Can Sclerals Replace Prism Glasses? - Scorecard - MDSpire

Can Sclerals Replace Prism Glasses?

  • By

  • Melissa Barnett, OD, FAAO, FSLS

  • May 1, 2026

  • 4 min

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Clinical Scorecard: Can Sclerals Replace Prism Glasses?

At a Glance

CategoryDetail
ConditionBinocular diplopia
Key MechanismsPrism incorporated into contact lenses to correct small-angle deviations.
Target PopulationIndividuals with binocular diplopia, including congenital and acquired conditions.
Care SettingOptometry and specialty lens fitting.

Key Highlights

  • Prism in contact lenses can correct small-angle deviations.
  • Impression-based scleral lenses (pibSL) can include up to 10 D of prism.
  • Good vision (20/20) and resolution of diplopia were reported in a case series.
  • Wavefront-guided optics can improve visual quality and comfort.
  • High levels of satisfaction reported with pibSLs.

Guideline-Based Recommendations

Diagnosis

  • Evaluate visual acuity and presence of diplopia.

Management

  • Consider prism-incorporated scleral lenses for managing binocular diplopia.

Monitoring & Follow-up

  • Assess visual quality and patient satisfaction regularly.

Risks

  • Potential for residual higher-order aberrations.

Patient & Prescribing Data

Patients with binocular diplopia and corneal irregularities.

PibSLs provide a well-tolerated alternative to traditional prism spectacles.

Clinical Best Practices

  • Utilize ocular impressions for fitting scleral lenses.
  • Incorporate wavefront-guided optics when necessary.

Related Resources & Content

Original Source(s)

Can Sclerals Replace Prism Glasses?

  • by Melissa Barnett, OD, FAAO, FSLS

  • May 1, 2026

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