FAQ 15: Lens dots

Do all scleral lenses have dots? Which lens is supposed to have one dot and which lens is supposed to have 2 dots?  Can the dots be replaced if they wear off?

Some scleral lenses have small black dots located close to the edge in the landing zone of a scleral lens. Lenses marked with dots most commonly have one dot for the right lens and two dots for the left lens. It is easy to remember which is which if you think of it as the "right one". However, there may be other lens designs with two dots for the right lens so it is important to verify with your fitter. Less commonly, some brands of lenses will tint one of the lenses a light blue to distinguish which lens is which rather than dots. For some people, the dots not only identify the right lens and left lens, they may also have the purpose of being orientation dots.  

Orientation dots need to be in the correct position in order for lenses to settle correctly into place either for astigmatism correction and/or for the proper fit over irregularities. The placement of the dots is usually at the 12 o'clock position or at the 6 'clock position, depending on individual instructions. In other words, if instructed to apply the lenses with the dots at the 12 o'clock position, then the lenses should be applied onto the eyes with the dots located at the top. If instructed for the dots to be at the 6 o'clock position, then the dots go at the bottom. Lenses might rotate slightly after applying them. When this occurs, the lenses typically settle where they are going to settle and it is usually okay if only slightly off. But if the lenses always rotate far out of position, then discuss it with your practitioner.