Severe chemical burns can damage the periocular area causing exposure keratopathy and resulting in ocular pain, foreign body sensation, epiphora, photophobia, and vision loss. A custom fit large diameter therapeutic scleral lens can protect the ocular surface by preventing desiccation and providing immediate improvement in comfort. This case describes the management of a patient with extensive chemical burn with complete lid loss and exposure keratopathy who has maintained excellent visual acuity and comfort with therapeutic scleral lens use.