Scleral Lenses for Severe Dry Eye at Spadina Optometry

How scleral lenses help severe dry eye

Standard dry eye treatments — artificial tears, warm compresses, prescription drops, punctal plugs — work well for most patients. But for severe dry eye, these may not be enough. The corneal surface is too exposed, too inflamed, or too compromised for topical treatments alone to maintain comfort.

Scleral lenses take a different approach. They vault over the cornea entirely, creating a sealed reservoir of preservative-free saline that bathes the eye continuously. The cornea never dries out while the lens is in. For patients with conditions like Sjogren’s syndrome or graft-vs-host disease, this can be the difference between constant discomfort and a functional day.

Who we fit scleral lenses for

At Spadina Optometry in downtown Toronto, we fit scleral lenses for patients with:

• Severe aqueous-deficient dry eye that has not responded adequately to drops, plugs, or other treatments
• Sjogren’s syndrome — an autoimmune condition that attacks moisture-producing glands
• Graft-vs-host disease (GVHD) — where dry eye is a common and often debilitating complication
• Stevens-Johnson syndrome — where corneal surface damage makes standard lenses impossible
• Post-surgical dryness — after LASIK, PRK, or corneal transplant, where the corneal nerves and tear film are disrupted
• Exposure keratopathy — where incomplete lid closure leaves the cornea exposed

Not every dry eye patient needs scleral lenses. We assess candidacy through a dry eye evaluation and corneal topography to determine whether sclerals are the right approach for your specific condition.

How the fitting works at our clinic

1. Dry eye evaluation — we assess your tear film, meibomian glands, corneal surface, and symptom severity to understand what is driving your dry eye
2. Corneal topography — we map the shape of your cornea to guide lens design selection
3. Trial lens fitting — we fit a scleral lens and evaluate vault (the clearance over the cornea), centration, comfort, and vision
4. Refinement — most patients need 3 to 6 visits to optimise the fit. Each visit refines the lens parameters until the fit is right
5. Lens order and training — once the fit is finalised, we order your custom lenses and train you on insertion, removal, and care

The fitting fee is $750, inclusive of all follow-up visits. Lenses are billed separately. See our scleral lens service page for full details.

We also treat the underlying dry eye

Scleral lenses protect the cornea and manage symptoms, but they do not treat the root cause. At Spadina Optometry, we also offer:

• Meibography — infrared imaging to assess meibomian gland health
• TempSure Envi — thermal radiofrequency treatment for Meibomian Gland Dysfunction
• Nutritional guidance — omega-3 and dietary support for tear film stability

Scleral lenses are often part of a broader management plan. We work with you to address both the symptom relief and the underlying condition.

Related

• Scleral lenses for keratoconus and irregular corneas — fitting overview, conditions treated, and pricing
• What to expect with scleral lenses — daily wear, care, and adaptation
• Dry eye disease — causes, types, and treatment options
• Meibography and advanced dry eye diagnostics — what we use to diagnose the cause