Scleral Lenses for Severe Dry Eye: When Nothing Else Provides Relief

When Conventional Treatment Falls Short

The majority of dry eye patients respond well to prescription drops and meibomian gland treatment. But patients with autoimmune conditions like Sjögren's syndrome, graft-versus-host disease (GVHD) after bone marrow transplant, or severe meibomian gland atrophy have dry eye that conventional treatment cannot adequately control.

These patients describe eyes that are constantly burning, unable to tolerate light, unable to read or drive. Drops provide seconds of relief. Nothing seems to last. Scleral lenses represent a fundamentally different approach.

How It Works

A scleral lens vaults over the cornea, creating a sealed space filled with preservative-free saline before insertion. Throughout 10-14 hours of daily wear, the cornea is continuously bathed in this fluid reservoir — independent of dysfunctional tear glands. Pain and light sensitivity often resolve within days of beginning scleral wear.

Patients Who Benefit Most

• Sjögren's syndrome — autoimmune destruction of lacrimal glands leaves severely insufficient aqueous production
• Graft-versus-host disease (GVHD) — considered a standard of care option in this population
• Neurotrophic keratopathy — reduced corneal sensation impairs blink reflex and tear production
• Severe MGD with gland atrophy — when glands are damaged beyond what treatment can restore

If you have severe dry eye that hasn't responded to conventional treatment, scleral lenses may be the answer. Contact Harnos Optometry in New Paltz at (845) 255-4696 to discuss your options.