Many people can’t wear standard contact lenses. This is especially true of patients with severe dry eye syndrome, keratoconus, irregular astigmatism, among other conditions.
That’s why eye doctors often prescribe scleral lenses to such patients. These specialized rigid, gas permeable contact lenses have a very wide diameter and extend over the entire corneal surface, making them effective and comfortable for people with irregular corneas.
At first, some patients may find scleral lenses to be difficult to insert and remove. However, after some practice, you’ll find it easy to care for your sclerals!
Safety and Hygiene for Scleral Lenses
Handling scleral lenses incorrectly can increase your risk of eye infection. Additional risk factors include improper lens cleaning, poor hygiene, and smoking. Therefore, it’s important to follow your eye doctor’s instructions on how to handle your lenses hygienically.
Before handling, inserting, or removing scleral lenses, make sure to:
- Always wash your hands thoroughly with non-oily soap or antibacterial-based pump soap and dry them with a clean lint-free towel or paper towel.
- Sit at a desk or table and place a lint-free cloth down to insert and remove lenses. Avoid bathrooms, as they often contain more germs than other rooms in the home.
- Inspect your lenses for chips or cracks and protein deposits on the lens surface. If you notice any defects or are unsure whether your lenses are damaged, don’t wear them until your eye doctor has inspected them.
How to Insert Scleral Lenses
- Remove your scleral lenses from their storage case and rinse with them with saline. If you're using a hydrogen peroxide solution, wait at least 6 hours from when the lenses were placed into the storage case for the solution to neutralize. Always rinse with saline before placing the lens on the eye.
- Either place the scleral lens between your middle, forefinger, and thumb — known as the tripod method — or secure the lens to a suction tool (plunger) supplied by your optometrist.
- Fill half the bowl of the lens with preservative-free saline solution to prevent air bubbles from forming between your eye and the lens. Insert the lens directly onto the center of your eye in a facedown position.
- Dry and wipe your lens case with a tissue and leave the case lid off to air dry.
How to Remove Scleral Lenses
There are two methods to remove scleral contact lenses: with your fingers, or with the aid of a plunger. First, to detach your scleral lenses from your eye, press firmly with your finger on your bottom eyelid just below the edge of the lens, then push upwards.
Method 1 - Manual Removal
Insert a drop of preservative-free saline solution or artificial tears to loosen the lens.
- Look down onto a flat surface (a mirror or towel can be placed there).
- Use your middle finger to open your eyelid wider than the lens diameter.
- Apply pressure to the middle of the lid — as close to the lashes as you can — and push down on the eyelid to move your eyelid under the lens and lever it off the eye.
Method 2 - Suction Tool
- While looking at a mirror in front of you, hold your bottom lid open. Wet the tip of the suction tool to allow for better adhesion and attach it to the bottom of the lens.
- Using the suction tool, remove the lens by tilting the lens up and out of the eye.
How To Care for Your Scleral Lenses
The number one rule in contact lens care is always to follow the professional advice of your optometrist. If you need any clarification, always contact their office first.
Never ever use tap water in any area of lens care, whether to rinse or fill your lens case. Tap water contains a multitude of dangerous microorganisms, including acanthamoeba, that can cause a severe, painful, and sight-threatening infection. Be sure that your hands are fully dry after using a lint-free towel prior to handling your lenses.
Remove Before Going to Sleep
Most people can comfortably wear scleral contact lenses for up to 12-14 hours at a time. Approximately an hour before going to sleep is the best time to remove the lenses. If your lenses fog up in the middle of the day, it’s best to remove them and try various methods to clear up the fogginess before reinserting.
Use a Peroxide Cleaner
You can sterilize your scleral lenses by immersing them in 3% hydrogen peroxide. Over a period of 6 hours, the catalyst in the case transforms the hydrogen peroxide into water and oxygen gas. This gives your lenses a deep clean and removes the need to rub them, thus decreasing the risk of accidental breakage. Do not use the lenses until they have been immersed for 6 hours, as the un-neutralized peroxide will painfully sting your eyes. Leave the lens case to dry when not in use.
Use a Filling Solution That Is Preservative-Free
When inserting scleral lenses, use unpreserved sterile saline solution by filling the bowl of the lens upon insertion. Don’t use tap water or a preserved solution as these can lead to an eye infection.
Remove Debris Using Multi-Purpose Lens Solution
Once you’ve thoroughly washed and dried your hands, remove your scleral lenses and rub them for 2 minutes in a contact lens case filled with saline solution. This effectively removes microorganisms and deposits, lowering your risk of infection. While scleral lenses are strong, too much force or an incorrect technique can cause them to break.
After rubbing your lenses, thoroughly rinse them using the solution for 5-10 seconds. Then place them in a case filled with fresh solution and leave them to disinfect for at least 4 hours.
Routinely Clean and Replace Your Lens Case
Regularly clean and replace your lens case to prevent infection due to bacterial contamination.
It is recommended to clean the storage case on a daily basis and to replace it monthly or as advised by your eye doctor.
Your optometrist will recommend when to get a new pair of scleral lenses, and will advise you when to schedule follow-up appointments. Failure to show up for scheduled appointments can compromise the lenses’ efficacy.
At Ala Moana Advanced Eye Clinic Scleral Lens and Keratoconus Center, we can recommend the best wearing schedule for your contact lenses to ensure the highest level of comfort and visual acuity. Always follow the instructions provided by your eye care professional. Call to schedule an eye exam and a scleral lens fitting today.
Ala Moana Advanced Eye Clinic Scleral Lens and Keratoconus Center serves patients from Honolulu, Kapolei, Waipahu, and Kailua, all throughout Hawaii.
Q: Why do I need to use preservative-free solutions to fill the lens?
- A: Long-term exposure to preservatives can cause corneal toxicity or sensitivity that results in irritation and redness.
Q: How long do my application and removal plungers last?
- A: Plungers should be replaced every 3 months, or sooner if necessary.