When your eyes are still uncomfortable despite drops and other treatments, it can be hard to know what to try next. Scleral lenses may help selected people with severe dry eye by holding a layer of fluid over the cornea while the lens is worn. They can support the eye surface and may also improve vision when the cornea is irregular. 1
They are custom-fitted contact lenses, with daily handling, cleaning and follow-up requirements. They do not suit everyone, and they usually form part of a wider treatment plan rather than replacing care for the cause of dryness.
At Vision Camberwell Optometrists, we fit scleral lenses for severe dry eye as well as irregular corneas. We’ll assess your eyes, review what you have already tried and explain whether a fitting trial is a sensible next step. You do not need to decide which lens you want before booking.
Contents
How can a contact lens help a dry eye?
A scleral lens is a large, rigid, gas-permeable lens that arches over the cornea and rests on the tissue covering the white of the eye. The space beneath it contains fluid, helping protect and hydrate the corneal surface during wear. Its optical surface can also help correct vision. 1
A fluid reservoir over the cornea
Before insertion, the lens is filled with the sterile, preservative-free solution recommended for your eyes. 5 Fluid exchange beneath a fitted scleral lens is limited; the reservoir is not continuously flushed with fresh tears. This is one reason the filling solution matters. 6
Protection without curing the underlying condition
The lens can support the surface while other treatments address inflammation, tear deficiency or eyelid problems. Current TFOS guidance recommends matching dry eye treatment to the contributing causes. A scleral lens does not remove the need to manage those causes. 2
Who might benefit from a scleral lens assessment?
An assessment may be appropriate when significant symptoms or surface problems persist despite treatment. We’ll consider the diagnosis and examination findings alongside the effect on reading, screen use, work and everyday comfort.
Severe dryness and ocular surface disease
Scleral lenses are used in selected patients with conditions such as Sjögren’s syndrome, ocular graft-versus-host disease and exposure-related surface damage. These conditions may need coordinated care with an ophthalmologist or the team managing the underlying disease. 1 3
Dryness alongside an irregular cornea
If you have keratoconus, a previous corneal graft or an irregular cornea after surgery, dryness can add to an existing vision problem. The fitting assessment considers both surface protection and the vision achievable through the lens. 1
Dry eye without corneal irregularity
You do not have to have keratoconus to be assessed. However, evidence is more limited for routine dry eye without associated corneal irregularity or other ocular surface disease. A review by Qiu, Fadel and Hui highlighted this gap. We’ll discuss the likely benefit and daily commitment rather than assume scleral lenses are the next step for every dry eye patient. 3
What does the research show?
A short-term study by Lu and colleagues reported improved dry eye symptoms and corneal staining after one month of scleral lens treatment. These findings are encouraging, but short follow-up cannot establish lasting benefit or long-term safety, and the results do not predict an individual patient’s response. 4
The wider literature also describes benefits for selected ocular surface conditions, alongside practical challenges such as fogging and poor wetting of the lens surface. 3 We use the evidence to guide assessment and then judge whether the improvement is worthwhile for your own daily life.
What happens during fitting at Vision Camberwell Optometrists?
Fitting starts with your eyes and your goals. Tell us which activities are hardest, when symptoms are worst and whether previous lenses have been uncomfortable. We’ll explain the assessment and fitting costs before you decide to proceed.
Reviewing your dry eye treatment
We review your diagnosis, current drops, previous procedures and any relevant medical conditions. Dry eye can have several contributors, so treatment may need adjustment before or alongside lens fitting. TFOS guidance supports this individual approach. 2
Assessing the trial lens
We assess the eye surface and corneal shape, then evaluate a trial lens where appropriate. We look at clearance over the cornea, the way the lens rests on the eye, vision and your response to wear. We’ll explain whether further adjustments are needed before ordering or finalising the lens.
Learning handling and planning reviews
We allow time to teach insertion, removal and the prescribed care routine. Tell us if hand movement, vision or confidence makes handling difficult, or if someone will help you at home. Follow-up appointments let us review your comfort, vision, lens fit and eye health as you build up wear.
What are the limitations and daily commitments?
The aim is an improvement that makes a difference to you. It may not mean a completely symptom-free day. We’ll weigh the benefit against handling, care, cost and the need for reviews before recommending continued wear.
Fogging and dryness on the lens surface
Some people develop cloudy vision from debris beneath the lens or poor wetting of its front surface. Persistent fogging needs review; it should not simply be accepted as part of treatment. See our page on scleral lens fogging, discomfort and refitting. The Scleral Lens Education Society also notes that corneal swelling can cause foggy vision, so the cause needs checking. 6
Continuing other treatment
Do not stop prescribed drops or eyelid treatment because the lens feels soothing. We’ll explain which treatments to continue and when to use them. Managing the underlying condition remains part of dry eye care. 2
Daily care and wearing time
Use the filling and disinfection products prescribed for your lenses; filling solution and disinfectant have different purposes. Clean and disinfect after removal, and use fresh solution as instructed. Our scleral lens care guide covers the routine step by step. 5 Your wearing schedule should be individual, and routine scleral lenses should be removed before sleep. 6
Before your appointment
Bring the information that will help us understand your eyes:
- A list of your eye drops and medicines, previous eye reports and details of treatments you have tried.
- If you already wear contact lenses, bring the lenses, case and care products.
Let us know about autoimmune disease, a stem-cell transplant, corneal surgery or another condition affecting your eyes. Ask us whether to wear your existing lenses before attending.
Note what you most want to improve, such as reading comfortably, managing a workday or reducing interruptions from dryness. This helps us set useful goals for the assessment.
Questions about scleral lenses for dry eye
Can scleral lenses help if ordinary contact lenses feel dry?
Possibly. Scleral lenses hold fluid beneath a rigid lens rather than behaving like a soft lens. That difference may help some people, but previous soft-lens discomfort alone does not establish suitability. An assessment is needed. 3
Will I still need eye drops?
You may. Scleral lenses are often used alongside other therapies. 1 We’ll explain your medication plan and which drops are compatible with lens wear. Do not add medication to the lens reservoir unless specifically prescribed for that purpose.
Can I fill the lenses with tap water or cleaning solution?
No. Use the sterile, preservative-free filling solution we recommend. Cleaning or disinfecting solutions are not interchangeable with filling solution. 5 Water exposure increases the risk of serious infection. 7
Can I sleep in them to help overnight dryness?
Not with the routine daytime lenses described here. Remove them before sleep and discuss overnight symptoms with us so we can plan appropriate care. 6
What if my eye becomes painful, red or suddenly blurry?
Remove the lens and seek urgent eye-care advice, especially with light sensitivity, discharge or reduced vision. Do not reinsert it or wait for a routine review. If we are unavailable, seek urgent assessment through another eye-care service or an emergency department. Bring your lenses and case. 7
Discuss severe dry eye care in Camberwell
Vision Camberwell Optometrists is at 784 Burke Road, Camberwell VIC 3124, in Melbourne’s inner east. We welcome patients from Camberwell, Hawthorn, Balwyn, Kew, Canterbury and across Melbourne. Consultations with Jue Wang are available in English and Mandarin.
Call (03) 9882 5666 or contact our team to discuss an assessment. If you are unsure whether you need a dry eye consultation or a scleral lens fitting, tell us what you are experiencing and what has already been tried. You can also read about our dry eye care and scleral lenses.
References
- Harthan JS, Shorter E. Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations. Clinical Optometry. 2018;10:65–74. doi:10.2147/OPTO.S144357.
- Jones L, Craig JP, Markoulli M, et al. TFOS DEWS III: Management and Therapy. American Journal of Ophthalmology. 2025;279:289–386. doi:10.1016/j.ajo.2025.05.039.
- Qiu SX, Fadel D, Hui A. Scleral Lenses for Managing Dry Eye Disease in the Absence of Corneal Irregularities: What Is the Current Evidence? Journal of Clinical Medicine. 2024;13(13):3838. doi:10.3390/jcm13133838.
- Lu C, Han D, Zeng L, et al. Short-Term Efficacy and Safety of Scleral Lenses in the Management of Severe Dry Eye in a Chinese Population. Journal of Clinical Medicine. 2025;14(3):658. doi:10.3390/jcm14030658.
- Scleral Lens Education Society. Scleral Lens Care Guide. Patient guidance. Accessed 14 September 2026.
- Scleral Lens Education Society. Lens Handling FAQs. Patient guidance. Accessed 14 September 2026.
- United States Food and Drug Administration. Contact Lens Risks. Patient guidance. Accessed 14 September 2026.
Reviewed by Dr Shonit Jagmohan, B.Optom (Hons), FIAOMC, IACMM, Ophthalmic Medicines Prescriber, Fellowship Chair for the International Academy of Orthokeratology and Myopia Control (Oceania). Last reviewed October 2026.
Visit us in Camberwell
T. (03) 9882 5666
E. vision@visioncamberwell.com.au
Find Us at:
784 Burke Rd, Camberwell
Victoria 3124, Australia
Opening Hours:
Monday, Tuesday and Friday. 9am – 6pm
Wednesday. 9am – 5pm
Thursday. 10.30am – 7.30pm
Saturday. CLOSED
Book your appointment with one of our friendly team members today
T: (03) 9882 5666
Serving Camberwell and the Surrounding South Eastern Suburbs
An independent practice in Camberwell since 1951, we are experts in specialty contact lenses, including scleral lens fitting for severe dry eye and irregular corneas. We welcome patients from Hawthorn, Deepdene, Surrey Hills, Balwyn, Kew, Canterbury, Box Hill, Glen Iris, and across greater Melbourne.
