Scleral Advice..

[John Smith]

Hi Ed,

I think this could be an air bubble under the scleral.

When the cornea is exposed to air, it gets its oxygen from that, and a little bubble's oxygen will soon be used up.

The cornea will then start taking on water for oxygen, and that causes odema (swelling) and cloudyness. I'm not really sure why this doesn't happen anywhere near as fast if the bubble is completely absent, but you must try to be completely bubble free.

Make sure that your head is pointing down so that your face is horizontal... then look down some more so it feels as though you're upside down (you're probably not ) Then insert the scleral lower lid first, and try and keep it level to avoid as much spillage as possible.

If you do keep on getting bubbles, it's worth trying a lens with a vial of Celluvisc instead of saline. It's so viscous that bubbles don't form so easily, and it doesn't spill so fast either. Ken at Moorfields suggested that to me, so I'm sure it's safe.

[rosemary johnson]

ABout the cloudiness:
it sounds to me as if you could be rinsing the Miraflow off too thoroughhly, and leaving the lens not sufficiently wetted.
Miraflow is an odd sort of stuff - wetter and cleaner together - if that's the same stuff I had.
try putting some more Miraflow on after the "clean away the baddies" coat, and don't rinse it too hard.
If you rinse *any* wetting solution away too hard, you remove the wetting effect - so the fluids, whether CL solutions or tears, don't really stick tot he lens. You then get "dry", unwetted bits that get foggy.
This can be hidden at first, as you have filled the lens with saline to put it in, and the cloudiness only comes out once all that saline has been washed/blinked away.

To tell whether you've rinsed too much wetting solution away (Miraflow, or whatever), before you fill up with saline, turn the lens over a few times, and peer closely at it to see if you can detect any uncovered patches. If you can. wet it again, and rinse the wetting solution more sparingly.
If this keeps happened, you haven't cleaned it well enough, and it isn't wetting because of the gubbins that hasn't been cleaned off.

I had this problem quite a bit when I first tried Miraflow, not being used to it. I just had to get used to Miraflow being, well, Miraflow!
It is one of the reasons I don't like Miraflow too much and have gone back to Boston (the other is it being alcohol-based, and not wanting a solvent that can irritate my asthma so close under my nose first thing int he morning.

Good luck!!
ROsemary (been on sclerals over 30 years now)