If you or your patient has been diagnosed with keratoconus, you may have been told that glasses no longer give clear vision — and that standard contact lenses don’t work. Scleral lenses are the solution most specialists now recommend. This guide explains what they are, how they work, and why they are the preferred choice for keratoconus worldwide.
What Is Keratoconus?
Keratoconus is a condition where the cornea — the clear front surface of the eye — gradually thins and bulges outward into a cone shape. This distorts vision in a way that spectacles cannot fully correct, causing blurry, distorted sight and sensitivity to light and glare.
Keratoconus affects approximately 1 in 2,000 people and typically begins in the teenage years or early twenties. Vision loss is progressive — but with the right correction, most patients maintain excellent functional vision throughout their lives.
As the condition advances, the irregular shape of the cornea means that even the sharpest spectacle prescription cannot produce clear vision. This is where scleral lenses come in.
What Are Scleral Lenses?
Scleral lenses are large-diameter rigid contact lenses that vault completely over the cornea — never touching it — and rest on the white of the eye (the sclera). The space between the lens and the cornea is filled with saline solution.
Vaults over the cornea
The lens bridges entirely over the irregular corneal surface. The saline reservoir fills in the cone shape, creating a perfectly smooth optical surface.
No corneal contact
Because the lens never touches the cornea, there is no discomfort from lens-on-cone pressure — a common problem with regular RGP lenses.
Constant hydration
The saline reservoir keeps the corneal surface continuously hydrated — providing comfort even for patients with dry eye.
How Scleral Lenses Help Keratoconus
The irregular cone shape scatters light in all directions — causing the blurry, distorted, ghosted vision keratoconus patients describe. Scleral lenses solve this in one step:
The saline fluid reservoir fills in the cone completely. Light entering the eye passes through the smooth front surface of the lens first — bypassing the irregular cornea entirely. The result is clear, stable, distortion-free vision that spectacles and soft lenses cannot achieve.
- Clear, sharp vision even in advanced keratoconus
- All-day comfort — worn 12–16 hours daily
- No lens-on-cornea pressure or discomfort
- Works after corneal transplant (post-PKP / post-DALK)
- Suitable for dry eye and sensitive eyes
- FDA-approved medical device
EyePal Mini Scleral Lenses — Available in India
Cosmos Enterprises is the authorised distributor for EyePal Mini Scleral Lenses in India — FDA-approved and manufactured in the USA by EyePal Contact Lens.
| Parameter | Detail |
|---|---|
| Regulatory approval | FDA Approved (USA) |
| Diameter range | 15.1mm to 17.9mm |
| Sagittal depth | Up to 6700µm — accommodates severe cones |
| Haptic design | Spherical and toric haptic options |
| Fitting method | Profilometry-guided (Eaglet Eye ESP) or trial set |
| Wear schedule | Daily wear, removed nightly |
For patients with highly asymmetric scleral anatomy — common in advanced or post-surgical keratoconus — Cosmos Enterprises also provides the i-Shape Freeform Scleral Lens (CE Certified, Switzerland), individually designed from Eaglet Eye ESP profilometry data.
What to Expect
Scleral lens fitting typically takes 2–3 clinical visits:
- Assessment — corneal topography and profilometry to map the eye surface
- Trial fitting — a trial lens is assessed under the slit lamp
- Dispensing — final lens delivered with insertion and cleaning training
Most patients adapt within 1–2 weeks. Cosmos Enterprises provides dedicated fitting consultant support throughout.
Interested in scleral lenses for keratoconus?
Contact Cosmos Enterprises for product enquiries, fitting support, or to find a trained practitioner near you.
Cosmos Enterprises is the authorised regional distributor for EyePal Mini Scleral Lenses (FDA Approved, USA) and i-Shape Freeform Scleral Lenses (CE Certified, Switzerland) in India.