Scleral Lenses in Canada?

[Aaron77]

Has anybody had any success fitting scleral lenses in canada?

I may have asked this question before, can't remember. I've had a couple OD recommended to me but as far as I know nobody that fits sclerals.

Need my night vision to improve a bit and hopefully get a bit of relief from the dry eye.

[Lucy]

Aaron, just for fun, I did a google of eye drs in Canada and here's a link if you care to look.

I also did a search for "scleral lens" and Canada and didn't really get much. If you look at the link, maybe you'll be able to some research. Lucy

http://www.allaboutvision.net/canada/

[gz9gjg]

Hello Aaron,

Be sure to check on the cost of sclerals - they are pretty outrageous. Someone on another forum told me they spent $1500 per eye for sclerals; but that was several years ago.

In 2006, my Wave RGPs cost me under $900 for fitting, follow up, and both lenses. They aren't sclerals but they do provide great vision and are comfortable.

Every OD will charge differently, and insurance coverage varies. In Michigan, I was told the cost of custom RGPs could not be covered as medically necessary; in Arizona supposedly they can.

ODs who fit sclerals will advertise they do specialty contact lens fitting, and typically mention they treat patients with keratoconus.

Good luck,

Lynne
Phoenix, AZ

[Aaron77]

In 2006, my Wave RGPs cost me under $900 for fitting, follow up, and both lenses. They aren't sclerals but they do provide great vision and are comfortable.

Thanks for the info. My wory about the RGPs is that they won't do anything to improve the dry eye pain which is why I'm interested in the sclerals, would be nice to have a little crisper night vision though.

[Lucy]

Aaron, please remember there is no guarantee sclerals or regular RGP's will help you or that you'll be able to wear them.

I'd rather go the cheaper route first and see how that worked as Lynne said. If you go and plunk thousands on sclerals and they don't work, then you have the additional stress of spending lots of $$ for nothing. I'd take a baby step first.

I have several kinds of lenses that sit in my kitchen cupboard and I'm unable to wear them. Hopefully this would not be the case with you. Lucy

[Aaron77]

Found a local (5hr drive) manufacturer of mini-scleral lenses http://www.viscon.net/

They referred me to one of their local fitters, cost would be 950/eye for a 15.8mm lens. I'll do a consult on Monday. The fitters office told me that they use this lens for people with severe dry eye.

[Aaron77]

Can anybody point out some of the main attributes that would make a scleral lens good for therapeutic use in dry eyes? Kind of worried that I'm going to get myself into another situation where I'm dishing out money for nothing to people that are'nt really to sure about what they are doing.

Does the 15.8 mm size sound adequate?

[ALK-O'd]

Aaron,

I wear a similar mini-scleral lens to the one by Viscon. I wear Blanchard's MSD lens. It is the same size (15.8 mm) and is made out of the Boston XO material as well. (http://www.blanchardlab.com/index.ph...=81&Itemid=159).

My need for the lens is primarily for vision purposes as I am a post-RS patient with bad GASH symptoms and residual myopia. But I am also a dry eye sufferer as well. I tolerate the lenses fairly well despite my dry eye but I do need to use re-wetting drops regularly (every 30 minutes or so) while wearing them. While the lenses provide me with fantastic vision, I would not say that this type of lens helps at all with my dry eye symptoms. It's more that these are the first RGP lenses that my battered eyes can tolerate for reasonable wear periods (which for me is about up to 8 hours). Perhaps you'll do better, but I personally wouldn't recommend them solely for dry-eye therapy. Mini-sclerals only trap a very minimal amount of fluid between the lens and the eye. Mine in fact are usually dry on the inside when I remove them.

[texaseyes]

Hi Aaron77,

I am a scleral lens wearer. After two separate and unsuccessful attemps with other lenses (left lens foggy, right lens never comfortable), I was successfully fit by Dr. G. the first time. He uses a technology that he invented (and has filed for a patent on), to calculate the fit of the lens in your eye. This is so important for scleral lenses, as the surface area is very large compared to conventional lenses. The larger the surface area, the more of the dry eye that is protected, and the less the lens will sink into the sclera because the load is distributed over a larger area. However, the larger the lens, the more important it is to get a precise fit, because more of the lens is in contact with your eye. A rigid lens is not comfortable when the fit isn't perfect, which is why I was drawn to Dr. G's fitting technique. It paid off for me, as it has for many, many other dry eye patients.

I think some people are under the impression that because Dr. G doesn't post on this site anymore that he isn't interested in helping dry eye patients. That is simply not the case. In fact, he has told me himself that he is happy to answer anyone's questions about sclerals. I think those on this board seriously considering sclerals are better served directly asking Dr. G, with his vast contact lens experience (he has the benefit of having fit the whole range of lens sizes, up to 18mm), rather than just thrashing around and speculating. His business is called Coppell Family Eyecare, and his website is Global Refractive Solutions - just do a Google search. Having more information will help you in your decision, and the best place to get that information is from someone who fits the lenses and is actually willing to discuss it with you.

Texaseyes

[Lucy]

Another note of importance........Dr. Gemoules has been taking care of special cases of post-refractive surgery, dry eyes, and other specialties for over 10 years and I know this personally. I also know he has helped a multitude of people over the last decade plus. He is deeply committed to the cause. He was the first, or one of the first, docs who really cared enough to take a second look and try and help fix us. Lucy

P.S. I have been examined by Dr. G early on after my Lasik, but it was only for a second opinion and not for contact lens. I was in town also being examined by another doctor. I was able to get two second opinions in one stop.

[Aaron77]

The MSD lenses I tried today did'nt do much for comfort the soft lenses helped out a bit with the vision but not so much for comfort. The optician I saw today took a picture of the debris under my flap, was suprised to see rectangular metal pieces reflecting light. Can this be the source of all my eye pain? He said he saw more debris under my right flap and this is the eye that hurts the worst.

[lboogie]

Oh my gosh....I wonder if all of us lasik people have debris like that under the flap! Good lord, it's the last thing I need to worry about. Good luck with all of the things you are trying.

[Aaron77]

Oh my gosh....I wonder if all of us lasik people have debris like that under the flap! Good lord, it's the last thing I need to worry about. Good luck with all of the things you are trying.

According to my current opthamologist everybody that goes under the microkeratome blade ends up with some metallic debris under the flap... some get much more then others...

[Rebecca Petris]

The optician I saw today took a picture of the debris under my flap, was suprised to see rectangular metal pieces reflecting light. Can this be the source of all my eye pain? He said he saw more debris under my right flap and this is the eye that hurts the worst.

What did the guy who saw it think? did he have any idea whether it was significant enough in size to do anything? Boy, I haven't read or even thought about keratome debris issues in years now but my vague memories are saying "Possible but unlikely". And I think your current doctor's comments are right about some debris being the norm. I know I have some but I've never had any reason to believe it's doing anything to me.

Aaron, is it possible you might have the opportunity to get confocal microscopy? Sometimes that can reveal things about nerves at the flap interface that could explain subsurface pain.

[Aaron77]

Aaron, is it possible you might have the opportunity to get confocal microscopy? Sometimes that can reveal things about nerves at the flap interface that could explain subsurface pain.

I'm not sure the docs still don't seem to want to put much effort into my case.

Definately have some surface issues, guess they might be the result if alll the subsiurface problems... wish I could get a more thorough examination.