“How much are they?” is usually the second question I hear about scleral lenses, right after “will they help me see?” It is a fair question, and the honest answer is that it depends. But “it depends” is only useful if you know what it depends on, so here is the full picture.
Why Scleral Lenses Cost More Than Regular Contacts
A box of soft contacts is mass produced. Thousands of identical lenses come off the same line.
A scleral lens is the opposite. Each one is made for one eye, and getting it right takes clinical time:
- Measuring the shape of the cornea and the white of the eye
- Trying diagnostic lenses on the eye
- Designing the custom lens and ordering it
- Often adjusting the design once or twice
- Teaching you to insert, remove and clean the lenses
- Follow-up visits to check the fit and the health of the eye
Most of what you pay for is that work. The lens itself is only part of it.
What Scleral Lenses Typically Cost
There is no single national price, because practices charge differently and eyes differ in how hard they are to fit. The American Academy of Ophthalmology has reported that in the United States the overall cost per eye, lens plus fitting, generally runs from about $1,000 to $5,000, depending on how complex the eye is and the technology used (AAO EyeNet, Update on Scleral Lenses).
At the top of the range are specialized hospital-based programs such as PROSE, which the same article puts at roughly $5,000 to $7,000 per eye for the whole process.
What moves the number:
How irregular the eye is. A moderately irregular cornea may fit well in a standard scleral design. Advanced keratoconus, a corneal transplant or a scarred eye can need more customization and more visits.
One eye or two. Fees are usually per eye, and some people only need a lens in one eye.
Lens design and extras. Toric edges, front-surface optics, special coatings and replacement lenses all affect cost.
Ongoing supplies. You will also buy preservative-free saline to fill the lens, a cleaning and disinfecting solution, and replacement plungers. Lenses themselves are typically replaced every year or two, or sooner if one breaks or is lost.
At Everyday Eye Care, we quote the fitting after the evaluation, once we know what your eye actually needs. You get the cost in writing before any lens is ordered.
Will Insurance Cover Scleral Lenses?
Sometimes, and it helps to know the two different ways it can happen.
Vision plans: “medically necessary contact lenses”
Many vision plans have a benefit for medically necessary contact lenses that is separate from, and usually richer than, the routine contact lens allowance. For example, the clinical policy used by Versant Health, the company behind Davis Vision and Superior Vision, states that contact lenses, including scleral lenses, and their fittings may be medically necessary for keratoconus, corneal ectasia and related conditions when glasses cannot adequately correct vision (Versant Health, Medically Necessary Contact Lenses policy).
The same policy lists additional situations where scleral lenses may qualify, including moderate to severe dry eye after other treatments have been tried, exposure keratopathy, limbal stem cell deficiency and neurotrophic keratitis. Every plan writes its own rules, so treat this as an example of how plans think, not a promise about yours.
Medical insurance
Some medical plans cover scleral lenses for specific diagnoses, especially keratoconus or severe ocular surface disease, sometimes with prior authorization and documentation that other options were tried. Coverage varies a lot from plan to plan.
Medicare
Original Medicare generally does not cover eyeglasses or contact lenses. The well-known exception is that Part B covers one pair of eyeglasses or one set of contact lenses after each cataract surgery that implants an intraocular lens (Medicare.gov, Eyeglasses & contact lenses). Some Medicare Advantage plans add vision benefits, so check your plan’s details.
How to Find Out What You Will Actually Pay
The quickest path is to let us check. When you call to book a scleral lens evaluation:
- Have your medical insurance card and your vision plan card ready.
- Tell us your diagnosis if you know it, for example keratoconus or a corneal transplant.
- We verify your benefits, and after the evaluation we give you a written cost before anything is ordered.
If part of the cost is out of pocket, ask about payment options. Health savings accounts and flexible spending accounts can usually be used for medically necessary contact lenses.
Is It Worth It?
That is a personal call, but here is how I think about it. For someone with keratoconus whose glasses no longer work, a well-fitted scleral lens can be the difference between not driving at night and driving comfortably, or between struggling through a workday and reading normally. In one study of keratoconic eyes, average best-corrected vision went from roughly 20/63 in glasses to about 20/24 in scleral lenses (Fuller and Wang, 2020).
It is also usually far less than surgery. Scleral lenses have helped many people with severe keratoconus avoid or delay a corneal transplant.
If you want to understand the lens itself first, start with scleral lenses for keratoconus or see how sclerals compare with hard, soft and hybrid lenses.
Book an Evaluation
We fit scleral lenses at our offices in Pasco, Sunnyside and Hermiston. From Kennewick, Richland or West Richland, our Pasco office is the closest. In Eastern Oregon, see our Hermiston scleral lens page.
Call and ask for a scleral lens evaluation: Pasco (509) 543-7953, Sunnyside (509) 839-4575, Hermiston (541) 567-5283. We will check your benefits when you call.
This article is general information, not financial or medical advice. Coverage depends on your specific plan and diagnosis.