Every remake means another appointment, another wait for the lab, and another round of hope. By the fourth lens, it’s natural to feel frustrated and to start wondering whether you’re in the right hands. That question is worth taking seriously, without jumping to conclusions in either direction.
How many remakes is normal?
More than one lens is normal. In an international survey, fitters each described one of their scleral lens patients, 259 patients in all. During fitting, an average of 2.4 lenses were ordered per patient, over an average of 3.8 visits. The range was wide: 1 to 16 lenses, and 1 to 18 visits.[1]
So a fourth lens is above the average, but well within what fitters report. That survey covered many kinds of eyes and most were fitted for an irregular cornea, so it can’t say what’s typical for yours.[1] Results vary by setting too. At one specialist center fitting people with eye surface disease, fitting took an average of 3 visits and 1.4 lenses per eye.[3]
More detail is in how many scleral lens remakes is normal?
Does the fitter’s experience matter?
It can. In a study that tracked one practitioner new to scleral lenses through their first 156 fittings, the number of remakes needed per eye fell from 0.95 in the first 20 fittings to 0.25 in the last ones. The authors saw a significant drop after the first 60 cases.[2] That was a single practitioner, so it doesn’t tell you how many fittings makes someone experienced. It does show that experience changes how quickly a fitter reaches a good fit.
Experience isn’t the only factor, though. Some eyes are simply harder: very irregular corneas, transplants, uneven whites of the eye, or surface disease. And some problems aren’t about the fit at all. Dry eye, eyelid disease, a reaction to a solution, or nerve-related pain can make every lens feel wrong. See my fitter says my lens fits: why does it still hurt?
Signs the fitting has stalled
Remakes are a problem when they stop making progress, not just when there are several of them. Wearers who eventually switched practices often describe some of these:
- No clear reason for each change. You can’t get an answer to “what are you changing in this lens, and why?”
- The same problem keeps coming back, with small tweaks but no change of approach.
- The lens is only ever checked straight after insertion. A scleral lens settles into the eye over the first hours of wear, so the fit can look different later in the day. If your lens has never been checked after a few hours of wear, ask whether that would help.
- Your symptoms are dismissed rather than explained, especially pain, redness, or pressure.
- There’s no plan B. No discussion of a different size, a different design, or a lens made from a scan or impression of your eye.
- The remake window is running out with no conversation about what happens next.
Any one of these on its own may have a good explanation. Several together are a reason to speak up.
How to raise it with your fitter
Most fitters want to know. Problems are often solved by changing the lens or re-teaching technique: in a keratoconus study, refitting made up 54.0% of the steps taken to fix problems, and patient re-education 29.5%.[4] A clear conversation helps them choose the right one.
- Keep a short log. Note the date, how many hours you wore the lens, what you felt, and when. “Pressure at the bottom of the right eye after four hours” is far more useful than “it hurts.”
- Ask direct questions. “What are you changing this time? What should I notice if it worked? If this one doesn’t work, what’s the next approach?”
- Ask about other designs. “Would a different size, design, or a scan- or impression-based lens make sense for my eye?” See impression-based vs scan-based vs PROSE.
- Ask the honest question. “At what point would you suggest someone else take a look?” A confident fitter can answer that without defensiveness.
Getting a second opinion
A second opinion is a reasonable step, not a betrayal. Fitters differ in experience, in the lens designs and labs they use, and in their fitting methods. Another fitter may see something new, or may confirm that your current plan is the right one, which is also worth knowing.
Practical steps:
- Request your records in writing, including your lens details for each lens tried.
- Choose someone who sees eyes like yours often. Ask how many patients with your condition they fit.
- Bring your lenses, your log, and a list of what has been tried.
- Ask about fees up front, at the new practice and about any refund or credit at the current one.
See how to get a second opinion, switching scleral lens practices, red flags when choosing a practice, and finding a scleral lens specialist.
Common questions
Is it rude to ask my fitter why the lenses keep failing?
No. A good fitter expects questions and would rather hear about a problem than have you quietly give up. Ask calmly and specifically: what they're changing, why, and what the next step is if this lens doesn't work.
Will my fitter be offended if I get a second opinion?
Some may be, most won't be, and either way it's your right. Second opinions are a normal part of medical care. In the US, you have a right to a copy of your medical records, and you can ask for your lens details too.
Does switching fitters mean starting over and paying again?
Often you pay new fitting fees, since the new practice is doing its own work. But you don't start from zero: your records, measurements, and the lenses you've already tried tell the new fitter what didn't work. Ask both practices about fees before you switch.
Could the problem be my eye rather than my fitter?
Yes. Some eyes are hard to fit, and some problems, such as dry eye, eyelid disease, solution sensitivity, or nerve pain, can make any lens uncomfortable. A good fitter will look for these and tell you. A second opinion can also help sort out which it is.
My remake window is about to close. What should I do?
Ask your fitter now, in writing if you can, what happens when it closes and whether it can be extended while you're still working on the fit. Try each new lens promptly so the window isn't used up waiting.