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  • Scleral Lenses - definite success, but was hoping for better vision

    Hi, everyone - I just wanted to write a post to let everyone know about my recent experiences with scleral lenses, since there still seems to be some amount of hesitation and controversy in the medical industry around their use as a treatment for dry eye. I also want to compare my experience to those of other scleral lens users.

    First of all, a bit about my background - I'm 32 and have been suffering from dry eye for a little over 4 years now. I've tried everything from compresses to Restasis to flax seed/fish oil, among many other things, with varying levels of success but no real relief. I work at a computer all day, and some days it's so bad that I can only squint at the screen. It wasn't until I finally obtained insurance through my work and was able to go see a specialist at Oregon Health and Sciences University (in Portland) that I found out about scleral lenses. The same doctor also put me on a course of Restasis and Lotemax (steroid drops) together, which worked wonders. But it was the scleral lenses I was really excited about - I used to wear contacts all the time, and I had resigned to wearing glasses for the rest of my life after the dry eye started. A contact that could both relieve dry eye and correct my vision - it seemed too good to be true!!

    So I went to see the contact lens specialist, and began trialing my first pair about a month ago. That first pair was such a strong vision prescription that I was unable to focus on anything beyond 4 feet or so away. I had to take them out to bike anywhere (which is how I get around) and could really only wear them at work while on the computer. However, there was a drastic improvement in my dry eye symptoms. I should note that the steroid/Restasis course had been over for a couple of months by that point (after which my symptoms started to ramp up again), so there's no way I was confusing the relief from the scleral lenses with relief from the drops.

    I told the lens doctor about the trouble with the prescription, and he explained that it's difficult to correct for both distance and close range simultaneously with scleral lenses, although I didn't entirely understand the logic. Since close range is more important for the majority of tasks, he said, close range correction is the priority. But he did order me a new pair which he said should correct my distance vision a bit, and they're definitely better - but still nothing like the correction I get with my glasses or my regular contacts. Biking is a little harrowing, and I would never dream of driving in them because I wouldn't be able to read street signs.

    The relief I get from them (considering the fact that I don't rely on driving to get around) makes the decrease in vision 100% worth it - I can wear them pretty much all day, work at the computer comfortably, and not worry about being around blowy air or heat vents any more - but I do hope to make one more try at improving my vision a bit more.

    Has anyone else had a similar experience with scleral lenses? Do you find it's been difficult to get the vision you expect with them?

    Bottom line - for anyone who's on the fence or has been dissuaded from trying sclerals by your doctor - I would DEFINITELY, definitely recommend at least trying them. They're expensive (mine were about $590 after insurance, plus about $400 for the fittings and adjustments) but you'll never know if they work until you try, and the relief you get could be invaluable. Mine have already changed my life, and that's with a hit to my vision.

    Thanks for any comments and similar stories you'd like to share - and good luck to all of you! It's a miserable condition...
    Elena

  • #2
    This question may be dumb, but wouldn't it be better to correct for distance and use reader glasses for closeup without removing the lenses - or would that not work?

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    • #3
      Hi elena, your sclerals have not been adjusted properly for vision it seems. May I ask you what diameter your sclerals are eg; 18mm ?

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      • #4
        Originally posted by elena View Post
        Has anyone else had a similar experience with scleral lenses? Do you find it's been difficult to get the vision you expect with them?
        My sclerals were Rxed for driving/distance (~+2.50), but for reading I need ~+3.50. So I had to use readers on top of my sclerals.

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        • #5
          Scleral lenses have given me my life back

          Originally posted by DCRdryeye View Post
          Hi elena, your sclerals have not been adjusted properly for vision it seems. May I ask you what diameter your sclerals are eg; 18mm ?
          Hi, everyone - I wanted to come back and update this thread. Sorry a couple of you asked questions I didn't answer - in response to the question about what diameter my sclerals are, I actually don't know. They're very small in comparison to some of the photos I see on the internet. My right one is slightly smaller because of a pinguicula on my sclera at the edge of the lens.

          So, to update my story: although the doctor became increasingly reluctant to keep trying different prescriptions, since it was a very small shift in prescription each time, I finally managed to find the levels that properly corrected my vision. My left eye is still a little out of focus, but my right eye is good enough that it makes up for it.

          More importantly, scleral lenses alleviate my discomfort almost 100% when I'm wearing them. Since I started wearing them back in April, I feel like I've been given my life back. I used to dread going to work, and I would look on future social occasions with apprehension rather than joy because all I could think about would be that my eye pain would be constantly distracting me from having a good time. Now I can work all day at the computer with no discomfort. Sometimes the lenses themselves dry out, but a few preservative-free drops in each eye takes care of that. I feel like I can be just as excited and carefree as I ever was about social engagements, meeting friends after work, watching movies - everything that I ever enjoyed doing before. I don't worry any more about whether an event that I want to go to will go too late at night for my eyes to bear it. My description might make me sound like I go to a lot of late-night parties, but it's really more that at 32 I still want to be able to be able to be socially spontaneous and not feel like I can't join my friends in activities just because my eyes hurt. Scleral lenses have helped me regain my spontaneity.

          My eyes do still hurt when I'm not wearing the lenses - mostly when I go to bed and then wake up in the morning - but I'm still on Restasis and since those are the times of day when I put the drops in anyway, they help mitigate the discomfort when i don't have the lenses in.

          I know this isn't a guaranteed outcome for every individual - my doctor was very careful to warn me about the range of efficacy that could be expected. So I feel like I'm extremely lucky to have been granted this amount of relief. But the reward is so great that I would encourage anyone who hasn't tried them yet - and who can afford them and isn't in some other way averse to lenses - to give them a try. I tried so many other methods without success before this that I genuinely believed I would suffer for the rest of my life. Scleral lenses have literally changed my life. I hope my experience brings some hope and encouragement to some of you out there.

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          • #6
            I went for a consult regarding sclerals today and he told me that being far sighted with astigmatism was a bad combo and that he could correct one or the other but not both at the same time. I opted for the distance correction and will wear readers for closeup work. The bad news is that the lens clouded up with oils within a minute of insertion so I am not sure that I am going to be able to wear them...sigh...F/G

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            • #7
              Originally posted by farmgirl View Post
              I went for a consult regarding sclerals today and he told me that being far sighted with astigmatism was a bad combo and that he could correct one or the other but not both at the same time. I opted for the distance correction and will wear readers for closeup work. The bad news is that the lens clouded up with oils within a minute of insertion so I am not sure that I am going to be able to wear them...sigh...F/G
              Ooh, sorry to hear your experience is a bit complicated. Turned out the reason my vision was so difficult to correct was because of astigmatism as well, but I'm near-sighted, not far-sighted. In the end I was able to find a prescription that corrected well for both, which I think the doctors regarded as lucky. As to the clouding, I had the exact same problem the first few days of wearing them, and found myself taking them out and cleaning them a couple of times a day. It may well be due to some minor error or clumsiness during insertion, which would explain why mine stopped clouding after the first week or so as I got better at putting them in. If you've already got the lenses in hand, keep at it and don't give up! Do you at least feel like they give you some relief when you have them in?
              e

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              • #8
                Originally posted by elena View Post
                As to the clouding, I had the exact same problem the first few days of wearing them, and found myself taking them out and cleaning them a couple of times a day.
                e
                I am actually really glad to hear that. What I had today was a trial insertion and after it clouded he took it out, cleaned it really well then reinserted it. The same thing happened. He said that the actual lenses have different coatings so I am hoping that makes a difference. The other thing is it could be oils from the copious drops that I use which I won't need so many of once the cornea is protected. Maybe that is why your cleared up after a few days when you weren't using so many drops. Thanks for the encouragement....F/G

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                • #9
                  Originally posted by farmgirl View Post
                  I am actually really glad to hear that. What I had today was a trial insertion and after it clouded he took it out, cleaned it really well then reinserted it. The same thing happened. He said that the actual lenses have different coatings so I am hoping that makes a difference. The other thing is it could be oils from the copious drops that I use which I won't need so many of once the cornea is protected. Maybe that is why your cleared up after a few days when you weren't using so many drops. Thanks for the encouragement....F/G
                  Yeah, that could totally be the reason too. It might even have something to do with your eye reacting to having a weird hard object in it. In any case, I really hope yours end up working out for you. Keep me posted!
                  e

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                  • #10
                    Several things came to mind reading this thread. First, I agree that if you are limited to one or the other, get corrected for distance vision and wear readers when you need to.

                    That said, you could be fitted for monovision, that is distance vision in one eye and near vision in the other. Happens all the time with regular contacts, and when correcting for LASIK for that matter.

                    Finally, there is a multifocal hybrid scleral on the market. It's called SynergEyes Duette Multifocal if I recall correctly.

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