My First Scleral

[Anna Mason]

I just got back from Oxford with my first scleral lens. I will be honest I am feeling very positive about it at the moment.
I have been given advice on cleaning and storing by Ben but would like some tips from some of you experienced users.
Do you use special rare saline and if you do how hard is it to come by and how do you dry your lens after cleaning?

Thanks from a fairly happy Bunny!

[John Smith]

Hello Anna,

I use Amidose saline to fill the lens itself - or the more viscous (and more expensive)Celluvisc on occasion.

As for drying for storage, I use a clean soft tissue; dabbing rather than wiping to ensure there's no scratching.

Hope this helps.

[Andrew MacLean]

Do we have any idea of how many people with Keratoconus now wear Scleral (aka Haptic) Lenses?

For some reason, unknown to me, some high street optometrists are very reluctant to dispense sclerals.

Andrew

[Kirsty Eldridge]

Hi, ive been wearing Sclerals for just over a year now. I have my good and bad days with them. I use 25ml sachets of normasol saline to fill them, i get 200 at a time on prescription. I use miraflow and saline to clean them, dry them with a soft tissue and store them dry in their case.
Hope you get on well with them! They are pretty comfy once you get used to them.
Kirsty

[jayuk]

Anna

When I had sclerals I used Amidose as John suggested....

Andrew - I am led to beleive its because of the cost, fitting expertise and the fact that high street places will not make alot out of them unless they make the lenses themselves....

J

[Lesley Foster]

In 1986 I had a scleral lens made for my left eye, I had a mould taken and the lens was made of PMMA with holes to allow the passage of oxygen. I found it uncomfortable so only used to wear it if I went swimming. Last year it was decided that I should try sclerals again as it was becoming impossible to fit me with corneal lenses. This time I didn't have to have a mould taken the lenses were "off the shelf" so to speak and are RGP, I have a large one for my left eye and a mini scleral for the right eye. I wear them for about 15 hours a day with few problems, I can even wear the PMMA one comfortably now so I alternate the left eye lenses. I use Miraflow or Boston cleaner, normal saline for rinsing and Amidose for inserting the lenses, I also use Quattro with the PMMA lens because although I don't need to fill it with saline to put it in it has to be wet, I store all of them dry. The Quattro is also used on my corneal lenses which I usually wear for about an hour in the mornings when I get up. If my eyes feel dry I use Systane to refresh them and I also use it when I remove my lenses at night.

The only real problem I have encountered with the sclerals is air bubbles, sometimes I will spend about ten minutes putting the lenses in another time they go in no problem at all.

Lesley.

[Lynn White]

Andrew...

Fitting scerals is a dying art. They were the first type of lenses made generally commercially available and they were quickly superseded by PMMA hard lenses and then soft. Because they cover the whole of the eye or a good part of it (depending whether they are full or mini), oxygen transmission to the cornea has always been an issue and the fit has to be very good to make sure enough gets through.

An experienced fitter can make sure the fit is good BUT nowadays it is such a specialist market (ie no-one with "normal" eyes would ever dream of wearing a scleral in preference to say daily or monthly soft lenses) that not many optoms coming out from the universities will ever even see one fitted, never mind become practised at it!

Add onto that the fact that KC corneas are much more tricky to fit and you are really cutting down the number of people who can comfortably fit them.

Historically as well, the last 15 years has seen the specialised contact lens fitting taken back into the hospitals, meaning the average high street optom has even less chance to practice his skills. Eventually, the costs and sheer chair time it takes up to fit them, price it out of the high street.

All of this is a terrible shame, as skills are being lost and patients are having to rely more and more on hospitals, which at the very least adds to the inconvenience of daily life!

[Andrew MacLean]

Thanks for that explanation, Lynne

I agree that this is a great shame. when I had my scleral fitted it gave me years before the graft that was already indicated became inevitable.

The scleral would not have been my first choice, but when all else had failed, it was a really good fall back before surgery. Once I got it in, the comfort was incredible, and the problem of oxygen had been solved by the drilling of a "fenestration" right beside the lens part of the scleral.

Andrew