How do I qualify for Scleral lenses??

[moni]

Hi,

My severe dry eye came on suddenly one day a couple of months ago when I was 20, I have always been very comfortable in contacts so this was very new to me. At the same time I experienced a general ill feeling with severe sinus pressure -type pain and lip sores. I have been tested for autoimmune conditions and hormones and they all come back normal, so the cause is a mystery.

I have tried punctal plugs, steroids, supplements, warm compresses... etc.. with no success, and I can barely get out of the house, I lost my job and Im going to have to withdraw from school.

I live in Houston, and I know Boston Foundation for Sight has a location here, so my question is... what makes me a viable candidate for the lenses? If you have been fitted or have some info please let me know!!
Thank you

[Rebecca Petris]

Hi moni and welcome

I think generally if someone has disabling pain from dry eye and have exhausted all normal treatment options they're going to be considered a candidate. Two months however is a very short time to have been treating severe dry eye - many drugs will take at least that long to even show if they're going to help. Why not give them a call (the satellite clinic at Baylor) or call Bill Rosenthal at the Boston clinic. They can give you better information on eligibility than anybody here can.

Meantime, can you give us more information on what's going on? What kind of pain or other symptoms? How did it start? What have you been diagnosed with? Have you tried moisture chambers (often the quickest way to start getting pain under control)?

[moni]

Hi

Well actually it has been four months, but the burning and blurred vision is so strong I can barely open my eyes sometimes. I went to various doctors who didnt take my case that seriously, until I found a dry eye clinic at my university with an awesome doctor. She told me I had a problem with my meibomian glands as she could not express any oil from them (they just look a bit red) and I am not producing enough tears.

She wanted to see if I would respond to steroids before putting me on Restasis..which I didnt.. and I dont think I can take six months of burning and depression to see if it works. Also, when she first saw me I had a lot of corneal staining and damage, and after five days of FreshKote my corneas healed beautifully, and she was astonished. So even though the are being protected, I still have the burning, dryness, pain, and blurred vision =(.
She mentioned to me the sclerals if all else fails, so here I am!

I called the Houston facility, but the person in charge of the sclerals is on vacation, so Im waiting to hear from them on Monday. :/

Do you think if I absolutely BEG them to let me try the lenses to have a chance at a normal life they would consider it?

[Rebecca Petris]

They are very sympathetic to all these issues (the practical life impact of eye pain) but at the same time they are a nonprofit and because of limited resources they have to limit treatment to those in the greatest need - i.e. those with no other effective treatment. I have no idea whether they'd accept you or not and I don't want to guess. I'm just trying to prepare you for the kinds of questions they will raise about your short history and whether other treatment options have been exhausted. There are quite a lot of MGD treatments around and new ones all the time.

What a lot of us have had to do is find other palliative measures (anything from moisture chambers to cold compresses) to get the pain under control while we're stuck in the tedious waiting game of figuring out whether a new treatment is going to help.

[moni]

I hope they let me try them... I am so depressed and hopeless, I find myself thinking of ways to overdose on drugs so I can just get it over with sometimes, it is very scary. Psych doctors just say Im exaggerating and it is probably just psychosomatic =/..
I think the worst dry eye symptom is the emotional one!

Im gonna see Dr. Pflugfelder sometime this month, I hope he can help me!

[Rebecca Petris]

I hope they let me try them... I am so depressed and hopeless, I find myself thinking of ways to overdose on drugs so I can just get it over with sometimes, it is very scary. Psych doctors just say Im exaggerating and it is probably just psychosomatic =/..
I think the worst dry eye symptom is the emotional one!

Im gonna see Dr. Pflugfelder sometime this month, I hope he can help me!

The emotional impact can be enormous and although it's hard for everyone who goes through it, it poses specially hard issues to people your age, I think. Please hang in there. And I hope you're reaching out for help on that issue too. I think a large percentage of people who have gone through this have needed treatment for depression while seeking better dry eye treatment.

Dr. Pflugfelder is one of the best-known dry eye experts in the world (literally wrote the book) so I too hope he can help you. Please take advantage as much as you can of the information on the site to prepare for the appointment so that you can get the most possible from it. Appointments with "dry eye experts" can occasionally be disappointing as they may not be able to give you as much personal time as most of us need, so preparing in advance, including faxing them information about your history, needs and goals for the appointment can be very helpful.

[moni]

Yup, and I already have a mild bipolar disorder, so this thing is dangerously sending me over the edge. I cant believe they can make heart transplants and such but they don't have decent treatments for dry eye...
I wish they could just stick people with lenses filled with liquid and send them home.. why is that so hard gosh.

Sorry for venting, Im in finals and Im having the hardest time concentrating.. Rebecca, what is the difference between the BSL sclerals and other cheaper ones? Do the cheap ones not have a liquid protection?