My Scleral Fitting Experience (UK)

[SueG]

Do you know what the highest prescription that scleral scan be provided for is. I wear RGP lenses and am -26 in one eye

[Hokucat]

Hi Sue. From what I've read, there is no limit to the prescription sclerals can correct. Here's an example of what one scleral specialist said about this:

Are there any limits to the amounts of prescription scleral contact lenses can correct?

No, there is no limit on the amount of astigmatism scleral contacts can correct. Scleral contacts are an excellent option for people who have higher amounts of nearsightedness, farsightedness, or astigmatism. They can also be made as bifocal contact lenses. Because scleral contacts are stable on the eye and do not move as soft contact lenses do, they work well as bifocal contact lenses.

https://www.completeeyecare.net/eyeg...cleral-lenses/

[SueG]

I contacted a supplier and they confirmed scleral lenses were supplied for my prescriptiom so it is something to think about.

[Hokucat]

That's great, Sue. And hopefully since you already wear RGPs, you could easily transition to sclerals. Some people cannot tolerate wearing sclerals.

[CharlieGreenEyes]

Hi Sue,

Are you going to try and get the sclerals via the NHS? From what I understand from looking into it for myself (also high myopic though not as high as you, and have some additional complex vision issues) you would be eligible for sclerals on the NHS - not for dry eye but because of your high prescription.

Not sure where you are in the UK but Moorfields state they fit sclerals for people with prescriptions higher than -/+15.

[SueG]

I'm in West Yorkshire. I'm not sure whether to progress to sclerals or not. I have worn RGP lenses for over 40 years now. Up until about 2 years ago I wore them full time with no discomfort. I didn't possess any glasses. I am going to try a new preservative free solution called Regard. The manufacturer also has a rewetting solution called Reset which cleans and rewets whilst wearing the lenses. The expense of scleral lenses is a factor especially if my prescription changes or I can't manage them. On top of that I need backup glasses and the blended lenticular lenses in my glasses are expensive to start with and I need them in both distance and reading glasses.To be honest over the years I have had almost no help with the NHS. I have an ophthalmologist treating me for high pressures and a tiny amount to compensate for needing special lenses. I think it's something like £20which amount to about 5% of the cost of one pair of glasses. I also qualified for free eye tests. I have always been of the opinion that the NHS don't consider myopia to be their problem. Goodness know how people on a low income cope. I do wonder about going half way with mini sclerals but will need to look into this, (no pun intended) a bit more and also it depends how the new solutions work out. It will be interesting to find out what the NHS say to you. Keep us informed.

[CharlieGreenEyes]

I've been referred to NHS optometry with the view to getting sclerals (the hospital reviews referrals before deciding whether they consider you eligible....). If they offer me an appointment, there's a wait of several months. I'll report back any updates. Trying to decide whether I should speed things up by spending my limited funds on going privately. Because of the situation it's a struggle to work - so money is tight. But if sclerals help with my dry eye and give me decent vision I'll be able to work properly again - so it's a dilemna.... I'm considering making an appointment with the private fitter - I'll also report back if I do this and get the mini sclerals.

Perhaps eligibility criteria varies between different NHS areas - but I'd have thought your level of myopia qualifes you for NHS sclerals? Epecially as glasses don't sufficiently correct your vision and you're no longer able to tolerate your rgps. I don't know if Leeds is your nearest big eye hospital? The optometry department deals with complex fittings (including for high myopia) for both glasses and contacts (including sclerals). Might be worth calling them to ask and/or asking your opthalmologist to refer you.

http://www.leedsth.nhs.uk/a-z-of-ser...ry/what-we-do/

They don't seem to specify the exact level of myopia eligible for their fittings - but Moorfields is -15
Perhaps bring the print-out from Moorfields below stating -15 eligiblity to your opthalmologist/GP when asking for the referral.

http://www.moorfields.nhs.uk/service/contact-lens

Your high eye pressure. Have you got glaucoma? I had raised eye pressure that went down naturally (It's being monitored). If you have glaucoma and/or are taking eyedrops to lower your eye pressure, be aware that some glaucoma drops can make dry eye worse. I think you can get ones without preservatives - might help your dry eye if you ask for those.

I agree the NHS does seem to forget people like us with high myopia and/or complex prescriptions. Like you, I get NHS sight tests because of my prescription, I've worn rgps for around 25 years, and now struggle to tolerate them because of severe dry eye (which has caused repeated corneal abrasions). Like you, glasses cost hundreds but don't properly correct my vision.

It really is a medical need for us to have glasses and/or contacts. We are disabled without but when it comes to standard high street opticians (including some more expensive independents) it's pot-luck as to whether they have the expertise to deal with more complex fittings. Some do, some don't. Having additional issues - whether dry eye, raised eye pressure, and/or anything else makes things even more complicated. It doesn't help that many optician practices/stores are so focused on sales and view us as customers rather than patients. Agree with you about the £15-20 voucher. It's pretty much a waste of time considering the cost of our glasses (I've spent so much money on glasses that don't even correct my vision properly).

[SueG]

I don't have glaucoma but have drops to control eye pressure as a preventative measure. I use Monopost which is in single vials and preservative free but I know that it can still contribute to dry eye. I did consider natural lens replacement but at the final hurdle they told me that my risk of retinal detachment was very high almost certain so I pulled out.

The last lot a glasses I was prescribed by a high street chain weighed a ton, ( they had to be glass lenses as plastic would have been exceptionally thick). and also had to have very small frames so I has problems when looking down etc and going down steps. Then I found a very good independent optician and was prescribed blended lenticulars. Unfortunately the new optometrist has now sold the business and I recently saw a locum. His reaction was "You have the prize for being the highest prescription that I have treated" another optometrist in the past greeted me with "Have you brought your white stick?" Which he thought was funny. It was like being back at school and being called names, I don't think they realise that it makes you feel a freak. At least when I always wore contacts when younger I looked normal.

Leeds would be my nearest hospital so I'll check that out.

Update: checked the Leeds site and I wouldn't be eligible as my prescribed glasses bring me just within the legal limit for driving!

[CharlieGreenEyes]

That's a shame about your eligibility! I wonder if it's worth asking anyhow because your prescription is so high and the vision you get isn't really ideal with glasses.

I didn't realise that was why I had problems looking down, etc! I've become convinced there was an additional problem with my eyes - ever since I had to wear glasses more often, I've had problems with both looking down and going down steps (going up isn't ideal either but better than down). I guess it's because with such small frames we have less field of vision?

I've not heard of blended lenticulars. I think I'll ask about them next time I go to an optometrists. It really is difficult finding a good one who you can trust - who has the experience of complex and/or high prescriptions. And who doesn't make you feel like a freak....It's already a blow to the confidence having to wear unflattering glasses (those small frames really don't suit my face shape) - especially after years of contacts (I'm used to it now and my biggest issue right now is the rubbish vision with glasses but still...

[SueG]

I have a photo of my original and lenticular pair of glasses here https://glallotments.blogspot.co.uk/...-for-nose.html I had the grand choice of one frame with the glass lenses but could choose from almost the full range with the lenticulars. They are still not exactly flattering but at least they are more comfortable and give you a better field of vision - they are expensive though especially when like me you need a pair for reading as well. Strange isn't it if your appearance is causing you psychological distress you can have plastic surgery on the NHS but if it is your appearance with glasses no help is forthcoming.

[CharlieGreenEyes]

I am so grateful to you for putting me on to lenticular glasses, which I'd not heard of. Your older glasses on the left in the picture are like my current ones (in terms of thick lenses).

I hate the very poor, tiny choice of small frames for my prescription. And agree it is strange they don't take into account psychological impact. I've worn rgps for so many years until the dry eye made things difficult a few years ago. Not great for my confidence because whilst I loved some of the larger/normal size frames, the small ones are very unflattering on my face. I've resigned myself to an extent to this- but the added issue of poor field of vision and the high cost (more expensive than my rgps) makes it very frustrating the NHS doesn't give a bit more help.

Are they more expensive than the thinnest high-index lenses? I guess it's worth it (I'll have to find the money somehow) especially if I can't get sclerals. I've not heard back yet - just crossing my fingers that the hospital optometrist will agree I'm eligible for an appointment for sclerals....

Your blog is very relatable in parts. I've had similar experiences. It's appalling how some opticians can take our money despite not having suffcient knowledge or expertise to fit glasses for our prescriptions. My old optician told me nothing more could be done for my vision - apparently I would never have proper correction and just had to get used to it. It was only because I moved house and had to find a new optician that I found out there were other options - including more specialised fittings. I really think people with higher prescriptions should be given automatic access to specialist optometrists as a matter of course.

[SueG]

I think I paid about £450 for the total pair of glasses which was about the same as for the thicker lensed glasses but in the end the chain that sold me the first glasses took them off my hands and gave a refund. When I contacted them they said if I had been referred to their specialist member of staff that they could have supplied blended lenticular lenses! I started to wear RGP lenses when I was 19 and my confidence soared. My personality changed and people treated me differently.

On on another note I am trying a new multipurpose (wetting, disinfecting and cleaning) contact lens solution which doesn't contain a preservative. It's called Regard K. It's early days and my eyes still dry up when wearing lenses but I am also trying a rewetting solution called Reset which is dropped into the eye whilst still wearing the lenses. The one thing that I have noticed is that the lenses don't 'sting' when first inserted.

[CharlieGreenEyes]

I'm nervous about switching contact lens solution - I've used the same one (Bausch & Lomb/Boston) since I started wearing rgps when I was 14, but perhaps I should consider it. Right now my corneas are still too damaged to tolerate the lenses for more than a couple of hours a week if that, but hopefully if things improve I can return to part-time wear at least.

I'm still yet to see an optometrist. I really need to because the vision is so poor with my current glasses (they were bad from the start and I ended up using my old ones but they've sadly broken).

I'm just agonising over where to go. Always get told I need to see a "good" and "experienced" optometrist - but never get told where to find one in my local area. I've found one - not ideal because I would need to travel a little (but not too far). Or I could go to my local large chain. It's a franchise - and I know has mixed reviews, but my local one seems okay. Reasonable reviews online (that I can find) and they seemed to have good customer service when I spoke to them on the phone. I'm just nervous they might mean well but not have the expertise I need with complex issues. My current glasses are such a disaster I don't want to risk another bad experience (and waste of time and money).

Problem with the independent optician. Not sure it's worth the travel. These are the ones that do sclerals privately, so I'm tempted to go for more info (even if I hold off for the nhs sclerals) but I'm a bit put off because they have different availabilities depending on whether you get a private or nhs test. It makes me worry they give a less comprehensive test to nhs patients. The whole point for me of seeing an independent optician was to ensure my complex vision got tested (and glasses fitted) by an experienced optometrist. But they seem maybe too concerned with making money and sales rather than patient care.

I'm leaning towards trying the large chain nearest me first - at least it's not far to go, and if they don't seem up to the job, then just paying for a private test at the other one (I assume I'm only entitled to one nhs test even if I want a second opinion).

Such a pain just trying to get glasses/contacts - even before the added complication of dry eye!

[SueG]

I found a brilliant independent optician. Unfortunately he has just sold his practice and retired! Just hope the one that has taken over is as good!