If you wear mini-scleral lenses for keratoconus, you may have experienced issues like midday fogging (cloudy vision from debris in the tear layer) or lens settling (when the lens sinks into the eye slightly after wear). A recent study compared two different sizes of mini-scleral lenses—one 15mm in diameter and another 16.5mm—to see if size made a difference in vision, comfort, and fogging. 

What Did the Study Do? 

Researchers fitted 10 patients with keratoconus with either a 15mm lens or a 16.5mm lens. They measured how much the lenses settled, whether vision changed over time, and how much midday fogging occurred. After 4 hours of wear, patients rated their comfort, vision quality, and overall satisfaction. 

Key Findings: 

• Both lens sizes improved vision significantly and maintained that improvement over 4 hours. 

• Midday fogging happened at similar rates in both lens groups. 

• The smaller 15mm lens settled more initially but evened out after a few hours. 

• Patients wearing the 15mm lens reported better comfort, clearer vision, and higher overall satisfaction. 

What Does This Mean for You? 

If you experience discomfort or struggle with handling larger mini-scleral lenses, a smaller diameter lens (like 15mm) may be a good option to discuss with your eye doctor. However, both sizes performed similarly in terms of fogging and vision quality, so your optometrist or ophthalmologist can help decide what’s best for your unique eyes. 

If you’re dealing with midday fogging, talk to your doctor about lens care routines or possible adjustments to improve your experience. More research is needed, but this study highlights that finding the right lens size can make a difference in comfort and satisfaction! 

Reference:  

Bagatur Vurgun E, Akkaya Turhan S, Toker AE. Size Matters: A Comparative Study on Midday Fogging and Lens Settling in Patients With Keratoconus Wearing Mini-Scleral Lenses With Two Different Diameters. Eye Contact Lens. 2025;51(2):53-57. doi:10.1097/ICL.0000000000001135