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Hi Everyone. New member. Look forward to learning from the group.

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  • Hi Everyone. New member. Look forward to learning from the group.

    Hi All,

    I'm a scleral lens retread with dry eye symptoms. I'm doing the education effort, trying to become a knowledgeable self-advocate. Lots to learn!

    I had RK back in 1982. 20 cuts left eye, 16 cuts right eye. Went from 20/400 to better than 20/20 with few side effects. Enjoyed 20 years without needing correction. Normal aging brought the need for single vision distance correction. The first real signs of trouble showed up about 23 years post op when I began experiencing variable vision. Visual acuity changed throughout the day / night. Rest, hydration, activity and other factors had significant impact on my vision. Initially it was just surprising and mildly annoying. My average visual experience was functional 20/20 with single vision correction. Around 2013 I was no longer correctable to 20/20 with glasses. Vision instability had increased. I began having ghosting / shifted copies of the visual field. The multiple copies are less intense, more like shadows. They greatly impact resolution, especially monocularly. (Amazing what binocular vision and a brain can overcome!). I also started requiring help with computer and reading distances.

    The inability to achieve functional 20/20 with glasses or traditional contacts led me to try scleral lenses beginning in late 2013. I worked with a fabulous local optometry group who went above and beyond. They were successful in achieving stable vision slightly better than 20/20, but we were unable to reach comfortable wear. I could wear them for 12-14 hours, but they never "disappeared". The discomfort wasn't horrid, but after perhaps 2 hours of wear, I was wishing they were no longer on my eyes. We tried several different manufacturers, different materials, different fluids for cleaning and filling. The scleral lenses brought awareness to my dry eye issues. I'm not very symptomatic when contacts are not in play. The contacts highlight my poor tear film and minimal oil production. Tried punctal plugs, lid scrubs, warm compresses, various eye drops. All helped a bit but my overall discomfort with sclerals wasn't being solved.

    After about 2 years of scleral use, we began pondering alternatives, including corneal cross linking and PRK touch up. I consulted with an experienced corneal specialist in my area. He did longitudinal studies of my RX: very early morning, mid morning, mid afternoon, very late at night, right after a 100 mile bike ride, and so forth. I stopped scleral use before the study. The data was interesting. He felt he had a good chance of stabilizing my corneas through a combination of cross linking and PRK. The possibility was appealing but my corneal surgery history has me cautious about doing anything else to my corneas. I decided to get a 2nd opinion which led me to wait on any corneal surgery. I was discouraged. Decided to live with glasses and reduced visual acuity.

    Fast forward 4 years. Vision is getting worse. Variability is worse. Wanting a solution and curious about current technology, I went through another round of refractions and consults with optometrists and corneal specialists. My local specialists encouraged me and referred me to the Casey Eye Institute at OHSU. Short story is they aren't ready to consider corneal cross linking or PRK and feel that scleral lenses are the best option. I've had my first fitting with one of the medical contact fitting specialists at Casey Eye Institute. My initial pair of lenses arrived last Friday. Today is day 5 of wearing sclerals again.

    I'm optimistically doing my part to achieve the best experience I can. So far, I'm encouraged. The first pair of lenses provide stable vision with good acuity. Comfort isn't there yet but I'm anticipating improvement through a combination of adaption, fitting adjustments, trying various fluids and improving my cleaning/usage technique. Happy to report insertion (application ) and removal ability came back quickly.

    My current lenses are Custom Stable Elite lenses from Valley Contax. No coating. 15.8mm
    My previous scleral lens routine used lobob ESC for cleaning, Unisol 4 for rinsing and filling. I variously tried eye drops suggested by my doctor for filling or in combo with Unisol 4. Back then, ivory soap was suggested for hand washing and rinsing lenses with water was OK (never right before insertion).

    I return to the scleral scene to find chaos in the consumables. I don't see a company that's a strong contender for providing all the supplies one needs for scleral use. Coating compatibility isn't well documented. Why is it so hard to determine if a product is preservative free? Buffered vs Unbuffered? What the heck happened to Unisol 4?

    I am surprised by the minimal info I received from my scleral lens fitter and sparse initial info and supplies I received with my lens set. The one bright spot was the strong recommendation I got from my scleral lens fitter for dryeyeshop.com.

    Thank you Dry Eye Shop for your fabulous resources. You have significantly reduced my hunt for quality info on scleral lenses and related matters.

    While waiting for my first order to arrive, I'm getting by with lobob ESC for rub cleaning, Unique pH for rinsing, Clear Care for nightly cleaning and LacriPure samples for filling. I'm using Refresh Plus eye drops before, during and after wear.

    When my order arrives, I'll be using PuriLens for rinsing and ScleralFil for filling. Seems like the right place to start.

    Next fitting/inspection is Monday, May 13th. High hopes for obvious comfort and acuity improvements.

    I anticipate reaching out for advice on various "living with scleral lens and dry eye" matters. Will do so under separate subjects so others can benefit.

    Assuming I'm successful adapting to scleral lens, I need to deal with acquiring a variety of glasses to use for various purposes: computer and reading, sunglasses (with near distance help) and clear sport glasses (with near distance help). I also need to find a good solution for carrying and organizing all my vision related paraphernalia. Sigh.

    Meanwhile, I'm doing my best to practice thankfulness for potential solutions and gratefulness for all those in the same boat who have shared generously about how they are working through their issues.

    Steve
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