Scleral Lens

[stuart]

There have been many references to Scleral Lenses but not much said about them. I have keratoconus in one eye and have had considerable trouble with hard contact lenses having had five lenses tried over nearly two years at Moorfields without success. I had double vision and considerable discomfort with them.

A Scleral lens was treated as a last resort, almost as much as a corneal transplant.

I have just had a fitting for a Scleral lens. I was a bit frightened of having this massive lens put in my eye but it was actually very comfortable without the irritation caused by a hard contact lens.

The Optometrist (I presume that is his title) said he couldn't understand why they weren't used sooner rather than later where a person had discomfort and /or double vision with a contact lens.

Although a Scleral lens is a bit more expensive than a contact lens it would have been considerably cheaper than trying 5 contact lenses unsuccesfully!

[GarethB]

Hi Stuart,

Welcome to the forum.

I know recently Sclerals have been reffered to but I must admit it does seem some time since someone was prescribed one.

It would also appear that the knowledge/ability of optoms to fit scelrals is quite limited when compared to contact lenses.

Did you ever try the soft lenses for KC, piggy backing or soft perms before the Scleral?

[stuart]

Hi Gareth,

Contact lenses are used for most eyesight conditions so it would seem the case that there would be far more optoms familiar with them. It is a pity that there are not more of them with Scleral lens experience because they would seem to be better suited to Keratoconus.

The optical part of a Scleral lens is kept well clear of the cornea whereas a contact lens is not. In my case the cornea cone meant the contact lens had to be more curved than was ideal and it slipped down on my eye with the consequence that I was getting double vision or shadowing when the lens slipped out of the visual centre of the lens.

One contact lens specialist did try a soft contact lens to see if it would help. It was much more comfortable than a hard lens, but did not help much - and that was when my eye was at just 3 dioptres of astigmatism.

I would have thought that piggy backing would be too complicated and the soft lens would be prone to damage from the hard lens. It may work though in a minority of people.

[Sweet]

This is definitely a case of trial and error as everyone is different!

I tried sclerals for about six months but found them to difficult to put in and out so went back to RGPs. Then i had so many problems with redness and overwear that i went onto piggy backing. I can cope with this so much better and now make fifteen hours painfree instead of five.

Best of luck with everything, hoping that the scleral lenses go well for you!!

[Andrew MacLean]

I loved my scleral! sure it was huge, but once you manage to get it in and out a couple of times, it has major advantages over RGP corneals.

Firstly the old problem of dist in the eye is overcome. That stabbing pain that has you rushing to et your lens out is a thing of the past.

They drilled a hold (called a fenestration) in my scleral so that air could pass to the cornea.

The sclearal extended the pre-graft life of my eye by a couple of years.

Andrew

[GarethB]

Stuart,

KC is actually the condition where contact lenses are most used.

Where optoms are mainly experienced is fitting them for vanity reasons. It is a whole other skill fitting a KC eye.

Sounds like you were tried with a bog standard soft lens which will not help.

The soft lenses for KC are much thicker and not many optoms (certainly in my area) have any knowledge of them.

Are your lenses being fitted at the eye unit of the hospital or high street optom?

If in the highstreet, it is worth enquiering how much experience they have treating KC.

[stuart]

Stuart,

Are your lenses being fitted at the eye unit of the hospital or high street optom?

As I said in my original post I have been dealt with by Moorfields over the past 2 years. I don't think you can get much better treatment possibly anywhere in the world. However they were not the ones who tried the soft lens. That was done before I was referred to Moorfields. As I am now around 8.5 dioptres a soft lens would not be much use.

[GarethB]

My astigmatism is the same and with the Kerasoft lenses, I was hitting 6/6.

The problem was that I have had grafts in both eyes and the oxygen transfer was not good for me.

Ask Moorfields about the Kerasoft ones, you might be surprised.

[stuart]

You have 8.5 dioptres after a cornea graft?

[Andrew MacLean]

Not so uncommon, Stuart.

Andrew