Inserting sclerals

[carmel]

Hi
I've been trying to use scelerals for 6 months with mixed results. The left one, always gets air bubbles when I use saline and it takes forever to get it in correctly, and the right can be uncomfortable and needs re-inserting throughout the day. My specialist has suggested using a gel for the left rather than saline, as this will prevent bubbles, but the vision is blurred and my eye stings. I also think I have air bubbles! I am at the point of giving up, and I feel very very low, I really wanted the lenses to work but I don't know what I am doing wrong. Any help would be we;come. Thank you!

[Anne Klepacz]

Hi Carmel,
I'm moving this post to the general discussion forum where I hope more people will see it. And you'll see you're not alone in asking questions about sclerals.
Good luck,
Anne

[gsward]

Hi,

It's really hard trying to give advice on a forum about how best to insert sclerals. I'll try. It is something that gets better in time.

Do you get one large bubble or a series of small ones? It is possible that the fit of the lens is different and one lens has a larger gap between the lens and the cornea. It's also possible that because you get bubbles in the left and maybe not the right is down to technique.

Here are some tips:

1. Relax, don't try too hard and if it is not going well, give yourself a rest for a few minutes.
2. For the left eye hold the lens between the thumb and first finger, fill to the rim with saline.
3. Lean forward so that your eye is horizontal (it's further than you think and someone watching you may be able to tell you when you are far enough over).
4. Now pull the upper lid back with the middle finger of the right hand. (It will be coming over from your forehead.)
5. You should be looking straight down (possibly slightly towards your nose.)
6. Slowly move the filled lens onto the cornea, keeping it still, allow the upper lid to slide over the lens.
7. Keep the lens in place whilst you slightly ease the lower lid downwards (right-hand middle finger again) so that it slips over the bottom edge of the lens.
8. You're done!

For the right eye, hold the lens between the thumb and forefinger of the right hand.

If you attend Moorfields, they do have nurse/technicians available to guide and practice your technique. So wherever you attend ask.

It isn't unusual to take the lenses out several times during the day and a chance to change the saline.

I have not experienced using gel, but I am not surprised you don't get good visual results. However, some scleral wearers do find putting a couple of drops of a viscous eye drop (e.g. Celluvisc) before the saline does help and can reduce bubbles.

If you have been wearing the lens for some time and they are still uncomfortable it suggests the fit needs reviewing. There is a lot of skill in getting the fit right (and probably a bit of magic sometimes).

[brian-ire]

I would echo all of the above, it's can be a frustrating experience at times but it's been by far the best lens I've ever had.

Even after ~15 years of inserting sclerals I've had occasions where I've found myself in that cycle of struggling the more stressed and annoyed I got.

[gsward]

I would echo all of the above, it's can be a frustrating experience at times but it's been by far the best lens I've ever had.

Even after ~15 years of inserting sclerals I've had occasions where I've found myself in that cycle of struggling the more stressed and annoyed I got.

I agree, that's what I learnt, hence my comment about "relax" especially when it's not going well. I have also on occasions backed off the wearing time on one lens or the other and even given one eye a complete rest for a day at the weekend.

[carmel]

Thanks for the replies, I am trying to take things slowly and not stress! I will persevere because I have little choice, I appreciate the support.

[GrandPaClanger]

I use preservative free celuvisc 0.5 % it is thicker than saline and helps with both dry eye and mid day fogging. Vision is ok not blurry