If you or a loved one is living with keratoconus, you may be familiar with prescription contact lenses to help with blurry or distorted vision. Contact lenses are a common part of a person’s keratoconus journey and can range from soft contact lenses to Rigid Gas Permeable (RGP) lenses.
Scleral lenses are a type of Rigid Gas Permeable lens that many people with keratoconus consider using. However, if you grew up wearing or have worn soft contact lenses in the past, you may notice that scleral lenses are a bit different. A scleral lens is made of durable plastic that can transmit oxygen, it’s larger in diameter than other RGPs, and it is designed to cover the entire cornea, plus a portion of the white of the eye.
Whether scleral lenses are brand-new to you or you’ve been wearing them for years, you likely still have some questions. Did you know that there is a proper way to insert and remove your lenses? Or, did you know that you should not rinse your scleral lenses with tap water? Like any other type of contact lenses, there are some fundamental do’s and don’ts to follow to make sure that your scleral lenses are cared for properly and inserted correctly.
To help explain the basics, Dr. Stephanie Woo, O.D., F.A.A.O., F.S.L.S., of Contact Lens Institute of Nevada, shares some tips for using and caring for scleral lenses. She also describes how to find a local doctor that has experience fitting scleral lenses and what resources are available to new scleral lens wearers. Continue reading to learn more.
Are there any tips you have for putting in or taking out scleral lenses?
Inserting scleral lenses is a common frustration for patients. Do not give up! There are many ways to insert a scleral lens. If you cannot get the lens in with a traditional large plunger, there are many other methods to help. Scleral lenses will not balance on one finger typically because they become top heavy when they are filled with non-preserved saline, and then the lens falls off your finger. To help with this, you can use the 2-finger approach or 3 finger approach to help balance the lens. You can also use devices to help balance the lens on one finger, such as an orthodontic ring, an O-ring, and the EZI scleral lens applicator. All of those devices allow the lens to rest on one finger, which gives you access to your middle finger, ring finger, and pinky to help control your lower eyelid. If you need both hands to help control your eyelids, there are several scleral lens stands available which allow you to balance the lens on a table or counter.
Watch the above video from the Contact Lens Institute of Nevada to learn how to insert a scleral contact lens
Watch the above video from the Contact Lens Institute of Nevada to learn how to remove a scleral contact lens
What is the best way to care for scleral lenses?
You should always follow the advice of your eye care practitioner on the best way to care for your scleral lenses. Typically, contact lens care systems made for gas permeable lenses are considered safe for scleral lens wearers. Hydrogen peroxide systems are also effective. However, some patients have certain eye diseases or conditions which are better served using a specific product recommendation. Please follow the instructions of your eye doctor on which care system is best for your eyes. It is important to stick to their recommendation. If you switch to a different care system, please notify them because that can help with troubleshooting at future visits.
Watch the above video from the Contact Lens Institute of Nevada to learn how to take care of your contact lenses with hydrogen peroxide
What resources are available to someone new to scleral lenses?
There are many free patient resources available. Non-profit organizations such as the Gas Permeable Lens Institute, National Keratoconus Foundation, and the Scleral Lens Education Society all have free resources such as written pamphlets, blog posts, webinars, and physician locators. There are also support groups online through social media that can be beneficial for some patients. Ask your doctor about resources that you need, as they are likely able to make some good recommendations.
What would you tell someone who is looking to get their first pair of scleral lenses?
Fitting and managing scleral lens patients requires special equipment and knowledge, so it is important to find a doctor who is skilled in this area. A great resource would be to ask your eye doctor who they would recommend or search non-profit organizations.
How do I find a doctor near me who has experience fitting scleral lenses?
One of the best places to start would be the Scleral Lens Education Society. Their “find a specialist” tool has a list of scleral lens practitioners who have earned the title of Fellow of the Scleral Lens Society (F.S.L.S). Practitioners with this designation have demonstrated scleral lens proficiency and are highly qualified to care for scleral lens patients. There is a provider locator on the website, so you will be able to locate a doctor near you. If there is no doctor in your area, you can also search for terms such as “scleral lenses” or “keratoconus contact lenses” in your area. A list of doctors who mention these key terms on their website may fit specialty contact lenses, such as scleral lenses. Not all eye doctors fit scleral lenses, so it is important to find someone who has the knowledge, technology, and experience in this special type of contact lens.
In case you missed it, in an earlier blog post, Dr. Woo discusses what you need to know about living with keratoconus and wearing scleral lenses. For more information on keratoconus and available treatment options, visit our website and follow Living with KC on Twitter, Facebook, and Instagram!