Extreme corneal surface disorders and dry-eye conditions cannot be adequately treated with corneal contact lenses. For these cases a scleral lens with a diameter of between 21 and 25 mm could be prescribed. In this study, high oxygen-permeable scleral contact lenses were fitted onto 50 eyes, of which 32 had a deviant corneal topography and 18 had dry-eye syndrome. A significant improvement of visual acuity and good lens tolerance were found. The large lens successfully created a moist atmosphere in front of the cornea with dry-eye circumstances. No signs of oxygen shortage were recorded. In three dry eyes (16.7%) immediate failure in fitting was found, due to lens binding. The new scleral lens provides a physiological condition of the cornea, which allows a revival in the application of such lenses.