Two kinds of blur from one scar
Light passing through an opaque scar is scattered, producing haze and glare, and a scar in the central cornea blocks some light altogether. But most of the vision loss from many scars comes from the surface. Healing pulls the cornea into an irregular shape around the scar, and that irregular astigmatism smears the image in a way glasses cannot correct. The test that separates the two is simple: vision through a rigid contact lens, which corrects the surface but not the opacity. If vision jumps with the trial lens, a lens is the treatment.
Which lens
Scleral lenses are preferred for most scarred corneas. They vault the scar and the irregular area around it without touching either, hold a fluid layer that neutralizes the surface, and protect a cornea that may have reduced sensation or a fragile epithelium over the scar. Corneal rigid lenses can be used for small peripheral scars on an otherwise regular cornea. Hybrids suit some intermediate cases. Soft lenses rarely help because they follow the irregular surface.
Fitting a scarred cornea
Tomography maps the irregularity and OCT measures the scar's depth, which matters if a surface laser treatment is being considered. A diagnostic scleral lens is placed and the vault over the scar is confirmed carefully so no part of the lens bears on it. Vision is measured and the custom lens ordered and refined. Follow-up watches the epithelium over the scar, which can be less robust than normal.
When a lens is not the whole answer
If vision through the trial lens remains poor, the opacity itself is limiting, and the cornea specialist considers phototherapeutic keratectomy for shallow scars or a lamellar transplant for deep central ones. Lenses are usually still needed after either, and the plan is made jointly. Scars from herpes are managed with suppressive antivirals alongside lens wear to prevent recurrence.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is the right choice for you is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Arbi Melikian, OD. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
