Scleral Lens Fits Have More than Doubled Since 2020, Survey Says

According to the latest Scleral Lenses in Current Ophthalmic Practice Evaluation survey, scleral lens fits have increased 53% in the last five years, though the number of new fitters and those who fit fewer than 10 lenses has decreased. The survey authors note that this reflects “an increase in more proliferative scleral lens fitters.” Photo: Vision Research institute at Michigan College of Optometry. Click image to enlarge. Last year, the Scleral Lenses in Current Ophthalmic Practice Evaluation (SCOPE) study group conducted an international survey to evaluate current scleral lens prescription and management practices. Then, they compared the demographics, indications, lens design choices and care/recommendation trends with prior SCOPE surveys from 2020 and 2015. The group’s findings, described below, were presented via two poster presentations on Monday at the annual ARVO meeting in Denver.The online survey was open from June to October 2025, receiving 892 responses from eyecare providers across 60 countries. The sample was concentrated in North America (59% United States; 4% Canada; 2% United Kingdom). Corneal irregularity remained the dominant indication for scleral lens fitting, with a median of 80% of fits attributed to this diagnosis. Ocular surface disease was the second most frequent indication (median 10%), followed by refractive error (median 5%).The data revealed that practice volume and fitter experience have shifted substantially since prior SCOPE surveys. The 2025 dataset represents 462,272 scleral lens fits, a 53% increase from the 248,828 fits reported in 2020. Moreover, the distribution of fitters has become more polarized: low‑volume providers fitting 10 or fewer lenses comprised only 7% (2025), down from 13% in 2020 and 21% in 2015, while high‑volume practitioners fitting 500 or more lenses increased to 26% (2025) from 12% in 2020 and 4% in 2015. At the same time, the proportion of clinicians who performed their first scleral lens fit within the prior five years declined to 16% (2025), compared with 18% in 2020 and 27% in 2015. Together, these trends suggest scleral lens practice is consolidating into higher‑volume, more experienced providers and fewer new adopters entering the field.Lens design trends indicate a shift toward larger diameters. Among respondents who estimated diameters, approximately 38% of fits used lenses smaller than 16mm, while the remaining 63% used lenses 16mm or larger (2025); by comparison, most prescriptions in 2015 were in the 15mm to 17mm range (65%). Practitioners reported using an average of 3.8 fitting sets at least monthly in 2025.Care product recommendations have also diversified since 2015, reflecting a shift toward greater use of non-preserved solutions, as well as a combination of hydrogen peroxide-based disinfection systems and multi-purpose rigid lens solutions. There also appears to be a relative decline in exclusive reliance on single‑use saline vials. In 2025, the most commonly recommended products were non‑preserved 0.9% inhalation solution (29%), non‑preserved solutions formulated specifically for scleral lenses (25%), single‑use non‑preserved saline vials (21%) and non‑preserved bottled saline (19%). This contrasts with 2015, when single‑use vials were recommended by 60% of responding clinicians. For disinfection in 2025, hydrogen peroxide‑based systems were recommended by 48% (compared to 61% in 2015) and multi-purpose rigid lens solutions by 39%.  In summary, the 2025 SCOPE results document a substantial increase in total scleral lens fits, consolidation toward experienced high‑volume practitioners, a shift to larger‑diameter lenses and more diverse filling and disinfection recommendations.Original abstracts ©2026 Association for Research in Vision and Ophthalmology. Click here for the first source and here for the second. Nau CB, Schornack M, Nau A, et al. Scleral lens prescription and management practices: SCOPE Practitioner 2025 Survey. ARVO 2026 annual meeting.Nau CB, Schornack M, Nau A, et al. Scleral lens fitting trends: SCOPE 2025. ARVO 2026 annual meeting.This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.