Flippin air bubbles in scleral lens

[CARMELTHOMPSON]

Hi, I am back again with yet another lens issue! My left cornea is very ectatic and I am now on the semi urgent list for a regraft, consultant said at my last appointment that it is as bad as it can get...I am persevering with a scleral lens whilst my right eye continues to recover from a regraft, without it my vision is very limited and I can't really do much, so do rely on the lens. I get air bubbles all the time and seem to be taking it out and putting it in every few minutes! Could the bubbles be forming because of the extent of the damage to the cornea, so that any lens would be the same, or can the fit be changed to accommodate the swelling of the cornea? Any thoughts would be most welcome.

[ChrisW]

Hi there. I've had keritaconus and GPLenses for 60 years but only recently developed dry eye syndrome. Drops have stopped the pain but I'm getting serious "fogging" - especially in the twice grafted eye. My specialist has now recommended mini sclerical lenses and I've been for two visits to the clinic. However, the first person told me that I have to fill the lenses completely (as do all the Youtube sites I've looked at) or else will get air bubbles. Today I saw a different person who informed me that I don't need to fill the lenses AT ALL with saline - just put them in dry and my tear layer will fill in the gap. When I asked about the possibility of getting an air bubble, his view was that they only happen if the lens is badly fitted.

[gsward]

I have worn sclerals for many years very successfully. However, from time to time I would be troubled by the air bubble problem in regular sclerals. I did try mini sclerals once but the Optom could not anything like a reasonable fit. Maybe the minis you have tried are like RGPs where you don't fill them with saline. Although I always filled RGPs with wetting solution anyway!

Back to the air bubbles, they can either occur either during putting your lens in - is the lens completely full to the rim, and is your eye horizontal? A mirror on a flat surface can help, but better get someone to check you by watching your eye from the side. They also can happen if the saline leaks from under the lens, which is probably more a fitting issue. Because my cornea was quite 'pointed' it was always a challenge to get a good fit and sometimes the Optom would fit the lens so that it sat a little closer to the cornea than ideal.