Scleral contact lenses are large, gas-permeable contact lenses that rest on the sclera (white outer layer) of your eye, that create a saline-filled reservoir over your eye’s cornea.
An absolute revolution in eye care, scleral lenses were designed to treat a variety of corneal conditions, many of which do not respond to other forms of treatment. When used correctly, they are among the safest, most effective, most life-transforming forms of visual correction.
But we need to underline that phrase—“when used correctly.” Anyone who does not follow his or her doctor's advice regarding scleral (or regular) contact lenses can be inviting serious problems or even dangers.
In this article, we tapped one of Optique’s highly experienced, staff technicians, Randy Teller, to ask him to highlight the 5 must-know steps to healthy scleral lens care. Randy’s guidance has been refined by all of the latest research (including a study completed at Optique) and over 12 years of experience, back to when scleral lenses were first developed.
Scleral Lens Care Tip #1: Remove Your Lenses at the Right Time of Day
Most people can comfortably wear scleral contact lenses for 12 to 14 hours. But there comes a time when you should remove them. The best time to do so is one hour before you go to sleep. If your lenses fog throughout the day and you have the sensation of wanting to remove them, it is best to do so. Most of the time, this fogging is the result of a poor alignment of the lens with the eye. When misaligned, the lens rocks and causes mucous to form. The mucous becomes trapped in the saline layer of the lens and blurs the vision. It is estimated that around 50 percent of scleral patients in the market experience some degree of filming and fogging.
At Optique, we take particular steps to arrive at the best fit for each of our patients. Our rate of filming and fogging is much lower. And if standard design lenses do not fix the problem, we are the only practice in Tennessee who has access to a custom-molded scleral lens, EyePrint Prosthetics. Our rate of filming and fogging with EyePrint Prosthetics is 2 percent, because of the perfect alignment of the lens with the eye.
Scleral Lens Care Tip #2: Rub Lenses After Removing
After removing your scleral contact lenses, rub them to remove surface debris. To illustrate the importance of this step, Randy uses a helpful analogy:
“For a moment,” he says, “think of your scleral lenses as you would a plate of spaghetti you’ve just eaten. You wouldn’t just throw that plate in the dishwasher, right? You’d rinse it first, because you know that’s how it will get REALLY clean in the dishwasher. Well, that’s exactly why you should rub your scleral lenses.”
Rubbing each lens for two to 20 seconds—depending on your care solution—removes deposits and microorganisms, and reduces complications. Follow the rub step with a thorough rinse-with-solution for the time specified by the manufacturer (usually between five and 10 seconds). According to recent, conclusive evidence, rubbing and rinsing your lenses after wear provides the safest lens-wear for ALL types of contact lenses.
PLEASE NOTE: For scleral lenses, Optique uses hydrogen peroxide systems to clean at night, and a very specific rewetting solution during the day.
Scleral Lens Care Tip #3: Use a Preservative-Free Filling Solution
Always use a preservative-free filling solution, because this is the best way to maintain the optimum health of your eyes. Also, never use those “Get the Red Out” eye drops with your scleral lenses, as they can cause damage to your eyes AND lenses. Because these eye drops nearly always contain preservatives, they can have a toxic effect on your eyes and vision, and should be particularly avoided.
One final, related and crucial point: Never use tap water for any part of lens care. Tap water contains microorganisms which can lead to serious eye infections and loss of vision. You should never use tap water in ANY area of your lens care, including while rinsing your lenses or in your lens case. Do not attempt to make your own homemade saline or contact lens solutions. Also, make sure your hands are completely dry before handling your lenses.
For the best guidance regarding filling and cleaning solutions, we invite you to consult your optometrist at Optique.
Scleral Lens Care Tip #4: Regularly Clean and Replace Your Storage Case
Most things you use in life need to be cleaned on a regular basis, and your scleral lenses storage case is no exception. Overuse of a case can result in significant eye infections due to bacterial contamination. Our technician, Randy, advises you to clean your storage case every day—and replace it each and every month. (A new case is typically provided with each new bottle of solution purchased.)
Scleral Lens Care Tip #5: Rigorously Follow Your Eye Dr’s Advice
If you are receiving the first-rate eye care you deserve, your optometrist will know more about your eyes than anyone, and know exactly how best to care for YOU SPECIFICALLY. He or she will also be thoroughly knowledgeable regarding how solutions, etc. interact.
A Final Thought . . .
Here at Optique, we specialize in unparalleled eye care, including everything related to scleral contact lenses. If you are in need of this amazing breakthrough in eye care, we are always here to deliver that superior service. When you leave our office wearing scleral lenses for the first time, we’ll spend significant time with you to ensure that you are comfortable in your lenses and that they will provide you with everything you need from them.
You—and ALL our patients—deserve absolutely nothing less.
More About Dr. Jeffrey Sonsino
Dr. Sonsino is a diplomate in the Cornea, Contact Lenses, and Refractive Technologies section of the American Academy of Optometry (AAO). He is also immediate-past chairman of the American Optometric Association’s (AOA) Council on Cornea and Contact Lenses, a fellow of the Scleral Lens Education Society, and is on the advisory board of the Gas Permeable Lens Institute (GPLI). In 2017, he was awarded the Practitioner of the Year by the GPLI, the Advocate of the Year by the American Optometric Association, and locally, was awarded a Top Three Optometrists in Nashville award by the Nashville Scene.