Scleral Lenses vs. RGP Lenses for Keratoconus: Which Is Right for You?

Keratoconus changes the shape of the cornea, causing it to become thinner and more cone-shaped over time. This irregular surface can lead to distorted or blurry vision that standard eyeglasses and soft contact lenses may not fully correct. For many patients, specialty contact lenses offer a clearer and more comfortable solution.

Two common options are scleral lenses and rigid gas permeable (RGP) lenses. Both can provide sharper vision for keratoconus, but their size, fit, and feel are different. Understanding those differences can help you know what to expect during a specialty contact lens evaluation.

How RGP Lenses Work for Keratoconus

RGP lenses are smaller rigid lenses that sit directly over the cornea. Unlike soft contacts, they maintain their shape rather than conforming to an irregular cornea. A layer of tears between the lens and corneal surface helps create a smoother optical surface, which can significantly improve vision affected by irregular astigmatism.

RGP lenses for keratoconus can provide excellent visual clarity and are available in customized designs. However, because the lens rests on the sensitive cornea, some patients require an adjustment period before they become comfortable with daily wear.

How Scleral Lenses Are Different

Scleral lenses are also made from rigid gas permeable material, but they are much larger than traditional corneal RGP lenses. Instead of resting directly on the cornea, a scleral lens vaults over it and lands on the white part of the eye, known as the sclera.

The space between the lens and cornea is filled with preservative-free saline before insertion. This fluid reservoir keeps the corneal surface covered throughout wear while the rigid lens provides a smooth surface for clearer vision.

Scleral Lenses vs. RGP Lenses

Although both lenses can correct vision affected by keratoconus, there are several practical differences:
 

• Size: RGP lenses are smaller, while scleral lenses extend beyond the cornea.

• Lens position: RGP lenses typically rest on the cornea, while scleral lenses vault over it.

• Comfort: Some patients find scleral lenses more comfortable because they avoid direct contact with the sensitive corneal surface.

• Stability: The larger diameter of scleral lenses can help them remain stable on irregular corneas.

• Handling: RGP lenses may be easier for some patients to insert and remove, while scleral lenses require filling the lens with saline before insertion.

Which Specialty Contact Lens Is Right for You?

There is no single lens that is best for every person with keratoconus. Your ideal option depends on the shape and severity of your corneal irregularity, your prescription, tear film, comfort needs, and previous contact lens experience.

Some patients achieve excellent vision and comfort with traditional RGP lenses. Others may benefit from scleral lenses, particularly when corneal sensitivity, significant irregularity, or ocular surface dryness makes smaller lenses difficult to tolerate.

A Customized Keratoconus Lens Fitting Matters

Specialty contact lenses require more than choosing a prescription. Your eye doctor must carefully evaluate the shape of your cornea and how the lens interacts with the eye. Adjustments may be necessary to achieve the right combination of vision, comfort, and lens stability.

At JC Eyes, we fit therapeutic contact lenses for keratoconus, including scleral and rigid gas permeable lenses, based on each patient's individual visual needs.

Schedule a keratoconus and specialty contact lens evaluation with JC Eyes in Jersey City, NJ, by calling or texting (201) 801-3600 to find out whether scleral lenses or RGP lenses may be right for you.