The Future of Specialty Contact Lenses
Specialty contact lenses are entering a new era in which technology is changing not only how lenses are designed and fitted, but also what contact lenses may ultimately be capable of doing. According to Melissa Barnett, OD, FAAO, FSLS, and Avani Davé, OD, FAAO, advances in imaging, impression-guided design, artificial intelligence (AI), and smart contact-lens technology are transforming the management of patients with irregular corneas, ocular surface disease, high refractive errors, and other complex visual needs. Modern specialty lenses can already provide highly individualized solutions, particularly through scleral, orthokeratology, and rigid gas-permeable lenses. The authors argue that these technologies can improve clinical precision while also reducing chair time, minimizing remakes and adjustments, and helping practices achieve better patient outcomes more efficiently.
One of the most significant developments is the use of image-guided and impression-guided lens design. Technologies such as corneal topography, tomography, anterior-segment OCT, profilometry, and scleral-shape measurement allow practitioners to capture detailed information about the eye and use those measurements to create more precise lenses. Rather than relying heavily on trial-and-error fitting with large diagnostic lens inventories, practitioners can increasingly begin with a design based on the patient’s actual ocular anatomy. This is particularly valuable for patients with irregular scleral shapes or highly irregular corneas, including individuals who have undergone glaucoma or retinal surgery or who suffer from severe ocular-surface disease. The growing integration between imaging companies, laboratories, and lens manufacturers could make the process even more efficient by allowing ocular measurements to move directly into lens-design and manufacturing systems.
Perhaps the most futuristic development discussed in the article is the smart contact lens. These lenses are being researched as platforms capable of monitoring biological information and potentially delivering medication. Instead of simply correcting vision, future lenses could potentially measure intraocular pressure, glucose, lactate, inflammatory markers, tear-film characteristics, temperature, and other biomarkers. This could be particularly valuable in diseases such as glaucoma and dry eye because many ocular measurements fluctuate throughout the day, while traditional clinical testing provides only a snapshot during an office visit. Smart lenses could eventually provide continuous or remote monitoring through wireless connections to smartphones or clinician-facing systems. The technology could also support drug delivery, allowing medications to be released gradually or in response to changes in the ocular environment. For glaucoma, for example, a future lens could potentially monitor pressure-related changes while simultaneously helping deliver medication. However, the authors emphasize that these applications remain largely developmental and face significant challenges involving comfort, oxygen transmission, biocompatibility, manufacturing, regulatory approval, cost, and long-term safety.
Artificial intelligence may become the bridge connecting these technologies to everyday clinical practice. AI could analyze large amounts of ocular and patient data to help optimize lens geometry, predict lens performance, interpret imaging, and recommend starting parameters for specialty lenses. In scleral-lens fitting, for example, AI-assisted imaging could potentially help determine sagittal depth, landing-zone alignment, centration, and other parameters before a diagnostic lens is even placed on the eye. AI could also analyze information collected from smart lenses, identifying patterns that may be difficult for a practitioner to recognize from isolated measurements. Patient management could eventually extend beyond the office as apps and AI systems monitor wear time, replacement schedules, symptoms, hygiene, and treatment adherence. Importantly, the authors do not envision AI replacing optometrists. Instead, they see it as a tool that can handle data-intensive tasks while allowing practitioners to concentrate more heavily on clinical judgment, interpretation, and the patient relationship.
The broader message of the article is that the specialty contact lens industry is moving from vision correction toward personalized ocular healthcare. Future lenses may simultaneously correct vision, monitor disease, collect biological information, and deliver treatment. This represents a potentially significant opportunity for eyecare practices because advanced technology can differentiate specialty services, generate referrals, and potentially support higher professional fees. At the same time, the industry will have to address privacy, cybersecurity, regulatory requirements, affordability, insurance coverage, and unequal access to advanced technologies. Ultimately, the authors believe the most successful future will not be one in which technology replaces the human side of optometry, but one in which technology makes personalized care more precise and efficient. The specialty contact lens of the future may therefore be much more than a medical device for seeing clearly—it could become an intelligent platform for diagnosing, monitoring, and treating the eye while allowing practitioners to deliver care that remains fundamentally human.
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