Question about scleral Lenses

[Gabriel]

I will be going to have a fitting done at a local Dr. here in Mississippi in two days. I had lasik done a year ago and my vision is 20/20 but unforunatly I have gotten the painful dry eye from the surgury. Does anyone here have lenses with no rx or know of someone who does? When I talked to the Dr. he said he can adjust the lenses to what ever rx is needed. I just hope all goes well. I'm feeling like I'm at the end of the rope here. He said he's never made lenses for anyone just to relieve dry eye with no other issues. For all of you out there with lenses, is there anything I should know going into this fitting to make it go best possible? Thanks.

[Eagle_39]

Hi, Gabriel. I'm guessing you are in Mississippi now, and I hope all is going well. I too have perfect daytime vision with chronic pain from Lasik. I had scleral lenses done in August of this year, and there was improvement, although the symptoms are still severe. The doc was able to adjust the vision to allow me to keep my great daytime vision. The lenses don't help me at night however.

My advice is to tell yourself that the procedure WILL help. Give the doctors the full time they need to make their adjustments. The first pair of lenses they gave me were very uncomfortable, and I could barely see my hand in front of my face! It took about 10 pairs of lenses, but they finally figured it out. I am a young individual who used to wear contacts before Lasik, so it didn't take me long to learn how to put them in, but the procedure is still difficult. It is a pain to keep up with all the different types of solutions, and going through the effort to keep them clean and put them in bubble-free in the morning. But it is definitely worth the effort, I notice about a 30-40% improvement than without the lenses.

It was also helpful to talk with some people in the waiting room that have also gone through similar nightmares. I am 2 years post-lasik, and August was my first opportunity to speak face-to-face with others who have experienced the problems of lasik.

One tip I have recently discovered: I recently went through a few weeks where I could not for the life of me get a bubble-free insertion. I was having to re-insert the lenses 3 or 4 times each to get rid of the tiny bubbles. In the morning, be sure to allow the lenses to soak for a few minutes in saline solution in the small white contact lens case after removing them from the peroxide. This allows a bubble-free insertion on the first try (most of the time).

[eyemech]

Sclerals

Just a bit of help for those looking for sclerals. Various fitting sets are available to your doctors. I feel these lenses are best fit using a set. At least that way the power can be determined pretty much on the first try. As to the power, here is the way it works. The scleral lens fits "steep" to the eye. This creates a plus tear lens that must be offset by a minus lens. Theoretically, it is therefore possible to negate the plus lens with minus power. I have only recently had the opportunity to try the really large ones 16mm and 18mm. Baylor here in Houston actually prescribes 24mm lenses. Those are just really large. I can hardly put the 18mm's in the patient's eye, so I really can't even imagine the degree of difficulty putting on a 24 by yourself. I personally think it will work with the medium size lens. Scleral lenses are the new miracle lens. I hope it proves to be the case. There are some pitfalls in that if they are too tight there will be problems. I have not posted for some time. I feel that there are many companies out there working on some additional drugs. I read the post about the acupuncturist with great interest. When I tell a patient to change their eating habits, they invariably tell me how they already eat "pretty good". I sort of doubt that pretty good is good enough. One of my patients works for an M.D. who has him on a raw food diet. Did a thirty day juice fast and still has dry eye...so it really isn't that easy even though I feel it is probably the best way to approach the problem.

[Gabriel]

Thanks for the replies. I went and had my first fitting and it was OK I guess. The Dr here (mississippi) said this was the first time he has ever fitted someone for just dry eye. He wanted to try mini sclerals first which didn't work for me and I already figured that. Next we went with 18. something and I could really feel it in the outer lid area. He said it was to flat and he could try to round the edges more. Then we adjusted the vision. First pair of lenses should be in today or tomorrow. We'll see how they feel. I'll keep it posted.

[Rebecca Petris]

Hello eyemech... thanks for your post. I wear 18.5mm lenses with no problems (typical size fitted at BFS) and most of the many PROSE wearers I know have that size or close to it.... completely vaulting cornea AND limbus seems pretty important for a lot of us. But if it were more than 1-2mm larger than that it would be a struggle for me and it's hard to imagine anyone putting in a 24mm lens.

Gabriel let us know how it goes with your first pair!!

[Gabriel]

Well I have my first pair of lenses. I put them in for about an hour yesterday just practicing putting them in and taking them out. I didn't get a chance to try them until late. Today I put them in and have had them in for about 45 minutes. So far they do seem to help with my dry eye but because I have never worn contacts there will be an adustment to the hard lenses. It does seem like something my eyes will adjust to, it will just take a little time. I have some forign body sensations and a little itchy eyes. I talk to a friend of mine and he said he had regular hard gas perm lenses for about 20 years and it took him a while to get used to them but then he didn't even notice them. I still need to put much more time into them to see how they are really going to do for me. These days you hate to get your hopes up to much. By the way these are the jupiter lenses. I think they are 18.2 with plasma coating. I go back to my Dr. in a week for a check up and adjustments if needed. Good thing is I get my money back if they don't work for me. I'll post a later review on them. But for now I will just keep praying that they will work. Cheers!

[darlenehovis]

I have worn sclera lens for 3 weeks now. This week, however, one of my lens became cloudy and no matter what I did, I could not clear it. My opthlamologist said they were defective and sent them back. Has anyone heard of such a thing? I used clear care to soak them overnight and Optimum extra strength cleaner to take the make up and oils off of them prior to soaking.

[eyemech]

I have both the 15.6 and 18mm fitting sets. What I found was that if the 15.6 stood off, so did the 18. By that I mean the edge was away from the eye in the bottom. The great thing is that the Jupiter consultants seem to have dealt with this before. They said they were changing the "outside" curves to accommodate the eye. My first set went on a patient without dry eye but just an irregular cornea. The next set is for a post RK patient. I am mostly interested in what I lovingly call "tortured" corneas. Like RK, and graft patients. It would be wonderful just to work on folks with dryness but all of mine seem to be really miserable from just not seeing. I have on order a tearlab. One thing that doctors do not actually do much of is to quantify the dry eye. Oh, sure we all put a little strip of paper on your eye and call it a test. But actually measuring the tear content and then treating the eye and remeasuring it..now that's real science. I have of course perscribed Restasis, Lotemax, Lacriserts etc etc...but its all just "I feel a little better doc.... I hope to be able to actually give you all some feedback on what actually changes the tear osmolarity.
I am really interested in the Lipiflow device. Much as I want to buy one tomorrow, I really need to hear some great testimonials and see what happens for months after.
Dr. P

[Gabriel]

eyemech, it's great to hear how you want to push the science to find relief for us dry eye folk. I hope there is something around the corner for us. I feel like everything is moving at a snails pace though. I have been wearing my jupiter lenses for a couple of days now and can only get about two or three hours out of them due to comfort. I feel they help with protecting my cornea but the edges of the lens are not comfortable and feel worse with time. I go back next week to see if my Dr can tweak them for more comfort. I surely hope so. I have heard of mini hybrids, I wonder if a someone would ever try making a full scleral with soft edges. We'll see what the future holds for us.

[Gabriel]

Well, I wore my first set of Jupiter lenses for a week and went back to the dr to see if he could tweek them for more comfort. Well he took a look at them and said the fit looks good and that he wants me to wear them for a month and come back to see him. He thinks I will get more comfort the more I wear them but to be honest they are so uncomfortable I don't even care to put them in anymore. This kind of fitting has got to be different from boston and Dr G's lenses. When I first got my lenses I asked him if I needed to put them in 12 o'clock or 6 o'clock and he said it doesn't matter just put them in. When I have them in I feel like the cornea sensitivity is much better but my lids rub so bad on the lenses it gets to a point I just can't stand it and have to take them out. I have heard of hybrid mini scleral's, I think it would be cool if someone would try hybrid full sclerals that way maybe people with the lid discomfort may be able to tolerate the lenses more. Anyway, I'm starting to give up hope on these jupiter lenses. At least I can get my money back if they don't work for me.

[Hopeful2]

Hi Gabriel,

Getting the fit right on sclerals can be tricky. You can expect to have about five different lenses made before the fit is right. I have heard that in some cases it can take upwards of ten different fittings to get it right. The lenses should not be uncomfortable. I would go back and ask for a better fitting pair of sclerals. Or alternately, you could go to someone who has easy access to the lens making equipment and get fiited. I would recommend either Dr. Gemoules or the Boston Foundation for Sight.

[Gabriel]

Hi hopeful2. Yea, I'm not sure about this Dr I'm getting my fitting from. He picked out a size adjusted the rx and thinks I just need to get used to the lenses. I'm sure this is partly true but I can't wear them longer than four hours if that long. My eye lids get so uncomfortable from the edges of the lenses. I go back to him I a week but don't know what to do about it because I don't think he wants to change the lenses. Very disappointed.

[mgshutterbug]

eyemech, thanks for adding to our knowledge, and exploring the world of sclerals. Wish we had more like you in the real world!
Maria

[mgshutterbug]

Hang in there Gabriel -

I admire you for trying out sclerals, and trying to stick it out. Sure hope it works out for you, and that maybe it would help to try a different doc as hopeful2 suggests?
Maria

[Gabriel]

Maria, I talked to Dr. G. in Texas on the phone before going to this Dr local. Because of time and cost difference I tried my local fitter just to see what is was all about. I think next year when I can get more time off work I will pay Dr. G. a visit. It would be cool if they would make full sclarals with soft edges. I've heard of other people having a problem with lid comfort. Maybe this is something we'll see in the future.