When to replace your scleral lenses

How long do scleral lenses last?

Scleral lenses aren’t disposable. They’re custom-made and meant to be worn for a long time, but there’s no fixed date when one needs replacing.

The best direct evidence we found is a review of records at one university hospital eye clinic in the US. It looked at 251 patients (445 eyes) who had reordered a scleral lens at least once. The average time between lens orders was 23.9 months, with a very wide range. Patients with more years of scleral lens experience went longer between replacements: about a month longer for each extra year of experience.^[1] The authors didn’t find a link with diagnosis, lens brand, or lens size, and they noted that more research is needed on how lens age affects eye health and vision.^[1]

A few things to keep in mind about that number. It’s from one clinic. It measures how often lenses were reordered, which can be for damage, loss, or a prescription change, not only wear. And it’s an average: your lenses may need replacing sooner or may last longer.

Signs a lens may be wearing out

A lens that’s slowly aging can cause problems that get blamed on something else. Look out for:

• Haze or film that cleaning won’t remove. Hold the lens up to the light. A lens that stays cloudy after a proper clean is worth showing to your fitter.
• Scratches or chips on the surface or edge.
• Vision that’s less sharp than when the lens was new, without another explanation.
• More end-of-day discomfort than you used to have.

None of these alone proves the lens is the cause. Your fitter will check the lens and your eye, and may adjust your cleaning routine before deciding on a new lens. If the lens is the problem, replacing it is usually straightforward.

Chips, cracks, and breaks

Rigid lenses can break, especially when dropped or handled roughly. In a retrospective study of 157 keratoconus eyes that had worn scleral lenses successfully for at least a year at one clinic, broken lenses were recorded in 26.1% of eyes over the study period, and deposits on the lens in 8.9%.^[2] Breakage is common enough to plan for.

Don’t skip follow-ups

The FDA advises regular eye exams for contact lens wearers, and replacing lenses as your eye care professional recommends.^[3] Follow-up visits are where your fitter spots surface wear you can’t see, checks that the fit is still right, and catches changes in your eye that a new lens might fix.

Be ready

• Keep current glasses. The FDA recommends always having a backup pair with a current prescription.^[3]
• Ask about replacement terms when you’re fitted: warranties, remakes, and the cost of a replacement lens.
• Think about a spare, especially if you depend on your lenses to drive or work.

To prevent damage in the first place, handle lenses over a towel with the sink drain covered. See dropped lens.