Semi scleral lenses

[Dlmc89]

Hi folks,

New member here. I'll just give a wee bit of background to my case.

I've had keratoconus for about five years now, but was misdiagnosed at the first hospital in 2013- the consultant dismissed me after about five minutes, saying there was nothing wrong.

Three years, and a 13 month waiting time later I was seen in March this year by a consultant at another hospital in Belfast and he diagnosed(also within five minutes) and said that the condition was now pretty advanced. That was 8 months ago and I still haven't got my contact lenses from the NHS. I'm hoping to get the RGP ones from them, but as I say, they are disgracefully slow.

I was going to apply to take my exams for the bar this year but all of that has had to be called off and I'm sitting twiddling my thumbs really. In the end I went privately to Cathedral Eye Clinic, also in Belfast, and have been fitted with Maxim CV semi-scleral lenses. At this stage I only have the lens for the left eye since the manufacturer messed up and made the wrong one for my right eye. The scleral lens is great, but it is an absolute pain in the backside to put in. Air bubbles are a massive annoyance and some days I've just had to give up as my eye has got so sore.

I'm wondering if anyone has any tips or advice that could help me? At the minute my life is placed on hold and the lens I've got is so unreliable I don't want to start making plans. Is there any way to get the scleral lens in that minimises the risk of air bubbles? I admit I'm not the most dexterous person in the world so it's most likely my own sausage fingers that are the problem. Any advice would be greatly appreciated.

Thanks in advance,

David

[dalbeath]

Hi

I have been through the same situation and tried all sorts and now have a more of less 95% first time try success rate getting my lens in. I have a 14.5mm lens in my right eye and in my left eye have previously had 16mm - but actually had a graft 10 days ago so not wearing it now.

This may not work for you my my method is.
1) Get a flat mirror - you will have to find a height that works for you but for me I lay a pillow on my bed and the mirror on top. But I am only 5ft2. You have to find a height and place that works for you though. Being away from home can be tricky !
2) Buy a wee plunger thing - a hollow one. The are very cheap and give you 100 times more control.
https://www.amazon.co.uk/Hollow-Permeab ... ver+hollow
3) Solutions - I find I need something quite viscous to coat the lens to avoid bubbles. It has to be preservative free or it stings. I use Viscoteas preserve free. One wee vial will do 2 couple of days as you only need a bit in the bottom of the lens.
http://www.expresschemist.co.uk/viscote ... ml-30.html
4) Once you have some viscoears in fill the lens full with saline.
5) make sure your face is parallel to the mirror, one hand hold both top and bottom lids open, other hand the plunger with the lens on. Try and aim for the centre of your eye. Sometimes if the solutions are too cold your eye will snap shut in shock so you can try warm them to body temp. It's a real 'mind over matter' moment to say 'ok, this is going to tough my eye, it may be cold, I will not blink'
6) Gently place the lens on your eye, shut eye, squeeze plunger to remove and hope you have it in. Make sure you really squeeze plnger so it releases the lens and does not dislodge it. Couple of blinks and hope for the best.

One word of warning, I can do this 100 times easier with my right eye than left as I am right handed.

To take it out, put some drops, saline, lubricant in your eye first. I have mirror upright for removal and not flat. try and get a finger nail under the edge to break the seal and ince seal is broken it should flip out. Again have a soft surface like a bed under you as they can ping out and drop.

If viscotears and saline do not work for you try experimenting with other more viscous drops

Good luck, you will get there

[Dlmc89]

Thanks for the reply- and I hope you're coping well with the graft and that it's successful

I'll keep your tips in mind when I try again. My problem seems to be at just the last split second when I always seem to spill the saline. I think I'm maybe not keeping my head parallel to the floor so will need to work on that. I'm 6'2 so it may take a bit of trial and error!

I was given some really good drops by the clinic, they're called Hyabak 0.15 and I sometimes fill the cup with it. It has two advantages: first up it's quite viscous so doesn't spill so easily... second it is a massive help with my eyes getting dry. With just saline I find my vision quickly gets cloudy as I'm not producing enough tears to keep the lens lubricated. The Hyabak drops prevent this for much longer and then when it does eventually happen, a drop in the eye will mean I'm good to go for another few hours.

I'm ambidextrous so I use the left hand to put the lens in. I've still not really done it on the right eye so wondering how I'll get on there!