vary scleral lenses

[TomV]

Hello,

how has got experience with the varieng lenses during the day? Can you vary slceral lenses without any problem with normal RGP during the day?

Tom (NL)

[Andrew MacLean]

Tom

I'm sorry, but I know I am being obtuse: do you mean wear one lens for part of the time and another type of lens for the rest of the time?

Andrew

[TomV]

Sorry,

I did not make my statement clear, I don't speak English very well.
Indeed, Andrew, I meant alternating lenses during the day. For example, in the morning and afternoon you wear normal RGP's and in het evening, when you have to drive by night f.e., you wear Scleral lenses, because they eleminate flare and glare produced by lights. Can you switch easily between different types of lenses during the day or is there going to be an unwanted side effect?

gr Tom

[Fernando FV]

Hello

My experience as an optometrist who fits a large number of keratoconus is: if you wear scleral lenses you dont need to switch to a different lens modality.
As an average,in my practice, patients wear sclerals 14 hours per day. Obviously, this lens has to be manufactured in a high oxygen permeability material i.e. Boston XO and with the correct geometry for each case.

Regards
Fernando J Fernandez-Velazquez
Madrid (Spain)

[TomV]

Thanx for you reply.
But scleral lenses do get dirty after a few hours when I am wearing these. And my eyes become red if I let them in too long. Any suggestions? Do you have to remove them often during the day to clean them and reinsert?
And waering them for 14 hours a day, that means that you have to seek for an alternative for the next twho hours when you still are awake?

Tom

[Fernando FV]

Hi TomV

Yes it´s correct, scleral lenses get dirty and may also dry. I recommend taking the lens off at lunch time and re-clean them. There are also certain re-wetting drops from major contact lens solution manufacturers with added cleaning properties that can be used with soft and scleral lenses.

About your specific problem, redness, it has to be studied. In general the very good thing of sclerals is that this lens never touchs the cornea. Please remember that a real scleral lens it has to be larger than the cornea, i.e. larger than 15.00 mm.
So the redness is not a sign of corneal involvement i.e. keratitis.

The eye could became red for mutiple causes i.e. dryness, conjuntival pression,.... For that reason it has to be evaluated.
But same good pearls could be:
1) Fill the lens with unpreserved saline to avoid allergic problems (alñso more commoen in keratoconus)
2) Clean the lens during the day
3) Use regularly artifital tears or unpreserved saline (from the fridge it would be better)

regards