Who fits scleral lenses
Scleral lenses are fitted by eye doctors, either optometrists (OD) or ophthalmologists (MD). Not every eye care provider fits them, and fitting them well takes specific equipment, training, and practice.
That’s why it’s worth looking for someone who fits sclerals as a regular part of their work, rather than someone who fits one occasionally.
Why experience matters
There’s research that backs this up. One study followed a single practitioner who had little previous experience with scleral lenses through their first 156 fittings, in 85 people. As the practitioner gained experience, the number of trial lenses needed to find the right fit and the number of lenses that had to be reordered both fell significantly, with a clear drop after the first 60 fittings.[1]
It’s one practitioner, so it can’t tell you how any particular fitter will do. But it fits common sense: an experienced fitter is more likely to get the lens right in fewer steps.
Where to look
- Ask your own eye doctor. If you were told you need scleral lenses, the doctor who said so may already have someone in mind.
- Ask your corneal specialist or surgeon. People with keratoconus, corneal transplants, or surgery complications often see a corneal specialist who works with scleral lens fitters.
- Ask other wearers. Patient groups for your condition can be a source of names. Treat recommendations as a starting point and still ask the questions below.
Questions to ask before you commit
About your eyes
- Are scleral lenses the right next step for me, or is there something simpler to try first?
- What vision and comfort can I realistically expect, given my condition?
- Is anything else going on with my eyes that will limit how much a lens can help?
About the fitting
- How do you fit scleral lenses: trial lenses, scans, or impressions?
- How many visits do you expect for me, and over how long?
- Who will I actually see at each visit?
- How will you teach me to put the lenses in and take them out, and what happens if I’m struggling?
About costs
- What does the fitting fee include?
- How many lens changes are covered, and for how long?
- What happens if the lenses don’t work for me? Is there any refund or credit?
- What does a replacement lens cost, and how long do lenses usually last?
- How do you handle insurance, HSA or FSA payments, and payment plans?
About support
- How do I reach you if something goes wrong, including after hours?
- What should I do if I can’t get a lens out?
- How often will I need check-ups once the fitting is done?
Why distance matters more than you’d think
Fitting scleral lenses usually takes more than one visit. In an international survey of fitters, patients averaged 3.8 visits during the fitting process, with a range from 1 to 18.[2] After that come regular check-ups, and occasionally an urgent visit. A fitter you can reach without taking a full day off each time is worth weighing against one who is farther away.
Signs you’ve found a good match
Look for a fitter who:
- gives you specific, realistic expectations instead of promises
- is open about challenges, including that sclerals don’t work for everyone
- explains why they’re recommending what they recommend
- listens when you describe what’s bothering you
- makes it clear how to reach them between visits
If you feel rushed or dismissed, that’s useful information too. It’s fine to see more than one fitter before deciding.
If you’re already with a fitter and it isn’t working
Start by telling them specifically what isn’t working. Many problems are fixable with a lens change or a new tool. If you’ve done that and nothing has changed, a second opinion is a reasonable step. See what if scleral lenses don’t work for me?
Common questions
Do I need a referral to see a scleral lens fitter?
It depends on the practice and on your insurance. Some practices see patients directly, and some plans require a referral for specialist care. Call the practice and your plan to check.
Is an optometrist or an ophthalmologist better for scleral lenses?
Either can fit scleral lenses. What matters more is whether the person fits them regularly and has the equipment to measure your eye and follow up.
Does insurance cover scleral lenses?
Sometimes. Some plans cover them when they're medically necessary, and some practices don't take insurance at all but can give you paperwork to seek out-of-network reimbursement. Ask the practice how they handle insurance, and ask your plan what it covers, before you start.
What if there's no scleral lens fitter near me?
Ask your eye doctor or corneal specialist who they refer to, and check whether a fitter within a day's travel would work. Some patients travel for the fitting and do routine follow-ups closer to home. Use the questions on this page to evaluate any fitter you find.