Still struggling with keratoconus vision — even with glasses, contacts, or previous scleral lenses?
Scleral Lenses for Keratoconus
Scleral lenses are one of the most effective treatments for keratoconus, helping patients achieve clearer, more stable, and more comfortable vision. However, not all scleral lenses are the same, and not all patients achieve the same results.
At Keratoconus Specialists of Maryland in Baltimore, Dr. Benjamin Azman, OD, specializes in advanced scleral lens solutions for patients who want the best possible vision. Whether you are new to scleral lenses or have tried them before without success, our approach focuses on improving both visual clarity and overall visual quality.
What Are Scleral Lenses?
Scleral lenses are large-diameter contact lenses that vault over the cornea and rest on the white part of the eye (the sclera). This creates a smooth optical surface that corrects vision distortions caused by keratoconus.
Unlike traditional contact lenses, scleral lenses also maintain a fluid reservoir between the lens and the eye, which helps improve comfort and protect the cornea.
For many patients, scleral lenses provide significant improvement in vision, reducing symptoms such as glare, halos, ghosting, and fluctuating vision.
Why Not All Scleral Lenses Are the Same
While scleral lenses are considered the standard of care for keratoconus, results can vary significantly depending on how the lenses are designed and fit.
Some patients achieve good vision with standard scleral lenses, while others continue to experience visual symptoms such as glare, halos, ghosting, or reduced sharpness. This is often due to higher-order aberrations (HOAs) – subtle optical distortions that are not fully corrected with traditional lens designs.
This is why customization matters.
Advanced scleral lens technologies, such as wavefront-guided lenses, scan-based scleral lenses, and impression-based scleral lenses, allow for a higher level of precision, helping improve both clarity and comfort for more complex cases.
Why Your Scleral Lenses May Not Be Working as Expected
If you have tried scleral lenses but are still not satisfied with your vision, you are not alone. A significant portion of Dr. Azman’s patients come to us after being fitted with scleral lenses at another practice, and still experiencing glare, halos, ghosting, or blurry vision, they were told was as good as it could get.
There are several reasons why scleral lenses may not provide optimal results, including:
- Residual higher-order aberrations (HOAs) not addressed by the current lens design
- Lens design limitations – not all labs or fitting approaches are equal
- Fit issues or lens stability on the sclera
- Changes in the cornea over time requiring a redesign
- Dry eye or ocular surface conditions affecting vision through the lens
In many cases, these issues can be substantially improved with a more customized approach and advanced lens design.
Our Approach to Scleral Lenses
At Keratoconus Specialists of Maryland, scleral lenses are not a one-size-fits-all solution. Dr. Azman uses advanced diagnostic technology – including Pentacam imaging, wavefront aberrometry, OCT, and HOA analysis – to analyze both the shape of the cornea and the full optical system of the eye.
This allows us to design lenses that are tailored not just for fit, but for visual performance.
Our goal is to help patients achieve:
- Sharper, more stable vision
- Reduced glare, halos, and ghosting
- Improved comfort and longer wear time
- Better overall visual quality – not just vision on the eye chart
Dr. Azman’s philosophy: no two keratoconus patients are the same, and no two lens designs should be either.
Who Can Benefit from Scleral Lenses?
Scleral lenses are commonly recommended for patients with:
- Keratoconus
- Irregular corneas
- Post-LASIK or post-surgical complications
- Corneal ectasia
- Pellucid marginal degeneration
They are also an excellent option for patients who are unable to achieve clear or comfortable vision with glasses or traditional contact lenses – and especially for patients who have already tried scleral lenses but are still experiencing visual problems.
Why Patients Choose Our Baltimore Keratoconus Practice
- Keratoconus-only focus – scleral lens fitting for keratoconus is what we do, not one service among many
- Nearly five decades of experience – the practice has been fitting scleral lenses for keratoconus since 1977
- Advanced HOA-correcting technology – wavefront, scan-based, and impression-based lens options that most practices don’t offer
- On-site cornea specialist – Dr. Richard Adler, MD, FACS (Johns Hopkins Wilmer fellowship) for medical evaluation alongside lens care
- The doctor’s doctor – optometrists and ophthalmologists refer their most complex scleral lens cases to Dr. Azman
- Patients travel from across the region and country – Maryland, Virginia, Pennsylvania, Delaware, DC, and beyond
Schedule Your Consultation
If you are considering scleral lenses — or are not fully satisfied with your current vision — we invite you to take the next step. Call today to request your consultation and complimentary record review with Dr. Azman.
Frequently Asked Questions — Scleral Lenses for Keratoconus
What are scleral lenses used for in keratoconus?
Scleral lenses are the most commonly recommended contact lens treatment for keratoconus. They vault over the irregular cornea and rest on the white of the eye, creating a smooth optical surface that corrects distorted vision. For many keratoconus patients, scleral lenses significantly reduce glare, halos, ghosting, and blurred vision that glasses and soft lenses cannot correct.
Why am I still seeing glare, halos, or ghosting with my scleral lenses?
If you are still experiencing glare, halos, ghosting, or reduced clarity with scleral lenses, the likely cause is residual higher-order aberrations (HOAs) — optical distortions that standard scleral lenses are not designed to correct. HOAs are common in keratoconus and require advanced diagnostics and custom lens designs such as wavefront-guided scleral lenses to address. At Keratoconus Specialists of Maryland, Dr. Benjamin Azman uses wavefront aberrometry and HOA analysis to identify the specific distortions affecting your vision and design a lens to correct them.
Are all scleral lenses the same?
No. Standard scleral lenses correct basic vision by vaulting the irregular cornea, but they do not address the higher-order aberrations that cause residual glare, halos, and ghosting. Advanced options — including wavefront HOA-correcting scleral lenses, scan-based scleral lenses, and impression-based scleral lenses like EyePrintPro — allow for a much higher level of customization. The difference can be significant: patients who have struggled with standard scleral lenses for years sometimes achieve dramatically better vision with a more advanced design.
What makes Keratoconus Specialists of Maryland different from other scleral lens fitters?
Most eye care practices offer scleral lenses as one of many services for many conditions. At Keratoconus Specialists of Maryland, scleral lens fitting for keratoconus is what we do — nearly exclusively. Dr. Benjamin Azman sees complex keratoconus cases all day, every day, including patients who have failed with standard scleral lenses at other practices. The practice has been dedicated to keratoconus since 1977, and optometrists and ophthalmologists throughout Maryland and surrounding states refer their most difficult scleral lens cases to our team.
Do scleral lenses cure keratoconus?
No, scleral lenses do not cure keratoconus or stop its progression. They are a non-surgical treatment that improves vision by correcting the optical distortions caused by the irregular cornea. If disease progression is a concern, our on-site cornea specialist Dr. Richard Adler, MD, FACS — a Johns Hopkins Wilmer Eye Institute fellowship graduate — provides medical evaluation and guidance on disease management.
Who is a good candidate for custom scleral lenses?
Custom scleral lenses are ideal for patients with keratoconus, corneal ectasia, pellucid marginal degeneration, irregular corneas, or post-surgical complications who are not achieving clear or comfortable vision with glasses or standard contact lenses. They are also the right next step for patients who have already tried scleral lenses but are still experiencing glare, halos, ghosting, or blurry vision — even with lenses that appeared to fit correctly.
Do you accept patients who have already been fitted with scleral lenses elsewhere?
Yes — in fact, many of our patients come to us after being fitted with scleral lenses at another practice and still not achieving satisfactory vision. We offer a complimentary record review so Dr. Azman can evaluate your prior fitting history and determine whether a more advanced lens design could improve your results. Call (410) 469-7111 to schedule.