Scleral lens

[Pinky]

Hi all

I have been wearing a RGP lens for nearly a year, thankfully quite comfortably, after a rocky start like most KCers ie uncomfy and loosing them etc. I have not managed to get a RGP to fit the other eye though, and my optician has tried several fits, but alas the lens will not fit! I have been told by Consultant that the next step would be to try a scleral and see if i can get a better fit, also my optician says the same. I have to get referred to another hospital as they only speciliase in this type of lens.

Can anyone tell me what to expect if i go and try to get a scleral lens ie: type of examination, length of time to wait for lens, Price, would it mean various trips to the hospital to get the fit etc? I would be grateful for any advice.

Thanks.

[Andrew MacLean]

If you get your Sclerals supported by the NHS, they will cost the standard £50 (ish) per lens.

The 'feel' of a scleral in your eye is quite different to the 'feel' of an RGP corneal.

Andrew

[rosemary johnson]

Hi.
Good luck with the scleral.
The cost is the same as for a corneal lens onthe NHS - quite a bit more privately.
Where are you being referred to for fitting?
I've never been fitted with anything else, but the process with fitting me with a new scleral is roughly:
practitioner takes a look across my eye at shape of outline of eyeball.
practitioner reckons which one (or possibly two or three) are likely to be the nearest standard sizes, selects it/first preference to try.
Gets standard lens in that size out, wets it, treis it in eye for fit, normally with fluorescine (sp?) to see the tears.
practitioner takes good look at lens in eye, with orange tears. May decide this is fine, or may decide to take it out and try next possible size for fit.
when between you there's a reasonable fit, it will be "how much can you see?" and then trying with different powered lenses in front to see how good the vision can be made.
May look at eye with lens in down a slit lamp as well.
If you've never worn sclerals before, they'll also have to teach you to put them in and take them out. There is a knack to this.
DOn't worry, it gets easier.
Have never worn any other sort, so don't know how this differs.
Best wishes and I hope the scleral(s) work(s) out for you.
Rosemary

[Vic]

I've just been fitted for my first pair of sclerals after lots of trials with RGPs that never really worked. By the time I go for my appointment in a couple of weeks' time I'll have waited about 10 weeks whilst the lenses were being made for me. As the others have said, because I went through Moorfields and got them on the NHS, they were the standard NHS lens charge which is about £50 per lens. I was very lucky, when I had my initial fitting appointment I wasn't meant to have had a lens appointment that day but was actually there to see my consultant. As luck would have it that was also one of the two days per week that the sclerals team ran a clinic and they very kindly agreed to see me there and then. I think the initial appointment took about an hour and a half to fit both lenses. Don't wear a white top! The lenses are large and they fill them with fluorescein-stained saline to get them in whilst they're fitting them so that they can then look at the fit under the slit lamp, and oh boy did I throw a lot of fluorescent yellow liquid everywhere - oops! It's a not dissimilar type of examination to RGP lens fittings, except it's a very different kind of lens to get in your eye. The appointment tends to involve the usual trial of lots of lenses and viewing them under the slit lamp till they're happy with the fit, and they then look at adding a refraction / power to them in the same way that they do with RGPs. When I go back for my next appointment in 2 weeks they'll teach me how to get them in and out. I've so far been very pleasantly surprised by sclerals - even just at the initial appointment although though looked a bit scary, they felt a lot more tolerable in my eyes than any of the RGPs I'd ever tried, and if they work for me then this will be the first time I'll have had 6/6 vision in 10 years - which is a very exciting prospect! I really hope they work out for you too.

[Andrew MacLean]

VIC

Lovely to see you again. Are you up to your armpits in exams?

It really is good to know that you have a pair of sclerals that seem to be working for you. All the best.

Andrew

[Pinky]

Hi all

Many thanks for the information it was really helpful. Thank you for sharing your experiences.
I don't know if this is the way i want to go or not yet! Intacs has been mentioned too, but need to read up on this! Its not easy to know what to do for the best. Is there any order in which to try options? Is it best to try scleral before intacs!! Is it best to leave any surgical option till last?

[Andrew MacLean]

Pinky

You need to be guided by your eye-care professionals; prior to the development of new surgical procedures the wisdom was that you were best to try all the options short of the knife before taking the final step.

If I were you, I'd be asking my optometrist and my ophthalmologist whether there are any clinical indicators that would constrain an early surgical intervention before all lens options had been tried. Ask whether intacs would still leave you needing a lens, and if so what were the advantages of having intacs over not having any surgery.

When you are satisfied with all the answers you will be in a position to make your decision. The important thing here is that the decision is yours to make, and cannot be made by anybody else.

Andrew