lenses becoming more common?
The evidence says yes. In international prescribing data, scleral and corneo-scleral lenses made up 28% of rigid lens fits in 2019 to 2023, and their growth helped reverse a decline in rigid lens fitting. The median experienced fitter had completed 100 scleral fits in 2020, up from 36 in 2015.
How old are typical scleral lens wearers?
It depends on why they wear them. In one large Dutch practice, the median age at first order was 43, and 35 for people with keratoconus. In a US veterans' clinic, the average age was 56.7.
Do eye doctors recommend scleral lenses first for keratoconus?
Increasingly. In a survey of 778 scleral lens practitioners, 42% ranked scleral lenses as their first choice for corneal irregularity, compared with 20% for corneal rigid lenses. Note that this survey was of people who already fit scleral lenses.