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A Guide to Scleral Lenses

Vision And Medicine Concept. Accessories For Contact Lenses: Con

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.

How to Insert Scleral Lenses

  1. Remove your scleral lenses from their storage case and rinse with them with saline. If you’re using a hydrogen peroxide solution, wait at least 6 hours from when the lenses were placed into the storage case for the solution to neutralize. Always rinse with saline before placing the lens on the eye.
  2. Either place the scleral lens between your middle, forefinger, and thumb — known as the tripod method — or secure the lens to a suction tool (plunger) supplied by your optometrist.
  3. Fill half the bowl of the lens with preservative-free saline solution to prevent air bubbles from forming between your eye and the lens. Insert the lens directly onto the center of your eye in a facedown position.
  4. Dry and wipe your lens case with a tissue and leave the case lid off to air dry.

How to Remove Scleral Lenses

There are two methods to remove scleral contact lenses: with your fingers, or with the aid of a plunger. First, to detach your scleral lenses from your eye, press firmly with your finger on your bottom eyelid just below the edge of the lens, then push upwards.

Method 1 – Manual Removal

  1. Try Scleral Lenses Thumbnail.jpg

    Insert a drop of preservative-free saline solution or artificial tears to loosen the lens.

  2. Look down onto a flat surface (a mirror or towel can be placed there).
  3. Use your middle finger to open your eyelid wider than the lens diameter.
  4. Apply pressure to the middle of the lid — as close to the lashes as you can — and push down on the eyelid to move your eyelid under the lens and lever it off the eye.

Method 2 – Suction Tool

  1. While looking at a mirror in front of you, hold your bottom lid open. Wet the tip of the suction tool to allow for better adhesion and attach it to the bottom of the lens.
  2. Using the suction tool, remove the lens by tilting the lens up and out of the eye.

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 Peroxide Cleaner

You can sterilize your scleral lenses by immersing them in 3% hydrogen peroxide. Over a period of 6 hours, the catalyst in the case transforms the hydrogen peroxide into water and oxygen gas. This gives your lenses a deep clean and removes the need to rub them, thus decreasing the risk of accidental breakage. Do not use the lenses until they have been immersed for 6 hours, as the un-neutralized peroxide will painfully sting your eyes. Leave the lens case to dry when not in use.

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 New Era Eyecare, 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.

New Era Eyecare serves patients from Clifton, Arlington, Sterling, and Alexandria, all throughout Virginia.

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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Tips For Wearing Scleral Lenses

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Scleral lenses are ideal for patients with corneal irregularities, dry eyes, and hard-to-fit eyes. Their uniquely large circumference offers the best in visual comfort and clarity. But wearing and caring for your scleral lenses can take some getting used to.

Below are our top 5 tips for anyone who wears scleral lenses. If you have questions about scleral lenses or any other optometric matter, New Era Eyecare in Northern Virginia is here for you.

1. Lens Hygiene is Top Priority

Keeping your scleral lenses hygienic and free of buildup is key in ensuring the clearest possible vision. When you remove them from your eyes, rub them for several seconds with lens cleaner to remove surface debris and bacteria. Then, rinse them on both sides with saline solution before storing them.

Another hygiene tip: Before handling your lenses, be sure to wash your hands with soap and water, and to rinse and dry them with a lint-free cloth or paper towel. Good hygiene will significantly minimize possible complications and keep your eyes feeling fresh.

2. Manage Your Dry Eye

Many patients with dry eye syndrome (DES) choose to wear scleral lenses for their hydrating and soothing properties. While sclerals can offer substantial relief from their dry eye symptoms, patients shouldn’t forget to seek treatment for their DES.

That’s because scleral lenses help manage dry eye, but don’t actually treat it. So, it’s best to follow up with your eye doctor about any eye drops, medications, or at-home remedies to support healthy tears.

3. Use a Cotton Swab For Cleaning

Patients with long fingernails can find it challenging to thoroughly clean their scleral lenses. Rubbing the inside bowl of the lens with a cotton swab and cleaning solution can effectively remove the buildup from the lens. Then, rinse off the cleaning solution with saline to remove the cleaning solution and any lint from the cotton swab.

4. Try Different Insertion Tools

Is your current insertion method not working as smoothly as you’d like? No worries! Ask your eye doctor about different tools you can use, such as the O-ring or applicator ring.

But please only insert your lens with tools that your eye doctor recommends!

5. Follow Up With Your Eye Doctor

Because scleral lenses are customized, they often require a few visits with your optometrist to optimize their fit. Even after the fitting process is complete, follow-ups will help ensure that your lenses are still in good condition.

If your scleral lenses are giving you any trouble at all, we can help. To schedule your scleral lens consultation, call us today!

New Era Eyecare serves patients in Clifton, Arlington, Sterling, Alexandria, and throughout Clifton.

Frequently Asked Questions with Our Scleral Lenses Expert in Clifton, Virginia:

Q: How do scleral lenses work?

  • A: Scleral lenses rest and vault over the entire sclera (white of the eye), encasing a hydrating reservoir in between the lens and the cornea (front surface of the eye). This allows people with irregular corneas to wear contact lenses, since the lens isn’t in direct contact with the cornea itself.

Q: How long do scleral lenses last?

  • A: Scleral lenses generally last 1-2 years, depending on how well you care for them and how your tear film reacts with them. Even so, check-ups every 6 months are recommended to ensure they still fit well and provide clear vision.


References

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Scleral Lenses Can Prevent Dry Eye, Tiredness, and Discomfort

protect your eyes 640x350It’s not uncommon for certain contact lens wearers to suffer from eyes that feel dry, red, itchy, uncomfortable, and at times very painful. Eye drops and artificial tears can deliver relief, but they are no more than a temporary solution.

One of the best contact lenses for optimal comfort and hydration are scleral lenses, as they simultaneously provide vision correction, protect the eyes, and lubricate them.

What are Scleral Lenses?

These rigid gas permeable lenses have an extra-wide diameter that vaults over your whole cornea. In contrast to other contact lenses, they rest on the white part of your eyes (sclera) and not the cornea. As a result, scleral lenses consistently rank at the top of the charts when it comes to providing sharp visual acuity, comfort, and healthy eyes.

Common Contact Lens Complaints

Below we’ll explore the most common contact lens complaints we hear at our practice and ways scleral lenses can prevent them.

End-of-day tiredness and dry eyes

After just 6 to 8 hours of contact lens wear during the day, many contact lens wearers experience tired and dry eyes. Though standard hydrogel contact lenses allow a high concentration of oxygen to permeate the eye, some people need an alternative.

End-of-day eye discomfort can be resolved with scleral lenses, as these custom-designed lenses have a liquid reservoir between the lens and the cornea that provides a continuous moist environment that soothes tired, dry eyes.

Not only does this cushion of moisture lead to a comfortable wearing experience; it also promotes healthy eyes throughout the day, allowing you to wear these lenses for 12 to 14 hours! It is for this reason that many of our patients turn to scleral lenses for unparalleled comfort and all-day ocular hydration.

Chronic dry eye syndrome

Certain dry eye patients may experience painful, red, and swollen eyes. For them, traditional soft contact lenses can be unbearable because they sit right on the irritated cornea. Moreover, these contact lenses tend to act as sponges, soaking up the moisture from the surface of the eye.

If you struggle with dry eye syndrome and have been looking for a more effective treatment method beyond eyedrops and artificial tears, ask your New Era Eyecare doctor about scleral lenses.

Feeling the contact lens in the eye

Feeling your contact lenses in your eyes often indicates a poor fitting. Everyone’s eyes are different and when it comes to contact lenses, no size fits all. Furthermore, if lenses are insufficiently curved, they can be dislodged with every blink. This isn’t just uncomfortable — the wrong size lens can damage your cornea.

Because scleral lenses have a large diameter and are custom-made to your eye shape and size, it is almost impossible for scleral lenses to dislodge during normal wear. And since these lenses do not make contact with the surface of your cornea, there is a decreased risk of corneal abrasions.

Operating in dusty environments

Dry, dusty or dirty conditions can cause contact lenses to not only dry out, but can also lead irritants to attach themselves to the lenses. Scleral lenses offer comfort, even in dusty or dirty environments. This is because the lenses cover a large area of the eye, and since the outer layer of the lens protects the eye surface, dust and tiny particles can’t reach it. While not a complete barrier, scleral lenses can provide you with more relief and all-day comfort than traditional lenses.

If you’ve tried traditional contact lenses and have experienced any of the above, or if you’re simply seeking a more comfortable alternative to wear all day, it’s worth considering scleral lenses.

Contact a knowledgeable and experienced eye care professional, our doctors, who will patiently assess and explain your condition to you. our doctors will perform a specialized scleral lens custom-fitting to ensure that you receive the best fit for optimal visual clarity and comfort.

Call the New Era Eyecare today to schedule your consultation. We help patients from the Clifton, Arlington, Sterling, and Alexandria, in the Virginia area enjoy great vision and comfort with scleral lenses.

Traditional contact lens wearers can at times suffer from eyes that feel dry, red, itchy, and uncomfortable.

This may happen after a long day of wear, having the wrong contact lens fit, or as a result of operating in dusty environments.

Many turn to eye drops and artificial tears for relief, though they offer only a temporary solution.

For optimal comfort and hydration, consider scleral lenses.

They provide not only visual clarity, but also protect the eyes, while ensuring that they remain moist all day long.

Because scleral lenses have a large diameter and are custom-made to your eye, it is practically impossible for them to dislodge during normal wear.

Moreover, scleral lenses decrease the risk of corneal abrasion, as they do not make contact with the surface of your cornea.

Speak to your eye doctor about scleral lenses today!

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What Is the Shape of a Healthy Eye and How Does It Affect Vision?

eyes eye care 640x350The human eye is a biological piece of functional art, capable of producing colorful moving three-dimensional images with high precision. At the same time, one can marvel at the aesthetic beauty of the human eye and its shape.

The Shape of a Healthy Eye

In a healthy and perfectly shaped eye, light passes through the cornea and crystalline lens, and is accurately focused onto the retina, located at the back of the gel-filled eyeball. This process enables an image to be passed onto the optic nerve and then the visual cortex of the brain. Accurate focus and convergence depend on the proper shape of each part of the eye. However, eyeballs can be either shortened (hyperopia) or elongated (myopia).

Unhealthy Eye Shapes That Impact Vision

The Myopic Eye

In an elongated myopic eyeball, the distance between the lens and retina is too long, leading the image to come into focus before reaching the retina. As a result, the photosensitive cells of the retina pick up a blurry image.

The Hyperopic Eye

In hyperopia or farsightedness, the opposite is the case. The eyeball is too short, as is the distance that light travels from lens to retina. Therefore, the image comes into focus behind the retina, causing distant objects to appear clear, whereas close ones do not come into proper focus.

The Cornea

While the crystalline lens is flexible and auto-adjusts its shape for proper focus, the cornea is static. A healthy cornea maintains its smooth dome shape. However, if the cornea is weak, the structure of the cornea cannot hold this round shape, causing the cornea to bulge outward and downward like a cone. Perfect curvature of the cornea ensures the correct bending of incoming light onto the lens, whereas inadequate curvature results in a refractive error.

An uneven or irregularly shaped cornea also distorts the image that forms at the retina. Common corneal irregularities include astigmatism and keratoconus.

Keratocoonus Labelled

Scleral Lenses for a Smooth Eye Shape

Scleral lenses are large contact lenses that rest on the sclera — the white part of the eye. The lenses span over the cornea, making them ideal for a deformed cornea as they even out the irregularity to create a perfectly shaped eye.

Contact our doctors at New Era Eyecare to learn more about how your eye shape affects your vision. We’ll be happy to discuss the different correction methods available that offer you sharp, comfortable and clear vision all day, every day.

We receive clients from Clifton, Arlington, Sterling, Alexandria, and throughout Virginia.

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Resources:

https://www.lasikmd.com/blog/eye-shapes-affect-vision

https://www.everydayhealth.com/vision-center/the-healthy-eye/how-the-eye-works.aspx

https://www.nvisioncenters.com/eye-shapes/

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors