Scleral lenses for keratoconus — what to know
Scleral lenses are large-diameter, gas-permeable lenses that vault completely over the cornea and rest on the sclera (the white of the eye). The space between the lens and the cornea is filled with a saline reservoir.
For patients with keratoconus or other irregular corneas, this design solves a problem that standard lenses cannot: it creates a smooth optical surface regardless of the shape of the cornea underneath. The result is improved vision, comfort, and the ability to wear lenses that were not possible before.
Does Spadina Optometry fit scleral lenses for keratoconus?
Yes. We have extensive experience fitting scleral lenses for keratoconus and other complex corneal conditions at our downtown Toronto clinic.
We are a Teaching Site affiliated with the University of Waterloo School of Optometry and Vision Science, and specialty lens fitting is a clinical area we take seriously. Fittings involve corneal topography, structured follow-up, and a clear fee structure.
Scleral lens fitting fee: $750, inclusive of all follow-up visits needed to optimise your fit.
Location: 477 Richmond St W, Suite 809, Toronto, ON M5V 3E7
What conditions do scleral lenses treat?
We have had good clinical success fitting scleral lenses for:
- Keratoconus — corneal thinning and bulging that cannot be corrected with glasses or soft lenses
- Corneal scarring — from infection, injury, or other causes
- Post-surgical and post-transplant corneas — irregular surfaces following refractive or therapeutic surgery
- Corneal dystrophies — such as granular dystrophy, where abnormal deposits affect the corneal surface
- High astigmatism or high refractive error — where scleral lenses offer superior optics and comfort over traditional rigid gas-permeable lenses
- Severe dry eye syndrome — the fluid reservoir provides continuous hydration and protection
How are scleral lenses fitted?
Fitting scleral lenses takes more than one visit. The process typically involves 3 to 6 appointments:
- Corneal topography — maps the shape of your cornea to guide initial lens selection
- Trial lens fitting — diagnostic lenses are applied and assessed for fit, vault clearance, and optics
- Optimisation visits — adjustments are made to the lens parameters until fit and vision are optimised
- Training — we teach insertion and removal technique, filling the reservoir, and lens care
- Follow-up — we confirm comfort and eye health once you are wearing lenses in daily life
All of these visits are included in the $750 fitting fee.
Custom gas-permeable lenses
For some patients with keratoconus, rigid gas-permeable (RGP) lenses — smaller than sclerals and resting on the cornea — may be appropriate depending on the stage of the condition and the corneal topography findings. We fit both scleral and corneal RGP lenses and will recommend the right design based on your clinical picture.
Why a specialty fitting matters
Scleral lenses for keratoconus are not off-the-shelf. The fit, vault, and optics need to be custom-matched to your cornea. A thorough assessment and structured follow-up process make the difference between a comfortable lens and one that fails.
Related pages
Ready to explore scleral lenses?
Book a specialty lens consultation at our downtown Toronto clinic. We assess corneal topography and work with you across 3 to 6 visits to optimise your fit.
Prefer to talk first? Call or text us at 416-703-2797.
Last reviewed: February 23, 2026