Deciding between a prose lens and a scleral lens can feel a bit confusing at first. Many people wonder about the differences and which one might be better for them. It’s a common question when looking into contact lens options.
Don’t worry, though! We’re going to break down the prose lens vs scleral lens topic in a way that’s easy to get. Get ready for a clear guide that makes choosing much simpler.
Prose Lens vs Scleral Lens Understanding Your Options
What Are Prose Lenses?
Prose lenses, also often referred to as multifocal or bifocal contact lenses, are designed to help people see clearly at different distances. Think about when you need to read a book and then look up at something far away. Regular contact lenses might only help with one of those distances.
Prose lenses have different power zones built into them. This means you can have one prescription that works for seeing things up close, like a phone screen, and also for seeing things far away, like a street sign. This is really helpful for people who have presbyopia, which is a common age-related condition where your eyes have trouble focusing on close objects.
These lenses work by having rings or zones with different powers. Usually, the center of the lens has the power for distance vision, and then there are rings around it that help with near vision. Some designs might also include a zone for intermediate vision, which is the distance for looking at your computer screen.
The way your eye moves and interacts with the light coming through these different zones helps your brain create a clear image at all the different distances you need. It’s a clever way to manage vision needs without needing separate reading glasses on top of your contacts.
What Are Scleral Lenses?
Scleral lenses are a special type of large-diameter contact lens. Unlike standard soft contact lenses that rest directly on the cornea (the clear front part of your eye), scleral lenses vault completely over the cornea. They rest on the white part of your eye, called the sclera.
This is where the name “scleral” comes from. Because they create a fluid-filled space between the lens and the cornea, they can be incredibly beneficial for people with various eye conditions that affect the front of the eye.
The main advantage of this design is that it shields the cornea from blinking and air exposure, creating a constant, smooth, and moist surface for vision. This is a big deal for people whose corneas are irregular or damaged. Conditions like severe dry eye, keratoconus (a condition where the cornea thins and bulges outwards), or post-surgical complications can make regular contact lenses uncomfortable or even impossible to wear.
Scleral lenses provide a stable and comfortable alternative, offering much clearer and more consistent vision for these individuals. The fluid reservoir also helps to nourish and protect the cornea.
Key Differences: Prose Lens vs Scleral Lens
When comparing prose lens vs scleral lens, the primary difference lies in their purpose and design. Prose lenses are about managing different vision distances, typically for presbyopia. Scleral lenses are designed to cover and protect the entire cornea, addressing complex eye conditions and severe dry eye.
While a prose lens aims to give you multifocal vision, a scleral lens aims to create a comfortable, protected environment for your eye’s surface.
Design and Fit
The physical structure of these lenses is quite different. Prose lenses are generally soft contact lenses, similar in feel and handling to standard daily or monthly disposable lenses. They are designed to fit snugly on the cornea.
Their diameter is usually similar to other soft contacts, and they move with your eye. The key feature is the different power zones within the lens material itself.
Scleral lenses, on the other hand, are rigid gas permeable (RGP) lenses but are much larger than typical RGP lenses. Their significant size is what allows them to rest on the sclera. They do not directly touch the cornea.
The fit is critical; an eye care professional will carefully measure the curvature of your eye to ensure the lens rests properly without causing pressure points. The space between the lens and the cornea is filled with a sterile saline solution or artificial tears, which is a defining characteristic of their function.
Purpose and Conditions Treated
Prose lenses are almost exclusively prescribed to address presbyopia. If you find yourself holding reading material further away or needing reading glasses over your bifocal or progressive glasses, you might be a candidate for prose lenses. They are for people who have generally healthy eyes but are experiencing the natural aging process that affects near vision.
Scleral lenses serve a much broader and often more severe range of conditions. They are a go-to for managing:
- Severe Dry Eye Syndrome: By keeping the cornea constantly bathed in fluid, they provide relief where other treatments fail.
- Keratoconus: The smooth surface of the scleral lens corrects the irregular shape of a cone-shaped cornea, improving vision dramatically.
- Post-Surgical Complications: After procedures like LASIK or corneal transplants, irregular corneas can cause vision problems. Scleral lenses can offer stable vision.
- Corneal Scars and Degenerations: Any condition that causes an irregular or damaged corneal surface can benefit from the protective and smoothing effect of scleral lenses.
- Ectasia: Similar to keratoconus, this is a progressive thinning and bulging of the cornea.
So, while prose lenses are about vision correction for aging eyes, scleral lenses are about rehabilitating and protecting the eye’s surface for those with significant ocular surface disease or corneal irregularities.
Comfort and Wearability
Comfort is a significant factor when comparing prose lens vs scleral lens. For many people, prose lenses are as comfortable as standard soft contact lenses. Because they are soft and flexible, they conform to the eye.
The main adjustment might be getting used to seeing through different zones of the lens, which can sometimes cause a slight ring effect or a shadow, especially in dim light.
Scleral lenses, despite being rigid, are often reported as very comfortable once a proper fit is achieved. The reason is that they don’t actually touch the sensitive cornea. The eyelids glide over the larger lens without causing irritation.
The constant tear film beneath the lens also contributes to a very moist and comfortable wearing experience throughout the day. However, the initial fitting process can be more involved, and there’s a learning curve to inserting and removing larger lenses.
Vision Quality
The visual outcome differs based on the intended use. Prose lenses aim to provide clear vision at multiple distances. While they significantly reduce the need for reading glasses, they may not always provide the absolute crispest vision at all ranges compared to single-vision lenses.
Some users might notice slight halos or glare, especially at night, or a subtle compromise in the sharpness of either distance or near vision depending on the lens design and individual eye.
Scleral lenses, when used for conditions like keratoconus or corneal scarring, can provide exceptionally clear and stable vision. By masking the irregular corneal surface with a smooth, perfectly shaped lens, they can restore sharp vision that may not be achievable with glasses or standard soft contacts. For those with severe dry eye, the consistent moisture and protection offered by scleral lenses can also lead to significantly improved visual clarity and comfort, as blurriness from dryness is reduced.
Cost and Availability
In terms of cost, prose lenses, being similar to standard soft multifocal contacts, are generally more affordable than scleral lenses. They are often available through standard contact lens suppliers and may be covered by many vision insurance plans.
Scleral lenses are typically considered a specialty lens. Their cost is higher due to the advanced design, the custom fitting process required, and the fact that they are often prescribed for medical conditions rather than just convenience. Insurance coverage for scleral lenses can vary significantly, and it’s important to check with your provider and eye doctor’s office about what might be covered, especially if they are prescribed for a medical necessity.
Prose Lens vs Scleral Lens A Comparative Table
| Feature | Prose Lens | Scleral Lens |
|---|---|---|
| Primary Purpose | Correcting presbyopia (difficulty with near vision due to age) | Managing irregular corneas, severe dry eye, and other corneal surface diseases |
| Lens Type | Soft contact lens | Rigid Gas Permeable (RGP) large-diameter lens |
| How it Works | Multiple power zones within the lens for distance, near, and sometimes intermediate vision | Vaults over the cornea, resting on the sclera, creating a fluid-filled reservoir to protect and smooth the corneal surface |
| Cornea Contact | Directly rests on the cornea | Does not touch the cornea; rests on the sclera |
| Conditions Treated | Presbyopia | Severe dry eye, keratoconus, corneal scarring, ectasia, post-surgical complications |
| Comfort | Generally comfortable, similar to standard soft lenses | Very comfortable once fitted properly due to no corneal contact; may have an insertion/removal learning curve |
| Vision Quality | Clear vision at multiple distances, though may have minor compromises in sharpness for some users | Can provide very sharp and stable vision, especially for irregular corneas; reduces blur from dryness |
| Cost | More affordable, comparable to standard multifocal contacts | More expensive, considered a specialty lens |
Frequently Asked Questions
Question: Are prose lenses the same as bifocal glasses
Answer: Prose lenses are like bifocal or multifocal glasses but in contact lens form. They have different power areas to help you see things up close and far away, just like bifocal glasses do.
Question: Can I wear scleral lenses if I don’t have a serious eye condition
Answer: Scleral lenses are usually prescribed for specific medical needs like severe dry eye or irregular corneas. For general vision correction like presbyopia, prose lenses or other multifocal contacts are more common.
Question: Which type of lens is harder to put in
Answer: Scleral lenses are larger and rigid, so they can take a bit more practice to insert and remove compared to soft prose lenses. Many people get used to it fairly quickly with guidance from their eye doctor.
Question: Do prose lenses correct astigmatism
Answer: Standard prose lenses are designed primarily for presbyopia. If you have astigmatism, you might need a special type of multifocal toric lens that corrects both issues, or your doctor might suggest a different approach.
Question: How long do scleral lenses last
Answer: Scleral lenses are typically designed for daily wear and can last for one to two years with proper care and cleaning. Regular check-ups with your eye doctor are important to ensure they are still fitting well and functioning correctly.
Final Thoughts
Understanding the differences between prose lens vs scleral lens helps a lot when thinking about your vision needs. Prose lenses are a fantastic solution for managing age-related near vision challenges, allowing you to enjoy clear sight for reading and everyday tasks without constant glasses. They offer a convenient way to adapt as your eyes change naturally.
On the other hand, scleral lenses are a specialized medical device offering profound benefits for those facing significant discomfort from dry eye or vision distortion due to corneal irregularities. They provide a protective shield and a smooth optical surface that can dramatically improve quality of life and sight for individuals with complex eye conditions. Your eye doctor is your best resource to determine which lens type best suits your unique situation and vision goals.
