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Scleral Lenses: A Literature Review

Schornack, Muriel M. O.D.

Eye & Contact Lens: Science & Clinical Practice: January 2015 - Volume 41 - Issue 1 - p 3–11
doi: 10.1097/ICL.0000000000000083

Objective: To present a comprehensive review of current and historical literature on scleral lenses.

Methods: A comprehensive search of several databases from each database's earliest inception to May 23, 2014 was conducted by an experienced librarian with input from the author to locate articles related to scleral lens design, fabrication, prescription, and management.

Results: A total of 899 references were identified, 184 of which were directly related to scleral lenses. References of interest were organized by date, topic, and study design. Most of articles published before 1983 presented lens design and fabrication techniques or indications for scleral lens therapy. Case reviews published after 1983 identified major indications for scleral lenses (corneal ectasia, ocular surface disease, and refractive error) and visual and functional outcomes of scleral lens wear. Statistically significant improvements in visual acuity, vision-related quality of life, and ocular surface integrity were reported. Reviews of ocular and systemic conditions suggested that comprehensive management strategies for these conditions could include scleral lenses. Early work investigating scleral lens fitting characteristics, optical qualities, and potential physiological impact on anterior ocular structures have been published in the past 5 years.

Conclusions: Indications for scleral lens wear are well-established. Developing areas of research on the physiologic impact of scleral lens wear on the ocular surface, the use of technology to improve scleral lens vision and fit, and the impact of these devices on the quality of life should further enhance our understanding of scleral lenses in the future.

Supplemental Digital Content is Available in the Text.

Department of Ophthalmology, Mayo Clinic, Rochester, MN.

Address correspondence to Muriel M. Schornack, O.D., Department of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; e-mail:

Supported in part by Research to Prevent Blindness, New York, NY and Mayo Foundation, Rochester, MN.

The author has no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal's Web site (

Accepted August 07, 2014

© 2015 Contact Lens Association of Ophthalmologists, Inc.