FAQ 12: Lens brand and lens diameter

Are PROSE devices better than scleral lenses for dry eyes?  Which brands of scleral lenses are best? Are larger diameter sclerals better than smaller diameter sclerals for dry eyes?

BostonSight PROSE treatment and devices/lenses are offered only at PROSE clinics, which tend to be academic institutions/hospitals with oversight by optometry and ophthalmology, and are usually equipped to manage more complex corneal and ocular surface disease. PROSE providers require additional and special training through BostonSight. Their lenses tend to be on the larger size and utilize a special software program to achieve highly customizable scleral lenses. BostonSight (formerly Boston Foundation for Sight) pioneered designing and fitting scleral lenses when they were not as prevalent globally 30+ years ago. BostonSight Scleral is a subset of the PROSE design based on the data from 7000 eyes and can be fitted by hundreds of practitioners throughout North America and a few in India.   

Today however, there are many more lens brands, labs, and clinics around the world that offer various scleral lens designs. Lens shapes/designs, modification techniques, and materials have improved significantly and there are many excellent scleral lens options now, aside from PROSE. 

Regardless of lens brand or company utilized, your scleral lens practitioner controls lens design and needs to ensure the best fit and design for your eyes. There is no one "best" brand or diameter size. Many patients obtain complete comfort and symptom relief with very small diameter scleral lenses while others require the largest diameter size of lenses available. The diameter range is anywhere from less than 14mm up to 24mm in diameter.  Many factors are considered when a scleral lens practitioner determines what size to use for each patient and each individual eye.