Sclera contacts can be safe when properly fitted, maintained, and used under professional guidance to avoid serious eye complications.
The Rise of Sclera Contacts and Their Popularity
Sclera contacts have surged in popularity over the past decade, especially among cosplay enthusiasts, actors, and those seeking dramatic eye transformations. Unlike regular contact lenses that cover only the iris, sclera lenses cover the entire visible white part of the eye—the sclera—creating a striking and often otherworldly appearance. This bold aesthetic appeal has made them a favorite for Halloween costumes, theatrical performances, and fashion statements.
However, their size and design raise important safety questions. Because these lenses cover a much larger surface area of the eye, they can potentially interfere with eye health more than standard lenses. Understanding how sclera contacts interact with the eye is crucial to answering the question: Are Sclera Contacts Safe?
What Sets Sclera Contacts Apart From Regular Lenses?
Sclera contacts differ significantly from conventional soft or rigid gas permeable (RGP) lenses in several ways:
- Size: While typical contacts cover just the iris (about 12mm diameter), sclera lenses range from 14mm up to 24mm or more.
- Coverage: They rest on the sclera (white part), vaulting over the cornea without touching it directly.
- Material: Often made from highly oxygen-permeable rigid materials to compensate for their large size and potential oxygen blockage.
This design allows for unique cosmetic effects but also introduces challenges in terms of oxygen transmission and tear exchange—both vital for maintaining corneal health.
The Core Safety Concerns With Sclera Contacts
The primary safety issues stem from how these lenses interact with the eye’s physiology:
Oxygen Deprivation Risks
The cornea relies on atmospheric oxygen since it lacks blood vessels. Large scleral lenses can reduce oxygen flow by covering more of the eye’s surface. Insufficient oxygen leads to hypoxia—a condition that can cause corneal swelling, redness, discomfort, and in severe cases, permanent damage.
Manufacturers address this by using materials with high oxygen permeability (measured as Dk value). Still, even high-Dk materials may not fully compensate if lenses are worn too long or improperly fitted.
Tear Exchange and Debris Accumulation
Normal contact lenses allow tears to flow beneath them, flushing out debris and providing nutrients. Scleral lenses vault over the cornea creating a fluid reservoir between lens and cornea filled with saline solution. While this can provide comfort initially, stagnant fluid may trap debris or bacteria if not cleaned properly or if worn excessively.
This stagnant environment increases risks of infections such as microbial keratitis—a serious corneal infection that can threaten vision.
Lens Fit and Eye Movement
Because scleral lenses cover a larger area including fragile conjunctival tissue on the sclera, an improper fit can cause mechanical irritation or inflammation. Excessive movement of an ill-fitting lens may scratch or damage delicate tissues leading to discomfort or long-term complications.
The Role of Professional Fitting in Ensuring Safety
One critical factor in safely wearing sclera contacts is obtaining a custom fit from an experienced eye care professional. Unlike standard contacts that often come in generic sizes, scleral lenses must be tailored meticulously to match each individual’s ocular shape.
During fitting sessions:
- The practitioner measures corneal curvature and scleral shape using advanced imaging techniques.
- Lenses are trialed to ensure proper vault over the cornea without touching it.
- The lens edge alignment is checked to avoid excessive pressure on conjunctiva or eyelids.
- The patient’s tear exchange under the lens is evaluated for adequate fluid movement.
A poor fit significantly raises risks of hypoxia, irritation, infection, and long-term damage. Proper fitting minimizes these risks by ensuring optimal lens positioning and comfort.
Caring for Sclera Contacts: Hygiene Is Paramount
Even perfectly fitted scleral lenses become unsafe without diligent care routines. The larger surface area means more material exposed to contaminants like dust, makeup residue, or microbes.
Key hygiene practices include:
- Daily Cleaning: Use recommended multipurpose solutions specifically designed for rigid gas permeable lenses; avoid tap water which contains harmful microbes.
- Sterilization: Proper disinfection after each use prevents bacterial contamination that could lead to infections.
- Avoid Overnight Wear: Unless explicitly prescribed by an eye care professional, sleeping with scleral lenses increases infection risk dramatically.
- Avoid Sharing Lenses: Sharing contacts can transfer bacteria or viruses between users.
Neglecting these steps invites complications such as conjunctivitis (pink eye), keratitis (corneal inflammation), or even ulcers that impact vision permanently.
Dangers of Buying Non-Prescription Sclera Contacts Online
A growing trend involves purchasing decorative scleral contacts online without prescriptions or professional consultation. This practice is particularly risky because:
- Lenses may not fit properly causing mechanical trauma.
- Poor quality control may result in non-sterile products harboring pathogens.
- Lack of guidance on safe wear times leads users to overuse lenses dangerously.
The U.S. Food and Drug Administration (FDA) classifies all contact lenses as medical devices requiring prescriptions due to potential risks. Using non-prescription scleras bypasses vital safety checkpoints.
Comparing Risks: Sclera vs Regular Contact Lenses
| Aspect | Sclera Contacts | Regular Contact Lenses |
|---|---|---|
| Coverage Area | Covers entire visible white plus iris (~14-24mm) | Covers iris only (~12mm) |
| Oxygen Transmission Risk | Higher risk due to larger coverage; requires high-Dk materials | Lower risk; smaller size allows better oxygen flow |
| Tear Exchange Under Lens | Tear reservoir; potential stagnation if poorly maintained | Tears flow beneath lens continuously flushing debris |
| Lens Fit Complexity | Requires custom fitting; complex due to scleral shape variation | Easier fitting; many standard sizes available off-the-shelf |
| User Base & Usage Frequency | Niche use—cosplay/theater; often occasional wearers | Mainstream use—daily vision correction wearers |
| Pain/Discomfort Potential | Higher if ill-fitted or overused | Generally lower with proper care |
| Infection Risk | Higher if hygiene neglected due to large surface area | Lower but still significant without proper hygiene |
| Cost & Accessibility | More expensive due to customization & material complexity | Generally affordable & widely accessible |