Sclera contacts, also know as scleral contact lenses, are different than corneal contact lenses in a number of ways. While corneal contact lenses rest on the central, clear part of your eye (the cornea), sclera contacts rest only on the white part of your eye (the sclera). It is because of this difference in how the lens rests on the eye that sclera contacts are appropriate in a variety of situations where corneal contact lenses are not. For example, when there is any disruption of the smooth surface of the cornea, vision while be compromised, and a soft contact lens that rests on the cornea will generally not provide clear vision. Sclera contacts vault over the corneal surface and create a new smooth, regular surface in front of the cornea to interact with incoming light rays. The space between sclera contacts and the corneal surface is filled with preservative free solution or preservative free artificial tears. In addition to filling in this space between scleral contacts and the corneal surface to provide clear optics, this liquid chamber protects the corneal surface, and it is for this reason that sclera contacts are often a good option for patients suffering from severe dry eye problems.
Scera contacts are generally covered by insurance for conditions including: keratoconus or other corneal diseases, post-corneal transplant, corneal trauma, severe dry eye, high eyeglass prescription, large difference in the eyeglass prescription between left and right eyes, or any case where the best vision with sclera contacts is significantly better than with eyeglasses. Generally, vision insurance limits coverage for sclera contacts to cases of keratoconus, high eyeglass prescriptions, high difference between left and right eyeglass prescription, and when visual improvement with sclera contacts is two lines or more on the vision chart compared to vision with eyeglasses. Medical insurance coverage is generally broader and will provide coverage in cases of severe dry eye or other conditions in which sclera contacts are necessary.
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