Pillar 03 · Specialty Contact Lens
Scleral Lens Specialist Seattle · Dr. Curtis Ono · 25+ years
When standard contacts can't, scleral lenses can. Dr. Curtis Ono fits the most complex specialty contact lens cases other Seattle practices refer out — keratoconus, post-LASIK ectasia, post-graft, irregular cornea, severe dry eye.
When standard contacts can't
What does a scleral lens actually do, and why does it work where soft and RGP contacts don't?
A scleral lens is a large-diameter rigid gas-permeable contact lens that vaults over the cornea entirely and rests on the sclera. Because it doesn't touch the cornea, it doesn't care whether your cornea is irregularly shaped.[2] Modern scleral lens studies report patient-satisfaction scores above 90% across post-graft, keratoconus, post-LASIK, and severe dry eye indications.[4]
Keratoconus
Corneal thinning + cone shape; the most common scleral indication
Post-LASIK ectasia
Cornea thinned by refractive surgery, no longer regularly shaped
Post-corneal-graft (PKP / DSEK / DSAEK)
Vision rehabilitation after corneal transplant
Severe dry eye
Fluid reservoir behind the lens bathes the eye all day
Pellucid marginal degeneration
Corneal thinning at the bottom edge
Post-trauma or scarring
Non-uniform corneal surface from injury
Irregular astigmatism
Soft toric or RGP options have failed
Your scleral specialist
Dr. Curtis Ono — 25+ years fitting the cases other practices refer out
Indiana University Optometry School. Beta Sigma Kappa optometric honor fraternity. The most decorated OD on PSEC's roster.
- Indiana University Optometry School
- Beta Sigma Kappa optometric honor fraternity
- Ocular therapeutic drug + laser + oral/injectable medication certified
- AOA President's Award
- OPW Jack Hale Lifetime Achievement Award
- OPW Optometric Physician of the Year
- OPW President's Distinguished Service Award
- Minnesota Optometric Association President's Award
- Consumers' Research Council of America · Top Optometrist
- Executive Chair · Affiliate Relations and Membership Group · AOA
- Past President · GWCO · OPW · Pierce County Optometric Society
- Founder + Chair · Minnesota Vision Project (volunteer)
What to expect
The fitting process · 3-5 visits over 6-10 weeks
Visit 01 · 45-60 min
Consultation + Assessment
Corneal topography (3D surface map), anterior segment OCT, specular microscopy when indicated, tear film analysis. Discussion of candidacy + realistic outcomes + cost estimate.
Visit 02 · 60-90 min
Diagnostic Trial Fitting
Trial scleral lens placement on each eye. Vault assessment via OCT or slit lamp. Settling time + refraction. Custom lens design parameters sent to lab.
Visit 03 · 60 min
Dispensing Visit
Custom lens arrives 2-3 weeks after Visit 2. Insertion + removal training. Care + cleaning protocol. Fluid solution prescriptions. Wear schedule + adaptation expectations.
Visit 04 · 30 min
1-Week Follow-Up
Wear time assessment. Lens-cornea relationship re-check. Symptom intake. Minor design refinement if needed.
Visit 05 · 30 min
1-Month Follow-Up
Final fit confirmation. Long-term wear plan. Schedule annual specialty CL re-evaluation.
Cost + insurance reality
Transparent pricing · we verify before we fit
| Service component | Range |
|---|---|
| Initial consult + corneal topography + workup | $250-$400 (often medical-billed for keratoconus) |
| Custom scleral lens (per eye) | $1,500-$2,500 |
| Annual replacement lens (per eye, Year 2+) | $400-$800 |
| Maintenance: 1-2 follow-ups/year | $150-$300/visit |
| Bilateral first-year typical total | $3,500-$6,000 |
Medical insurance typically covers fitting + follow-ups for medically-necessary cases (keratoconus, post-LASIK ectasia, post-graft) under CPT 92072 + 92313. Vision plans typically do NOT cover scleral lens fitting. HSA/FSA fully eligible. CareCredit financing available for the patient-paid portion.
For referring physicians
If you have a patient who needs scleral lens fitting, Dr. Ono accepts referrals.
Send referrals to scleral-referrals@pugetsoundeyecare.com or fax (206) 526-5224. We send a referral-back letter to every referring physician documenting the fit, follow-up plan, and outcomes.
“Twenty-five years of scleral fitting taught me the lesson keratoconus patients need to hear: standard contacts fail because the cornea is irregular. Sclerals work because they don't touch the cornea — they vault over it. We can fit eyes that other practices have told the patient are 'unfittable.' The first dispensing visit is often the first time the patient has seen clearly in years.”
FAQ
Common questions
How is a scleral lens different from a regular contact lens?
Regular soft contact lenses sit ON the cornea. Scleral lenses VAULT OVER the cornea entirely and rest on the sclera (white of the eye). Because they don't touch the cornea, they don't care whether your cornea is regularly shaped — making them ideal for keratoconus, post-LASIK ectasia, post-graft, and other irregular cornea conditions.
How long does a scleral lens fitting take from start to finish?
Initial consult to fully comfortable all-day wear: typically 6-10 weeks across 3-5 office visits. Complex cases may run 12+ weeks.
Will my insurance cover scleral lenses?
Medical insurance typically covers the fitting (CPT 92072, 92313) for medically-necessary cases like keratoconus. The lens itself is usually patient-paid. Vision plans (VSP, EyeMed) do NOT cover sclerals. HSA, FSA, and CareCredit financing all apply. We verify your specific benefit before the fitting begins.
Can I sleep in scleral lenses?
No — scleral lenses are designed for daily wear (typically 10-14 hours per day). They are not approved for overnight wear.
How long do scleral lenses last?
Typically 12-24 months per lens. Annual replacement is recommended. Some patients with stable corneas can wear the same lens for 2-3 years if it remains in good condition.
I have keratoconus. Is scleral lens the right answer, or should I consider corneal cross-linking?
For most keratoconus patients, both are appropriate at different stages. Cross-linking is a surgical procedure that strengthens the cornea and slows or stops progression — it doesn't restore vision. Scleral lenses restore functional vision but don't stop progression. Modern keratoconus management combines both. Dr. Ono co-manages cross-linking referrals with Seattle-area corneal surgeons.
Are scleral lenses uncomfortable?
Most patients adapt to scleral lenses within 1-2 weeks of all-day wear. The first few days can feel 'weird' (the eye isn't used to a large lens) but pain is uncommon. After adaptation, most scleral wearers report better comfort than they ever had with standard contacts.
Book a scleral lens consultation with Dr. Ono
Primary-source evidence
Sources cited on this page
- [1]Severinsky B, Behrman S, Frucht-Pery J, Solomon A. Scleral contact lenses for visual rehabilitation after penetrating keratoplasty: long term outcomes. Contact Lens & Anterior Eye 2014;37(3):196-202. View source →
- [2]Schornack MM. Scleral lenses: a literature review. Eye Contact Lens 2015;41(1):3-11. View source →
- [3]Romero-Jiménez M, Santodomingo-Rubido J, Wolffsohn JS. Keratoconus: a review. Contact Lens & Anterior Eye 2010;33(4):157-66. View source →
- [4]Visser ES, Visser R, van Lier HJ, Otten HM. Modern scleral lenses part II: patient satisfaction. Eye Contact Lens 2007;33(1):21-25. View source →
- [5]Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus. American Journal of Ophthalmology 2003;135(5):620-7. The original cross-linking publication. View source →