Introduction
Scleral lenses provide outstanding vision and comfort for people with irregular corneas, post-surgical eyes, and severe dry eye. Because they vault the cornea and rest on the sclera, careful cleaning and handling are essential to protect the eye, extend lens life, and reduce the risk of complications.
Why proper scleral lens care matters
Scleral lenses are large-diameter, rigid gas-permeable lenses that create a tear-filled vault over the cornea. That design gives many patients dramatic vision improvement and symptom relief, especially those with keratoconus or severe ocular surface disease. But the same features that make scleral lenses effective also mean they require disciplined cleaning and handling: trapped debris, poor disinfection, or contaminated solution can lead to deposits, discomfort, and infection.
Proper care minimizes microbial keratitis and other complications, preserves lens wettability and clarity, and helps maintain comfortable lens fit. Your optometrist will review an individualized care plan based on your ocular surface health, tear film, and lens material.
Daily routine before insertion (hand hygiene, inspection, filling)
Step-by-step
- Wash and dry hands thoroughly with a mild, fragrance-free soap and a lint-free towel before handling lenses.
- Inspect the lens for chips, tears, or deposits. Do not insert a damaged lens.
- Rinse the lens bowl and optical surface with sterile, preservative-free saline recommended by your doctor. Do NOT use tap water or saliva to rinse or fill lenses — these increase infection risk.
- Fill the bowl completely with the saline to avoid bubbles that can cause blur or discomfort; then insert according to the technique taught at your fitting appointment.
- After insertion, check for a comfortable, centered lens and adequate clearing of the cornea under the lens.
Note: Some patients with dry eye or surface disease may be advised to pre-treat the ocular surface with preservative-free drops or to use a specific insertion solution. Discuss any cleaning agents or rinses with your doctor before using them.
Daily routine after removal and storing
Cleaning and disinfection
After removal, immediate lens care prevents deposit build-up and microbial growth. The basic goals are to remove debris and mature protein, then disinfect according to an approved system. A common daily routine includes:
- Rinse the lens with preservative-free saline to remove gross debris.
- Use a non-abrasive gas-permeable surfactant cleaner or recommended cleaner and gently rub the convex (back) and concave (front) surfaces as instructed. Follow your fitter’s specific rubbing technique — gentle but thorough.
- Rinse again to remove the cleaner, and then place lenses in your storage case with fresh disinfecting solution as directed.
Disinfection systems may include hydrogen peroxide-based cleaners (which must be fully neutralized before reinsertion) or solutions formulated for rigid gas-permeable lenses. Use only products approved and recommended by your eye care professional for scleral lenses. Do not mix solutions or substitute tap water.
Case hygiene
- Empty and rinse your lens case daily with sterile solution (not tap water), then allow it to air dry with the caps off.
- Clean the case and caps regularly (your clinic will give a recommended schedule) and replace the case periodically — many fitters recommend routine replacement (commonly every few months), but follow your doctor's guidance.
Weekly and monthly maintenance
In addition to the daily routine, periodic deeper cleaning is important for scleral lenses because they can accumulate proteins and lipids over time. Typical recommendations include:
- Weekly enzymatic protein cleaning: Use an enzymatic cleaner designed for gas-permeable lenses to remove protein deposits, unless your doctor advises otherwise.
- Monthly professional inspection: Bring lenses and your case to appointments so the doctor can evaluate lens condition, check for damage, and assess the ocular surface. Some patients will need monitoring more often during the first few weeks after fitting.
- Replacement planning: While scleral lenses are durable, they are not permanent. Discuss expected lens lifespan with your fitter based on wear patterns and material.
Maintaining the lens surface also helps with comfort and optical clarity. If lenses become persistently cloudy or uncomfortable despite cleaning, stop wearing them and contact your clinic for assessment.
Risks, red flags, and regular follow-up
Scleral lenses are safe when used correctly, but there is always some risk of infection, corneal abrasion, or hypoxia if lenses are misused. Reduce risk by following solution instructions exactly, avoiding tap water exposure, and attending scheduled follow-ups. Your optometrist will create an individualized follow-up schedule — more frequent early visits are common as your fit is refined, with ongoing periodic exams tailored to your eye health.
Contact your eye doctor immediately if you experience any of the following:
- Increased redness, pain, or sensitivity to light
- Sudden decrease in vision or persistent haze that doesn’t clear after blinking
- Unusual discharge or swelling
- Difficulty removing the lens
Do not attempt to treat possible infection at home; stop wearing lenses and seek prompt professional care. If you have keratoconus, be aware that scleral lenses improve vision and comfort but do not halt disease progression. Cross-linking (CXL) is a corneal stabilization procedure to discuss with your specialist or a corneal surgeon when appropriate.
Complementary treatments and special considerations
Many scleral lens wearers also have dry eye or ocular surface disease. At Evolutionary Eye Care we offer therapies like Low Level Light Therapy (LLLT) for meibomian gland dysfunction and dry eye that can improve comfort and success with scleral lenses. If you use topical medications, make sure they are compatible with lens wear (some preserved drops can deposit on lenses).
If you are considering Ortho-K for myopia control or refractive needs, note that orthokeratology is an overnight corneal reshaping approach distinct from scleral lens wear. Ortho-K has its own insertion, removal, and care requirements and should not be confused with scleral lens routines.
Final thoughts and scheduling
Consistent, doctor-directed care is the best way to keep scleral lenses comfortable and safe. Follow your customized cleaning regimen, replace solutions and cases as advised, and attend follow-up visits so your clinician can monitor fit, ocular health, and lens condition. If you have questions about cleaning products, protein removal, or whether LLLT might help your comfort, bring them to your appointment — small changes in routine often make a big difference.
To review your scleral lens routine or schedule a fitting or follow-up, contact Evolutionary Eye Care. We serve patients in the Houston area with offices in Sugar Land, Webster, and Downtown Houston and are happy to help you maintain clear vision and healthy eyes.