Many people can’t wear standard contact lenses. This is especially true of patients with severe dry eye syndrome, keratoconus, irregular astigmatism, among other conditions.

That’s why eye doctors often prescribe scleral lenses to such patients. These specialized rigid, gas-permeable contact lenses have a very wide diameter and extend over the entire corneal surface, making them effective and comfortable for people with irregular corneas.

At first, some patients may find scleral lenses to be difficult to insert and remove. However, after some practice, you’ll find it easy to care for your sclerals!

Safety and Hygiene for Scleral Lenses

Handling scleral lenses incorrectly can increase your risk of eye infection. Additional risk factors include improper lens cleaning, poor hygiene, and smoking. Therefore, it’s important to follow your eye doctor’s instructions on how to handle your lenses hygienically.

Before handling, inserting, or removing scleral lenses, make sure to:

  • Always wash your hands thoroughly with non-oily soap or antibacterial-based pump soap and dry them with a clean lint-free towel or paper towel.
  • Sit at a desk or table and place a lint-free cloth down to insert and remove lenses. Avoid bathrooms, as they often contain more germs than other rooms in the home.
  • Inspect your lenses for chips or cracks and protein deposits on the lens surface. If you notice any defects or are unsure whether your lenses are damaged, don’t wear them until your eye doctor has inspected them.

Scleral Lens Insertion and Removal

Removing and inserting scleral lenses can be tricky and requires patience and practice. Scleral lenses are special contact lenses prescribed for patients with cornea diseases and irregularities such as keratoconus, post LASIK or surgical ectasias (irregularities), autoimmune disorders that can lead to scarring (Steven Johnson Syndrome), dry eyes, and many more. They have a larger diameter than a soft lens but provide excellent comfort. They are inserted differently than soft lenses or smaller RGP lenses. We provide all the training needed to become successful.

Applying Scleral Lens

  1. To avoid confusion, it would be best to insert and remove the same lens into the same eye if you have two scleral lenses.
  2. Wash your hands thoroughly with water and mild soap. This reduces the risk of eye infection. If you have any eye makeup remove it with a gentle cleanser to avoid transferring makeup into the inside of the lens. Dry your hands well with a lint-free towel or cloth.
  3. Place a flat mirror on the table before you to inspect your eyes for redness or secretions. If you notice vision changes, discharge or irritation, contact your optometrist.
  4. Hold your scleral lens to the light to check for debris, chips, or cloudy deposits. Attach a suction cup to the front of the lens or hold the lens with your thumb, index, and middle fingers (tripod method). If the suction cup is not vented, you can cut off the bottom of the cup to expose a hole so that it does not create suction.
  5. Fill the cup of the lens with preservative-free saline. Ensure you always over-fill the lens to prevent letting air bubbles in. Keep the lens full until it touches the eye and if it spills, refill it. Lean over, look toward the mirror and tuck your chin into your chest until your face is parallel to the floor.
  6. Use one hand to hold your upper and lower eyelid open and place the less with your other hand. Ensure that you do not release your eyelid until your scleral lens is positioned. As soon as you feel the solution against your eyeball, gently press the lens and let it go. The lens will attach or adhere to your eye. Repeat the process for the other eye.
  7. Release the lens and blink severally to help the lens find a good position in your eye. If there is any discomfort in your eye, an air bubble might be trapped beneath the surface of the lens; therefore, you have to remove the lens and re-insert it.

It is essential to clean the suction cup with a sterile alcohol swab after every use to prevent bacteria from growing and causing an infection.

Removal of Scleral Lenses

  1. To remove your scleral lens, wash your hands thoroughly with mild soap and dry with a lint-free towel. It is essential to keep bacteria away from your eyes to reduce the chances of an infection.
  2. Look straight into the mirror to locate the lens and place a towel over the sink to cushion the lens in case it falls out. Peel back your eyelids and use your index finger to press your lower eyelid into your eye below your lens to break the suction. The lens will fall out of your eye once the suction is broken.
  3. The second option is to use a plunger and stick it at the lower part of your lens, then slowly pull it up and out.
  4. Clean and store your lenses as directed by your doctor and place them in their storage case.

It is normal for your eyes to feel dry and have redness after removing your scleral lenses.

Solutions Used for Scleral Lenses

Tap water should never be used since it can cause severe eye infections. Saline solution should never be reused, and don’t use any solution that your doctor does not recommend.

Scleral lenses can be kept clean by different types of lens solutions, including:

  • Multiple-purpose solution: This removes debris from the lens surface.
  • Peroxide cleaner: This sterilizes your lenses as they sit inside their storage case overnight. The peroxide solution must take six hours to work. If you re-insert your lenses before waiting the full time, it will cause a stinging sensation since the solution did not have enough time to turn into a safe diluted solution for your eyes.
  • Preservative-filling: This is used before insertion when filling the bowl of your scleral lens.

If you need help with scleral lens insertion and removal, the experts at Sunrise Specialty Lens & Dry Eye Institute specialists can help. Contact us for more information, or schedule an appointment online today.

How To Care for Your Scleral Lenses

The number one rule in contact lens care is always to follow the professional advice of your optometrist. If you need any clarification, always contact their office first.

Never ever use tap water in any area of lens care, whether to rinse or fill your lens case. Tap water contains a multitude of dangerous microorganisms, including acanthamoeba, that can cause a severe, painful, and sight-threatening infection. Be sure that your hands are fully dry after using a lint-free towel prior to handling your lenses.

Remove Before Going to Sleep

Most people can comfortably wear scleral contact lenses for up to 12-14 hours at a time. Approximately an hour before going to sleep is the best time to remove the lenses. If your lenses fog up in the middle of the day, it’s best to remove them and try various methods to clear up the fogginess before reinserting.

Use a Filling Solution That Is Preservative-Free

When inserting scleral lenses, use unpreserved sterile saline solution by filling the bowl of the lens upon insertion. Don’t use tap water or a preserved solution as these can lead to an eye infection.

Remove Debris Using Multi-Purpose Lens Solution

Once you’ve thoroughly washed and dried your hands, remove your scleral lenses and rub them for 2 minutes in a contact lens case filled with saline solution. This effectively removes microorganisms and deposits, lowering your risk of infection. While scleral lenses are strong, too much force or an incorrect technique can cause them to break.

After rubbing your lenses, thoroughly rinse them using the solution for 5-10 seconds. Then place them in a case filled with fresh solution and leave them to disinfect for at least 4 hours.

Routinely Clean and Replace Your Lens Case

Regularly clean and replace your lens case to prevent infection due to bacterial contamination.

It is recommended to clean the storage case on a daily basis and to replace it monthly or as advised by your eye doctor.

Your optometrist will recommend when to get a new pair of scleral lenses and will advise you when to schedule follow-up appointments. Failure to show up for scheduled appointments can compromise the lenses’ efficacy.

At The Scleral Lens and Keratoconus Center at Sunrise Specialty Lens & Dry Eye Institute, we can recommend the best wearing schedule for your contact lenses to ensure the highest level of comfort and visual acuity. Always follow the instructions provided by your eye care professional. Call to schedule an eye exam and a scleral lens fitting today.

The Scleral Lens and Keratoconus Center at Sunrise Specialty Lens & Dry Eye Institute serves patients from Sunrise, Plantation, Davie, and, all throughout Florida.

Q&A

 

Q: Why do I need to use preservative-free solutions to fill the lens?

  • A: Long-term exposure to preservatives can cause corneal toxicity or sensitivity that results in irritation and redness.

Q: How long do my application and removal plungers last?

  • A: Plungers should be replaced every 3 months, or sooner if necessary.

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