Five ways to stand out with specialized contact lenses

Keep patients coming back to your practice by offering them what the competition doesn’t have.

Doctors of Optometry (OD) who invest in the supply of specialized contact lenses are rewarded in several ways.

First, the focused care that patients receive tends to cement them as long-term loyal customers. This is because, in many cases, a vision that had been deemed impossible to achieve becomes achievable.

Second, patients with contact lenses are more likely to develop a long-term relationship with the practice that prescribes their specialty lenses because of an increase in visits for examinations and follow-up care. This translates into professional development for the practitioner and the practice.

Related: Contact Lens Outerwear Has Short- and Long-Term Consequences

Why specialty glasses are different

What makes specialty contact lenses so unique is the niche community they create. Designed for patients with eye problems such as corneal conditions, specialized contact lenses can fully support desired treatment results in cases where conventional contact lenses are not suitable.

Specialty contact lenses are a great choice when looking for a custom fit for patients with regular and irregular corneas. They can improve visual comfort and visual function in patients who have difficulty finding properly fitting contact lenses.

There are a myriad of specialized contact lenses that help treat a variety of corneal conditions. These include progressive myopia, hyperopia, high rates of astigmatism, keratoconus, pellucid marginal degeneration, post-corneal surgery such as corneal transplant, post-laser keratomileusis in situ ectasia. (LASIK), corneal scars, dry eyes and the general discomfort that results from wearing contact lenses.

Related: Try Ortho-K Toric Lenses

Likewise, there are a plethora of specialty contact lens options. These are flexible and rigid gas permeable (RGP) contact lenses (which include orthokeratology), superimposed contact lenses, scleral contact lenses, corneoscleral lenses, mini scleral lenses, contact lenses hybrid contact lenses and prosthetic contact lenses.

Scleral lenses, RGP lenses, hybrid lenses, soft prosthetic contact lenses and corneal molds are the 5 most used types. Their track record of success supports the integration of all specialty lenses more broadly.

1. Scleral lenses

The diameter of scleral contact lenses is larger than that of conventional contact lenses, making full use of their highly oxygen permeable material and increasing comfort.

In addition, rather than being placed directly on the surface of the eye, scleral contact lenses rest on the sclera and tend to lift up on the cornea; this leaves a tear reservoir between the lens and the cornea.

Sagittal height or central clearance is produced by a layer of tears, which is trapped under the lens to help reduce corneal aberrations, providing better visual results for patients.

Scleral lenses should be filled with a non-preservative saline solution to prevent bubbles from forming in the lens bowl. They should then be inserted on the front surface of the eye.

Related: Use OCT to determine scleral lens clearance

The saline solution (with an occasional added drop of artificial preservative tears or drops of autologous serum) acts as a continuous reservoir for the tear film, which keeps the front surface of the eyes hydrated and nourished for longer, improving symptoms of dryness. ocular and replacing the irregular cornea with a smooth surface. This often corrects visual problems caused by corneal irregularities.

Scleral lenses are adapted to each patient. Therefore, fitting them requires greater expertise, more chair time, and more frequent office visits than fitting conventional soft or smaller RGP lenses.

Automated imaging devices and measuring equipment are used with the scleral lenses during the initial fit and subsequent follow-up visits to ensure a proper fit. These instruments are generally not needed when fitting soft contact lenses.

The size of the scleral lens is determined by the complexity of the corneal condition. Often with keratoconus, due to apical ectasia, the lens tends to dislodge more frequently and may move excessively with blinking, causing eye discomfort.

For this reason, we tend to fit the majority of our keratoconus patients to scleral lenses.

More advanced and complex conditions such as moderate to severe keratoconus and ocular surface disease may require a scleral lens with a larger than average diameter to ensure full coverage and smooth the entire optical surface affected by the irregular cornea.

Related: Scleral Lens Wear and Ocular Surface Disease

Keratoconus corneas tend to progress quickly to the severe stage and usually do not respond to other therapies. Preserving eye health along with optimal vision and comfort is of the highest priority for patients with this disease.

The advantage of scleral lenses is that they do not become dislodged with rapid eye movements, and particles such as dust and debris rarely find their way under the lens as long as the patient practices good eyelid hygiene and maintains the lens.

2. Rigid gas permeable lenses

RGP lenses have been around for a long time and were the first choice before hybrids and sclerals became available. RGP lenses provide sharper vision than soft and silicone hydrogel lenses due to superior optics, less lens flex and reduced adhesion of deposits.

GP lenses are excellent for providing support for patients with corneal toricity or blurry glasses and for those with poor vision with soft lenses.

In addition to visual correction, RGP lenses offer orthokeratological correction, which reshapes the corneal surface to slow myopic progression.

They temporarily correct vision without the need for contact lenses or day glasses and are ideal for both children and people who play sports or whose work makes it difficult to wear corrective lenses during the day.

Dlated: Total 30 contact lenses coming in early 2022

3. Soft prosthetic contact lenses

Soft prosthetic contact lenses provide cosmetic, therapeutic and psychological benefits to patients, especially those with scarred corneas, irregular irises, and disfigured eyes. These can result from trauma, glaucoma, infections, surgical complications, and birth defects.

In addition to improving aesthetic appearance, lenses can help block light and reduce visual disturbances that can cause pain, photophobia, double vision, and discomfort.

Several lens options are available, such as transparent tint, standard opaque designs, and custom hand painted designs, depending on therapeutic and cosmetic requirements.

Related: How to Fit Scleral Lenses Confidently and Cautiously

Soft prosthetic contact lenses can help relieve emotional trauma while providing therapeutic care for patients with a host of eye complications.

By equipping patients with custom soft prosthetic contact lenses, DOs can offer solutions that provide comfort to their patients.

4. Hybrid contact lenses

Hybrid contact lenses offer the longevity, durability and clear vision of RGP lenses along with the comfortable and wearable design of soft lenses. They achieve these results with a GP center surrounded by a soft outer lens material.

The soft skirt featured around the hybrid lenses bridges the junction between the soft material and the GP material, allowing a more efficient tear pump mechanism and oxygen delivery throughout the day.

Ideal patient profiles include patients with regular corneal astigmatism and problems with lens rotation or fluctuating vision in soft lenses as well as irregular corneal profiles.

Hybrids are a great option and a value for those practices that struggle to find a rhythm with other lens modalities.

Related: Podcast: Wearing Contact Lenses is a Healthy Option for Kids

5. Corneal molds

When it comes to more nuanced eyes, ill-fitting contact lenses increase the risk of complications such as corneal scarring. If diagnostic and empirical adjustments fail in a more complicated case, molded eye prostheses can create personalized scleral lenses.

They do this by taking impressions of the corneas, a process that takes no more than 2 minutes, and use them to design specialized lenses that match the exact contours of each eye. The lenses that result from this process offer great stability and comfort to the wearer.

The large coverage area and durability of the corneal molds can result in improved comfort and more stable vision than smaller traditional GP or hybrid lenses.

These specialized scleral lenses can be designed to accommodate corneal stiffness and irregularities found in corneal ectatic conditions.

Related: Multifocal Lenses For Presbyopia In Eyes Having Previous Corneal Surgery


Specialty contact lenses have had a huge impact in the world of optometry. Understanding and sharing their benefits is a journey that many ODs have not yet fully explored.

However, when time is invested in troubleshooting for optimal vision, fit and quality of care, patient satisfaction skyrockets. In fact, many specialty contact lens wearers are so happy with their personalized lenses that they are unwilling to revert to alternate terms.

As a result, the ODs that offer them benefit from more loyal patients who are less likely to shop elsewhere.

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