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Inserting and Removing Scleral Lenses

When you handle scleral lenses incorrectly, poor hygiene and improper cleaning can increase your risk of getting an eye infection. For this reason, it’s crucial to follow your eye doctor advice on how to properly care for your contact lenses.

Before Handing Scleral Lenses

Make sure to do the following before inserting or removing scleral lenses:

  • Always wash your hands thoroughly with antibacterial pump soap or non-oily soap and dry them with a clean paper towel or lint-free towel.
  • To insert and remove your lenses, sit at a table or desk with a lint-free cloth. Bathrooms frequently have more germs than other areas in the house, so avoid them when handling scleral lenses.
  • Examine your lenses for chips or cracks, as well as protein deposits on the surface. If you see any flaws or are unclear whether your lenses are broken, have your eye doctor inspect them before wearing them.

Inserting Scleral Lenses

  1. Remove your scleral lenses from their storage case and rinse them with saline. If you’re using a hydrogen peroxide solution, wait at least 6 hours for the solution to neutralize after you place the lenses in the storage case. Before placing the lens on the eye, always clean it with saline.
  2. Secure the scleral lens to a suction instrument (plunger) provided by your optometrist, or insert it between your middle finger, forefingers and thumb (the tripod method).
  3. To prevent air bubbles from accumulating between your eye and the lens, fill half the bowl of the lens with preservative-free saline solution. In a facedown position, place the lens directly on the middle of your eye.
  4. With a tissue, wipe and dry your lens case, then leave the cover off to air dry.

Removal of Scleral Lenses

Scleral contact lenses can be removed in two ways: with your fingers or with the help of a plunger. To remove your lenses, press firmly on your bottom eyelid just below the edge of the lens with your finger, then push upward.

Suction Tool

  1. Hold your bottom lid open while looking in the mirror in front of you. Attach the suction tool to the bottom of the lens after wetting the tip for greater adhesion.
  2. Remove the lens with the suction tool by tilting it up and out of the eye.

Manual Removal

  1. To loosen the lens, use a drop of preservative-free saline solution or artificial tears.
  2. Look down at a level surface (a towel or mirror can be placed there).
  3. Use your middle finger to open your eyelid wider than the lens diameter.
  4. Push down on the eyelid and apply pressure to the middle of the lid, as close to the lashes as possible, to move your eyelid beneath the lens and pull it off the eye.

Caring for Your Scleral Lenses

Always follow your optometrist’s advice when it comes to contact lens care.

Never use tap water at any stage of lens maintenance, including rinsing and filling your lens case. Tap water contains a variety of harmful microbes, including acanthamoeba, which can cause a severe, painful and sometimes sight-threatening infection. Before handling your lenses, make sure your hands are clean and completely dry after using a lint-free towel.

Use a Filling Solution That Is Preservative-Free

Before inserting your scleral lenses, fill the bowl of the lens with unpreserved sterile saline solution. Using preserved saline solution raises the risk of infection.

Use a Peroxide Cleaner

Soaking your scleral lenses in 3% hydrogen peroxide solution sterilizes them. The catalyst in the case converts hydrogen peroxide into oxygen gas and water over the course of 6 hours. This deep cleans your lenses and eliminates the need to rub them, lowering the danger of accidentally breaking them. If you use the lenses before they’ve been immersed for 6 hours, the un-[neutralized] peroxide will irritate your eyes. When not in use, let the lens case dry.

Remove Before Going to Sleep

Most people can wear scleral contact lenses for up to 12-14 hours at a time without any discomfort. The optimal time to remove the lenses is around an hour before going to bed. If your lenses fog up in the middle of the day, remove them and clean them before reinserting them.

Remove Debris Using Multi-Purpose Lens Solution

Remove your scleral lenses and rub them for 2 minutes in a contact lens case filled with saline solution after properly washing and drying your hands. Microorganisms and sediments are effectively removed, minimizing your risk of infection. While scleral lenses are durable, they can be broken if used or handled incorrectly.

After massaging your lenses, rinse them well for 5-10 seconds with the solution. Then place them in a case filled with new solution for at least 4 hours to disinfect.

Routinely Clean and Replace Your Lens Case

To avoid infection from bacterial contamination, clean and replace your lens case on a regular basis.

Cleaning the storage case on a daily basis is recommended, as is replacing it monthly or as directed by your eye doctor.

Your optometrist will let you know when it’s time for a new pair of scleral lenses and when you should book a follow-up appointment. Failure to show up for scheduled appointments can [jeopardize] your lenses’ effectiveness.

At Mississauga Vision Centre and Brampton Vision Centre, we can recommend the optimum wearing schedule for your contact lenses to provide the highest level of comfort and visual acuity. Always follow the advice given to you by your eye doctor. Call today to make an appointment for an eye exam and scleral lens fitting.

Our practice serves patients from Mississauga & Brampton, Vaughan, Oakville, and Toronto, Ontario and surrounding communities.
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Why Do Scleral Lenses Sometimes Get Foggy?

Scleral lenses provide a successful contact lens option for people with corneal conditions such as keratoconus, severe dry eye, and those needing vision correction following eye surgery. Unfortunately, about 30% of patients with scleral lenses may experience lens fogging. This requires them to remove their lenses and refresh the saline solution, that keeps their lenses lubricated, multiple times a day. Here are some reasons why scleral lenses fog up and tips on how to keep your lenses clear.

What is Midday Fogging?

Midday fogging is when scleral lenses fog up after a few hours of wear. The most likely causes appear to be an accumulation of debris from the tears between the lens and the cornea or an inflammatory reaction of the eye or eyelids to the contact lenses.

Fogging Caused by Debris

Blinking can sometimes cause the debris to dissipate, but it doesn’t always help. There are three types of tear debris that may lodge between the eye and the lens and cause fogging.

Mucin Debris

Mucin is an opaque, white, fluffy, oil-like layer of the tears. If the fit of the scleral lens isn’t perfect, mucin debris can move from the tears into the tear reservoir behind the scleral lens. If this is the case, your eye doctor will evaluate how the scleral lens fits and make the required adjustments to its design, most likely changing the peripheral edge lift.

The peripheral edge lift, the very edge of the scleral lens, allows a refreshing flow of tears to get under the lens and into the tear reservoir behind the scleral lens. However, if there is too much lift, excessive tears will flow, allowing debris to accumulate in the tear reservoir.

If the peripheral edge lift is the problem, the lens edge may be irritating your eyelid. Your eye doctor may ask you to reduce the amount of time you wear the lens, or have you remove and reapply the lens during the day. Another option is following a lens cleaning regimen using an enzymatic cleaner or a sodium hypochlorite-potassium bromide-based system.

Meibomian Debris

Meibomian glands are tiny glands in your eyelids that produce the essential oils for our eyes. Meibomian debris can be caused by Meibomian Gland Dysfunction (MGD) or blepharitis. The debris occurs when the oils of your tears find their way under the lens and appear as semi-transparent droplets of oil floating on water. It can disperse light, like an oil slick, or appear yellowish in color.

To reduce this form of debris your eye doctor will treat the underlying cause in the eyelids as well as review the lens design. If issues with meibomian debris persist, removing and reapplying the lens can help as well.

These types of debris can occur in combination, resulting in multiple management strategies.

Front Surface Debris

Front surface debris is any debris found on the outside of the scleral lens, from the buildup of protein to the debris mentioned above. External sources such as oil-based lotions, makeup, and face and hand soaps can also cause foggy vision. Knowing where the debris is coming from can help you and your eye doctor eliminate the problem.

To remove foggy vision, make sure to wash your hands with mild hand soaps, and then rinse before handling your lenses. Also, make sure to apply face cream or makeup after inserting your lenses. Avoiding oil-based moisturizers on the eyelids, and not applying makeup to the inside area of the eyelid margin or over the meibomian glands can decrease the risk of MGD or obstruction.

Fogging Due to Inflammation

Giant Papillary Conjunctivitis (GPC)

GPC is an inflammatory reaction caused by the contact lenses. It occurs in up to 15% of all hard lens wearers and is likely due to the edge of the lens rubbing up against the conjunctiva, the protective layer on the eyelids and the outside part of the eyes. The signs of GPC are red, swollen and irritated eyelids.

If you have GPC your eye doctor may alter the design of your lens, most commonly the peripheral edge lift, and prescribe mast cell stabilizer antihistamine drops or reduced lens wearing time. The doctor may also do a deep clean of the lens with a sodium hypochlorite-potassium bromide-based system with enzymatic cleaners.

Atopic Disease and Keratoconus

Another type of debris that someone might experience with scleral lenses is due to an association between atopic disease (typically associated with the immune response to common allergens). This type of debris appears as a diluted milk-like fog in the scleral lens fluid reservoir under the lens.

Your eye doctor may recommend the following treatment options, including: reducing excessive edge lift, reducing base curves, taking an antihistamine to reduce inflammation, lens removal and reapplication, or in extreme cases, topical steroids.

Scleral lenses can be a great option for many patients, even if fogging occurs. These management strategies, along with proper lens care, can go a long way to ensure healthy life-long scleral lens wear. Contact Mississauga Vision Centre and Brampton Vision Centre to determine what may be causing your foggy vision and how to treat it today!

Our practice serves patients from Mississauga & Brampton, Vaughan, Oakville, and Toronto, Ontario and surrounding communities.
Request An Appointment
Can Scleral Lenses Help You? Find Out! Call Our Locations

Learn More About Scleral Lenses

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