Survey period: March 2-7, 2023

We had 363 participants in this survey, however, for the primary questions of the survey, we limited it to those who have used sclerals for at least three years (that was about 70% of total participants). Those who have used sclerals for fewer than three years were limited to comments only.

Lens replacement

(253 participants, who have worn scleral lenses for at least three years)

Question 1: Think of the lens you most recently replaced due to "ordinary wear & tear" (or any reason other than loss or breakage). How long did you have the lens?

Question 2. Which of the following is mostly likely to be your PRIMARY reason for replacing a lens that you are currently using?

Question 3: Have you ever had to replace a lens for the following reason? Check all that apply.

Question 4: Think of the most recent time you had to purchase a duplicate lens (i.e. no new fitting or lens modification). How much did it cost?

Question 5: Did you understand scleral lens replacement needs and costs when you got your first lens(es)?

63% said yes, so there is considerable room for improvement here. - There is a lot of information to absorb when you first start the process for scleral lenses. This is a good one to ask and to write down the answer for future reference.

Comments from participants who have used sclerals for fewer than three years

I had to have my first pair replaced after one year. They were very worn out. I am now 7 months in on my second pair. Fortunately, it was from wear, so my insurance covered them again.
Identifying dots wore off of EyePrint in 4 months. This appears to be common.
My lenses are 1.5 years old and they are still in good condition
Lost one lens while in the hospital.
I tried to replace at one year and was told my prescription had not changed much. I then ordered a replacement pair same prescription as the first.
I replace them every two years on the advice of my doctor. I’ve never broken any.
Have been in same pair for 14 months. Use clear care plus for cleaning. Will be interested in responses
I put reminders in my calendar to replace inserters and removers every 3 months
none at this time
With proper care and storage, sclerals can last a long time…as long as your prescription and curvature doesn’t change. On my first pair 3+ years. I do have a back up pair just in case/ and for travel!
My first doctor told me to “rub the lens gently with Purilens and then soak them overnight in Purilenms” I broke a lens that way. I was not told the manufacturer of the lens,l which cost $500. Went to another OD who fitted me without any fancy tests and told me just to clean them overnight in ClearCare. [I wonder if there was a misunderstanding. Contact lenses should NEVER be stored overnight in a preservative free saline.]
2.5 years and they are as good as the day I got them. I did get a second pair for backup at the 1 year mark. I have never needed them.
The first year I broke 2 lenses, but I have learned how to better handle them.
Have been wearing my lens about 8 months. So far so good.
Iit’s super stressful and time consuming
Good so far
After paying out of pocket for my first set of sclerals, my dr suggested that I change insurance companies to one that he knew would cover the entire cost - which I did and it is now great!! He likes to replace my lenses each year since my eyes do change often.
First set of sclerals cost 2500. Zenlens from Bauch Lomb. Replaced 4 times within warranty period which is 6 months. I’m on new set ordered in Feb this year at cost of 700. Hopefully these will last longer.
I envision changing my scleral lenses every 2 years
I’m very curious about how long my scleral lenses should last! Waiting with anticipation. . .
no breakage
Had them for 6 months
I been wearing scleral lenses for 1+ years. Important is to clean them well everyday.
By the time it’s closer to my one year of use, the lenses become foggy a lot faster and drier.
I have had then at lease crack one crack or a small piece break off with in 8 months at lease 3 times. I'm told that they are only after three months. That doesn't make sense?? Not happy but when you have sever dry eye, I don't have much of a choice
The only time i have broken a lens was when my doctor's office gave me too small of a case at my exam... !@#$
My contacts are great. What happens after a year?
When do I need to replace them? [Great question for your provider, as it depends on many factors.]
The Scleral lens has been a life changer! Due to the scar on my cornea, I cannot see much at all our of my left eye. With the Scleral lens, I can see great! It's so much more comfortable than the regular hard contacts I used to wear. It is definitely worth the cost. I've had no trouble keeping mine clean. Once I learned how to put it on, I never go without it! It's the best thing to happen to my eyes in years!
The first pair of scleral lenses I had broke while I was cleaning them after about a year of wearing them, and I get a new pair every year due to my insurance coverage.
I wish they did not have to be changed out yearly. It is very expensive too.
replaced every 12 months. Only problem I have is protein buildup. Love them.
I replace annually
normally I would keep them for 2+ years but now I go every year and get a new pair. I've only had one crack (was safe to use) after I put it the disinfectant case.
I replaced my first lens after 1.5 years as the hydrapeg coating had worn off. The new lens was covered by Medicare.
I have only had the lens for 4 months - its all new to me
My sclerals have lasted well. So far, replacements have been due to trying different fits and correction factors. I haven't replaced due to breakage yet, thankfully.

Comments from participants who have used lenses for 3+ years

My doctor makes the decision when to replace my lens.
My vision is so much better with the lenses than with glasses that it is worth the cost, but I wish they were not so expensive. I have insurance for eye glasses, but because medicare is primary, I can't get coverage for the lenses.
The pair I am wearing is a year old. My doctor said they were gunck up? [Are you using any kind of special cleaner to remove proteins, such as Miraflow or Sereine daily cleaners, or Progent weekly cleaner? Might be worth a conversation with your doctor about the options.]
The lenses were high maintenance. They are fragile and the fit changes causes vision changes and decrease comfort.
I wish that they were more affordable, the fitting fee went from 1000, to 2850- plus lenses are another 1200. My eye Dr requires yearly replacements.
When the lens are replaced due to wear and tear (i.e scratches on the lens), I did notice an improvement in watering my eyes afterwards.
The lenses I am wearing now are a new type. The old type was a hybrid scleral lens. New one is Scleral (100% hard). I went in to see the Optometrist in November, because I was due for a new set (I have to replace them every 6 months). But then he told me there is a new type (the scleral hard), so I switched to them. I started wearing this new pair in January, and I love it. More comfortable for sure.
Scleral lens are way to expensive like it’s ridiculous that most insurances don’t cover the cost this is a rich man’s disease and a lot of poor people have it something has to be done it’s either pay the 2k or go blind that inhumane especially for tax paying citizens
I have to replace my lenses about once a year due to the inability to rewet. It comes to a point where any fluid just dissipates straight off the lens. I use boost regularly (or as regularly as I could with the shortages this past year), but this continues to be a yearly problem.
Whenever the prescription needs updating
Be careful handling them. I dropped one on a tile floor and it broke.
I had to change lens primarily because my lens did not track with the vision correction required.
I get new ones annually in connection with my annual eye exam. They are pricey but life changing!
I wish someone would have told me to purchase a duplicate set with the original so that I could rotate sets and have one set cleaning while I'm wearing the other.
I have found them to be similar to rgp lenses I have worn in the past. I have worn hard contact lenses for 60+ years
During COVID I went over 2 years without replacing the lenses, now that things are more normal I plan on going in 1x/ year for an exam and new set. Overall I found the lenses to be very durable if handled with care during cleaning.
I have had to replace a device due to it being broken, chipped, scratched but a very few times. It seemed to have Happened in my case? Or for unknown reasons. Replacements cost $750 at first but now cost $1,000. If I am not mistaken, insurance didn’t cover it. But this happened only a few times and my devices seem to last for years.
My problem is debris buildup and the coating on the lens wearing off.
Extremely hard to get my VSP vision insurance to pay for the lenses as “medically necessary lenses”, which is a fine-print clause in my VSP coverage. My eye doctor spent time on the phone with VSP to find a diagnosis code that she could use to enable VSP to cover sclerals for me as my eyewear for the year. It was a miracle that she was willing to do this, but should be much easier.
I suffer from GVH as a result of a bone marrow transplant. As a result, my corneas have dried out. The sclerals approximate a moist cornea surface, but they are not perfect given the clouding and limited time I can wear them.
Frustrated by how fast protein builds up after you purchase a replacement lens. Even with peg application.
My scleral lens life has been longer than any other lenses I have used. I wear mine all day and usually the majority of a week. I have had my same lenses for 4 years and have yet to need to replace them. I have used hard lenses and soft lenses in past years and would have to replace them at least once a year. I would highly recommend scleral lenses to anyone that wears contacts over any other kind.
I have never had to buy a replacement lens because during the fitting process my Dr told me to use one of my almost perfect trial lenses in case the one I purchased somehow became damaged.
I will use Scleral lens no matter what. They are well worth the cost and time spent.
After 3+ years my lenses were fogging quite a bit and Dr thought it was due to some wear and tear on lens . I did not have the money to replace the lenses . I found my “emergency pair” , the second last pair that they tried when doing the fitting and wore them to the Dr and had him examine them on me . He said the fit wasn’t perfect but actually pretty close . He told me to go ahead and wear these as replacement lenses until I was nna better financial situation . Very pleased and happy
Seems like there is never a bad reason to replace a lens.
My lenses are replaced when my vision changes.
there needs to be a low cost provider if you have a prescription. I should not have to buy them from the provider of which there are not many
In regard to replacement when I broke a lens, I actually didn’t pay. My insurance covered it
I typically only change lenses if there is a prescription change or the lens breaks. I have had two break while handling (over the course of 9 years)
Cannot see without the lens, it is must have.
The only extra lenses I ever bought were to have a spare pair, $800. I have never broken one. Mine typically stay in such good shape, I only change if prescription does, or otherwise see new features as making it time.
Insurance should to cover at least one time part of cost for change of vision for medical use in a diagnosed diseased eye.
Not clear to me if a lens has to be replaced with a newer “healthier” lens after a two year period.
My work is mostly with tiny black dots (music) at various distances.....piano distance (arm's length) and sometimes computer screens (giant dual monitors.....arm's length plus 2 feet) and accompanying singers onstage (up to 20 feet distance), so my left eye is corrected for distance as well as a lens for closer up if that's what the day entails. My right eye is just for closer work. But I've adjusted well to the differences. (That might be a good topic too: How many have different distance corrections in the two eyes?) [Great suggestion, thank you, putting it on the list.] The higher order aberrations (double vision, halos, etc.) make vision progressively difficult within 2 years. My doctor (not local) had me go to a local optometrist for glasses to wear over the sclerals and that is helpful, but I need to update the sclerals when able.
Replacements have only been due to improved fit or prescription. Doctor always impressed at condition of lenses over time.
I am happy to help anyone who has questions about scleral lenses. They can be very daunting in the beginning.
I still have my original PROSE scleral lenses. Tried a larger non-PROSE scleral lens for improved left eye comfort - it cracked as I started removing it and broke on the plunger as soon as it came off my eye.
I am getting a new scleral lens annually at my eye exam. My provider said they can last for up to 3 years (approx).
So important to handle with care and to clean them properly
My experiences have been with PROSE lenses. I wear them until they break or until my prescription changes. On average, I get two years use from a lens. I have had one that needed to be sent back to Boston Sight for polishing but that is unusual. I have found that I can remove most deposits by pre-soaking in Boston Simplus, then using an RGP cleaner.
I had to replace first set of lenses after 10 months due to protein buildup. They became very uncomfortable to wear and I noticed a definite difference in my vision. My provider recommended using Clear Care daily and Progent cleaner bi-monthly. That made a huge difference. My second pair of lenses lasted 18 months.
I am now at the point where my scleral lenses do not last as long as they should based on the high cost of lenses. They accumulate so much mucus/oil that I have a very hard time getting a clear, precise vision. The mucus causes irritation. It's becoming a problem that is not easily solved. I'm currently trying to wear a soft lens over the scleral, but this really is not a long term solution. [So sorry. These chronic depositing issues are so hard.]
I am fortunate to have good vision insurance through my employer and get a pair of new sclerals every year because of it.
I am about to replace my lenses for the first time due to deposits that are difficult to remove
My PROSE are life changers for me. I wear them all my waking hours, blind & in pain without them. I have 2 sets that I rotate between. Worth EVERY penny!!
The first set of lens cost $2400 each now they are $1200 each i hope they continue to go down in price they are very good to see with but very expensive
I have PROSE lenses and have broken several of them. Medicare pays the $1,200 cost.
My provider said the normal life span of scleral lenses was a bit more than a year. I wore mine for almost 5 years before I replaced them. I handle them very carefully and use only alcohol based cleaners though. I replaced them because of the aging prescription and the fear that my existing prescription was so out of date and if I lost/broke one I couldn't get it replaced.
Mine is needed since I lost my eye in an accident. Fitted several weeks op op so I think maybe a new one will be less irritating.
I get an annual exam and usually have had a slight change in vision. Typically I get new lenses each year.
The costs vary significantly between doctors for replacement lenses.
I live in Canada. My health plan replaced a broken lens.
I replace at 6months, when hydra peg wears off. Unfortunately, My eyes don't tolerate Boost treatments.
Sclerals are wonderful lenses for those of us with no other choices. They do require constant consistent care and budgeting for replacement about every 2 years, but once fitted correctly, in my experience are the best for eye health ( the constant moisture is very healthy for eyes) and vision.
Suffer from keratoconus
I have been extremely fortunate that my vision insurance covers the cost for annual lenses.
Boston Sight sent me a new lens very quickly. Twice! Emergency! And my lenses last years and I take very good care of them.
Provider suggests replacing every year. Last set were 3.5 years old and in excellent condition. Replaced due to RX change and desire for more comfort.
The products I need for wearing the scleral lenses are expensive to maintain.
Taking proper care of the lens extends the life, I have been extremely happy with the improved vision i get from scleral lenses.
I have been a scleral lens user for about 4-5 years. I have never had an experience with them breaking or becoming brittle, but my doctor does explain over time approximately a year they begin to wear down in a sense and the vision will not be as clear. I am fortunate that my insurance covers medically necessary lenses so I have never had to pay out of pocket for the expense of a lens, only for copay for the visits themselves. I see Dr. Sarai in Village Eyecare in Chicago, he is pretty good at making sure I receive the right fit.
I appreciate how much insurance knowledge my ophthalmologist provided to ensure easy insurance info
My ophthalmologist was very knowledgeable
They actually are more comfortable to wear than my old gas permeable lens once I got used to them and figured out how best to insert and take them out.
My lenses are usually pretty scratched at the end of the year when my insurance will replace them. I am trying a new cleaning protocol to see if that helps, my eye doctor is surprised how scratched they are and I can't figure out what's causing it.
I have been wearing a PROSE lens since 2003. I only needed to replace it 3 times. I have been wearing my current (3rd) lens since 2014.
How sad that these lenses are not covered by insurance for us patients who need corrective lenses the most.
I had to have lens replaced when vision in that eye changed.
Prose lenses can be sent back to the manufacturer for recoating which extends their life. I believe the cost for this is around $300.00 a pair
100% of the cost was covered by my medical insurance
At first the Lens would be comfortable for 6 months. After that I would take them out and clean them 2-3 times a day. Using Progen improved comfort. I then had 2 sets of Lens which I would alternate every couple of weeks. I worked with my Optician to reduce power of the lens to the minimum which improved comfort. Currently I use 3% hydrogen peroxide to clean the lens, one set is 18 months old the other is 30 months old. I wear the lens 12 to 14 hours a day and only occasionally have to refresh them
refitting is time consuming as a patient but it’s worth it
I started with just regular scleral lens then they came out with the hydro peg which my first pair was awesome but the hydro peg wore off within 4 months. Using the tangible boost is ok but it does not replace the original hydro peg. I actually purchased a new pair with the hydro peg and they weren’t the same as the original. I really wish I could get replacements exactly like the original pair. At least all the gunk my eyes over produce would slide right off of them. Now I have to continually clean my lenses throughout the day.
Why are lenses in NY (Eastern Suffolk County) so expensive. My lenses are 3000.00 a pair. My insurance will not cover any of it.
Unfortunately, replacing lens are not optional for me. Unless, it’s during a short period from the order date of purchase due to fitting issues or vision adjustments only. They run me around $400 each lens after additional vision insurance discount was applied under my employer.
I have only had to replace because my eye shape changed and they didn’t clear the cornea enough. This happens every 6months to a year. I’ve also had to order new ones due to a cornea transplant. I’ve never had a problem with vision changes or breaking of the lens
My 20 year old daughter has autism with cognitive impairment. Her dad and I insert and remove both lenses daily for her. She seems to have excessive protein buildup and gets "eye boogers" or "floaties" in the fluid in the lenses after several hours. We have to take them out and clean them at least once per day. The main reasons we've had to replace a lens: 1- I dropped one on a tile floor and it shattered, 2- her prescription and eye shape changed, 3 - excess buildup that neither we, nor the doctor could not remove so the lens was cloudy.
I highly recommend the hydra peg coating. Just be careful when you first get new lenses with this coating as they are incredibly slippery.
My comment is when wearing one of the Scleral lens there may be times you'll have to change your len until your doctor is able to find the proper fitting for your eye;especially, if you have an eye disease like Keratoconus that usually changes the shape of your eyes Cornea.
I'm based in the UK so on the cost question I used a standard exchange rate conversion
Sclera's have been a godsend; however they are difficult to fit/adjust due to my extreme astigmatism.
The only lens that ever broke due to wear was a boston foundation for sight lens. They did not warranty it - had to replace, very $$. New lenses from my local optho are much cheaper and have yet to fail after 3+ years. I would like to know the expected lifecycle, esp if they warp over time. My optho has never offered guidance.
I love my lens, I see so much more with them
if no changes to fitting or new modifications, replacement less will be almost 1/2 cost as initial lens. Crosslinking prior to getting lens, helped me for no modifications needed.
My Vision plan pays for new lenses yearly even though nothing has changed since I started wearing them. I will be getting my fifth pair this month. My lenses are for KC.
I worry about switching brands. I have Blanchard, but providers in my area do not carry Blanchard. I wish I didn't have to go through all the fitting, the pain of adjustment, the replacement lenses when they don't fit again. Next time, I'm ordering 2 pairs of duplicates.
Would like to get the cost down
It's not a inexpensive process.
I no longer pay for lenses as they are covered by insurance
Be gentle with them. Don't rush. Make sure your sink drain is closed.
I can have almost normal life
I have an issue with milky deposits in the lenses when I wear them I have to rinse them about 2 or 3 times a day. Not sure what is causing that.
When first fitted for scleral lenses, the ophthalmologist never actively discussed how long the lenses would last, however did provide additional set as backup. These lenses lasted for over five years, as I used both sets for periods of time. I moved to a different state and the new provider indicated these should be replaced virtually every year, which was a surprise to me.
With all the recent difficulty getting proper cleaning solutions a more hands on follow up would be welcome. Like a my chart way to communicate with patients.
Fortunately all were covered by insurance.
They are amazingly comfortable to wear and adjust to; be very careful when handling for cleaning and inserting! They are very delicate.

Scleral lens life cycle (3/2023)Updated a year ago