It is agreed that a scleral lens needs to vault over cornea and the limbus. We now know that the
diameter of the average cornea and limbus is significantly larger than indicated by previously quoted
measures which have been based on horizontal visible iris diameter, providing limitedacknowledgement of limbal width and its inclusion as part of the corneal diameter.
It follows that the diameter of the cornea together with the limbus should have a considerable impact on the diameter at which a scleral lens touches down on the sclera - the so-called 'landing zone diameter' - in order to promote safe long term wear.
The key sagittal height dimension for scleral lenses should be the sag at the landing zone diameter; the sag at the total diameter is then a secondary dimension which depends on how the scleral alignment zone is tailored to align with the sclera.
The IS19 scleral has a landing diameter of 15.00mm which will bridge the total corneal diameter in almost all cases. The fitting reference sagittal height of trial lenses is given for this diameter.