Scleral Contact

Welcome to Scleral Lenses!

You are now about to embark on your scleral lens journey. If you have any questions along the way, use this guide as one of your available resources to address common concerns or questions.

*Disclaimer: This guide is intended for educational purposes and is not to be used a substitute for consulting with Dr. Ellison or office staff for any medical advice related to your specific medical condition. Please always seek advice from the physician if you have any questions regarding your specific medical condition. You may reach our office at 407-678-9151.

ABOUT SCLERAL CONTACT LENSES: Scleral lenses are a type of rigid gas permeable (RGP) lenses that are larger in diameter, completely cover, or vault, over the cornea, and further extend over the sclera (the white part of the eye). Because these lenses are larger in diameter, they tend to be more comfortable than your average corneal lens. This is due to the fact that they rest on the sclera which has fewer pain receptors than the cornea. There are several patient populations that can benefit from the use of scleral lenses, such as those with irregular corneas, ocular surface diseases (e.g. Graft vs. Host Disease (GVHD), chronic dry eye syndrome, Sjogren’s syndrome), and patients who have had corneal surgery. Because the cornea is no longer smooth due to these conditions, these lenses help to cover any anomalies, as well as provide improved vision. Many patients may ask, “Why have I never heard of these lenses before?”, and most would be surprised to know that they have been a part of medical literature since the late 1800s. Of course, times have changed, and the proper materials and resources are now available for these lenses to be reliably produced.

MATERIAL NEEDED

1. New Patient Kit (Case, Insertion/Removal Aids, Saline)

2. Clear Care Cleaning and Disinfecting Solution

3. Saline Preservative Free (PF) Solution (or a comparable PF Saline Solution)

4. Clean hands and surfaces!

INSERTION

1. Place the lens on your bulbed insertion aid (with or without suction)

2. Fill the lens bowl with saline, allowing the fluid to heap over the top of the lens

3. Bend over as forward as possible, looking straight down

4. Holding eyelids open as wide as possible, apply the lens directly over the iris (colored part of the eye)

5. Remove the insertion aid

REMOVAL

1. Place the removal aid on the inferior (bottom) ⅓ of the lens

2. Tilt the lens directly off the eye

CLEANING YOUR LENSES

Here at Trinity Eye Associates, we have certain recommendations for your general cleaning and daily storage. If you are required to have a more specific cleaning regimen, you will be informed of this by either or both the Doctor or office staff. ● After removing your lenses at the end of the day, you will need to soak your lenses in the Clear Care Plus Hydraglyde Cleaning and Disinfecting Solution* ● Fill the vial included in the packaging to the fill line with the solution, place a lens in each side of the vial and close the vial with the lenses inside ● Once closed, you will see bubbles forming and rising to the top of the vial ● These lenses need to be soaked for a minimum of 6 hours (generally overnight) ● When ready to reinsert lenses in the morning, it is not necessary to further clean them once taken out of the vial. They are ready for direct insertion into the eye *This solution has a RED CAP which signals that it is NOT to be directly inserted into the eyes. We understand that all patients have different work/life schedules, so it is important to account for cleaning after “what-if” situations. If you happen to need to take a nap, for example, or participate in any activity requiring temporary removal of the lenses, you may not have time to wait 6 hours for them to be cleaned with your Clear Care Solution. In this case, you may use the Unique pH provided to you in your new patient kit for a temporary cleaning alternation. ● After removing these lenses, place them in a flat case filled with a Unique pH solution. ● Once ready to reinsert, you may remove the lenses from the flat case, rinse the lenses with saline, and follow normal insertion procedures.

TIPS AND TRICKS

1. Make sure that your face is fully parallel to the floor, this is the most correct position for insertion.

2. Air bubbles are insertion errors! If you see one, don’t worry; simply remove the lens, refill it with saline, and reinsert it.

3. Lid control plays a crucial role in insertion success. While using one hand to hold the lids completely out of the way, do not release them until the lens is fully in place and the insertion aid has been removed.

4. If you can see the hole of your bulbed insertion aid, looking directly at this will 3 give you the best insertion position and will help you to know that the lens is indeed positioned correctly.

5. Keep both eyes open! This will allow you to not only see what you’re doing but will minimize insertion errors on the eye that you are working on. 6. If you feel any bit hesitant about this process, you can always refer to a fantastic insertion and removal video provided by the Scleral Lens Education Society. ○

FOR FOLLOW-UP APPOINTMENTS

Follow-up appointments will be scheduled every few weeks during the first few months of your journey. There are a few guidelines that will make your appointment as efficient as possible. ● Insert your lenses first thing in the morning. For these appointments, lenses must be worn for at least two hours before your appointment. ● If lenses are not worn upon arrival, at least a 30-minute wait period will be required before your exam can start, resulting in the need to reschedule your appointment. ● These appointments will be scheduled either in the morning, or mid-afternoon. A combination of these appointments is also acceptable so we can see what differences may be exhibited by the lenses at different times of the day.

FREQUENTLY ASKED QUESTIONS

1. Do scleral lenses hurt? ○ Though they may take some time to get used to, they do not hurt! From our staff’s personal training and experiences, we can say that these are probably some of the most comfortable lenses we have ever worn!

2. What if I see a bubble in my lens right after putting it in? ○ That’s okay! Air bubbles are simply errors upon insertion and are a fairly quick fix. Simply take out the lens, reinsert saline into the lens bowl, and try 4 again. 3. Can I sleep in my scleral lenses? ○ We do not recommend that you sleep in your scleral lenses. Because tear production stop at night, this could lead to a higher risk of eye infection

4. Can I wear my scleral lenses all day? ○ Of course! Most patients will start off wearing them for a few hours a day, and add on an hour or two per day as they progress in their journey, but ultimately many patients with scleral are about to wear them up to about 16 hours daily! There may be times throughout the day when your vision may seem a little blurry or you may experience some slight discomfort. In cases like these, you can remove the lenses and simply reapply fresh saline to help you achieve the best possible vision and comfort.

5. Will my vision be corrected to where I will not require glasses while wearing my scleral lenses? ○ That is always our goal. Overall, scleral lenses can help you to achieve better vision than some other forms of correction. It is still possible that you may need to wear glasses to help you with things like being in front of the computer or reading, especially if you are over the age of 40.

6. Can scleral lenses help with my dry eyes? ○ Yes! While they may not replace other things that you are already doing to manage your ocular surface condition, they are a fantastic contribution to your already existing therapy regimen. Scleral lenses promote corneal protection, so because the back of your eyelid rubs over the surface of the lens, you made need additional lubrication to reduce any irritation this causes.

7. Will I be able to continue using my eyedrops now that I wear scleral lenses? ○ Unless told otherwise by Dr. Ellison, you may continue to use your eyedrops while wearing your scleral lenses. You should instill your prescription eyedrops at least 10 minutes prior to inserting your scleral lenses. For over-the-counter products such as artificial tears, you may continue to use those while you have your scleral lenses in, if necessary.

8. How long will my scleral lenses last? ○ Your scleral lenses may last 1-2 years depending on your particular eye condition and how you care for them.