Scleral Lens Candidacy Questionnaire

Struggling with comfort, vision, or dryness in your current lenses—or been told nothing else will work? Find out if scleral lenses could change everything.

Thank you! Our specialty lens team will review your responses and reach out to help you take the next step toward clear, comfortable vision.

In the meantime, please visit our Scleral Lens Center of Excellence page. Whether you've struggled with vision clarity, contact lens discomfort, or failed surgeries, our expert team offers life-changing solutions that go far beyond standard lenses.

1. What are you currently using for vision correction?

GlassesSoft contact lensesRGP/hard lensesHybrid lensesScleral lensesNone - I don't wear any correction

2. What vision or eye comfort issues are you experiencing? (Check all that apply)

Blurry or fluctuating visionDry, irritated, or painful eyesTrouble tolerating contact lensesLight sensitivityFrequent eye strain or fatigueNone - just exploring options

3. Have you been diagnosed with any of the following? (Check all that apply)

KeratoconusPost-LASIK ectasiaSevere dry eye / Sjogren's syndromeCorneal scarring or transplantGraft-vs-host diseaseStevens-Johnson SyndromeOther corneal irregularitiesNone of the above / not sure

4. Have you been told you're not a candidate for traditional contact lenses?

YesNoNot sure

5. Have you ever worn scleral lenses before?

YesNoI've heard of them but never triedI'm not familiar with them

6. What is your main goal with your vision care right now?

Clearer, more stable visionBetter comfort or dryness reliefA solution after LASIK complicationsReturn to contact lenses after intoleranceExploring all options

Scleral Lens Candidacy Questionnaire

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