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Medically Reviewed by Dr. Alexander Bonakdar, O.D.

BostonSight SCLERAL: We Fit the 18mm Class Locally

BostonSight SCLERAL offers the widest diameter range of any scleral lens — 14.5 to 19mm. We fit the 18mm class in our office for keratoconus and ocular surface disease, delivering the same fluid reservoir and corneal protection as PROSE without travel or PROSE-level cost.

What Is BostonSight SCLERAL?

BostonSight SCLERAL is a large-diameter gas-permeable scleral lens designed by BostonSight — the same organization that created the PROSE prosthetic device. It is available in diameters from 14.5 to 19mm, making it the most versatile scleral platform on the market.

Unlike PROSE, which is custom-manufactured at BostonSight facilities, BostonSight SCLERAL is fitted by trained specialists in their own offices using profilometry-guided design. This means local care, faster turnaround, and significantly lower cost.

For most keratoconus and OSD patients, the 18mm class provides maximum fluid volume and corneal clearance. The marginal benefit of increasing from 18mm to a 19mm PROSE device is minimal — most patients achieve equivalent outcomes with BostonSight SCLERAL at a fraction of the cost.

BostonSight SCLERAL vs PROSE

Diameter range14.5–19mm~18.5–19.5mm
Cost per eye$1,800–$3,500$5,000–$10,000+
Where fittedLocally (our office)BostonSight center
Travel requiredNoUsually yes
InsuranceV2531 / V2627Case-by-case
Best forKC + most OSDSevere OSD only

Why We Fit the 18mm Class

BostonSight SCLERAL comes in a range of diameters. We typically fit the 18mm class for patients who need large-diameter scleral coverage — particularly ocular surface disease, severe keratoconus, and post-keratoplasty cases.

Maximum Fluid Reservoir

The 18mm diameter holds substantially more saline than standard 15.5–16mm sclerals — providing hours of continuous corneal hydration for severe dry eye patients.

Full Corneal Vault

The larger diameter clears the entire cornea with room to spare — even in advanced keratoconus with steep, protruding cones that smaller designs struggle to vault.

Stable Scleral Landing

The wider landing zone distributes bearing pressure over more scleral tissue, reducing focal compression and improving all-day comfort.

For standard keratoconus without OSD, a 15.5–17mm design (Zenlens, Onefit, Jupiter) is typically sufficient. We reserve BostonSight SCLERAL 18mm for cases where the extra diameter provides a measurable clinical advantage.

Need Large-Diameter Scleral Lens Care?

We fit BostonSight SCLERAL locally in Santa Ana — no travel to a PROSE center required.

When BostonSight SCLERAL Is the Right Choice

Ocular GVHD

Maximum fluid reservoir replaces destroyed lacrimal function. The 18mm class provides continuous hydration that smaller sclerals cannot match.

Stevens-Johnson Syndrome / TEN

Large diameter protects the cornea from lid scarring and symblepharon. The rigid dome acts as a mechanical barrier over compromised tissue.

Advanced keratoconus

Steep, protruding cones that approach or exceed the vault capacity of 15.5–16mm designs. The 18mm provides clearance without excessive edge lift.

Post-keratoplasty

Irregular post-graft surfaces with significant corneal-scleral junction asymmetry. The wider landing zone accommodates graft-host junctions that smaller lenses bridge.

Neurotrophic keratitis

Full corneal protection for insensate corneas at risk of epithelial breakdown. The sealed fluid environment promotes healing.

See also: scleral lenses for OSD · scleral lens brand comparison · PROSE vs scleral lenses

Is BostonSight SCLERAL Right for You?

Tell us about your condition and we'll determine whether a large-diameter BostonSight SCLERAL — or a standard scleral design — is the best fit for your eyes.

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Insurance Plans We Accept

We work with most major vision and medical insurance providers to maximize your benefits.

Vision Plans

  • VSP (Vision Service Plan)
  • EyeMed
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  • Spectera
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  • Avesis

Medical Plans

  • Medicare
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*Medical insurance is often used for medically necessary contact lenses.

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