Sclerals for MGD

[Santaklauzz]

Hi everyone,

I was wondering how likely it is that scleral lenses would provide any symptomatic relief for me.
I have MGD, but my eyelids don't bother me and I have no aqueous deficiency worth mentioning.
Does anyone here wear sclerals because of MGD alone?

It's just that I don't think my MGD will be solved anytime soon although I'm trying treatment after treatment and I'm really suffering.
I'd like to get my life back on track so I can still tackle this issue without having to go through such a hell every day.
And it would be awesome to have perfect vision and no dry eyes all in one.
It sounds too good to be true and many people have been very disappointed by the outcome.
But is there a good chance this might benefit me?

There's a prominent scleral lens fitter in the Netherlands but if that doesn't work out, I'm even considering going to Boston.

[Nightbird]

Hi Santaklauzz,

I just asked my doctor the same question and he said definitely yes. I have MGD with no AD. He said he has patients with worse MGD than mine who can wear sclerals for 8-9 hours with no problem. He put me in touch with a couple of them and they confirmed it relieves their symptoms completely.

He also said he can continue treating the MGD and the sclerals won't affect it. They can be fitted so that they don't interfere with the blink reflex, which is very important with MGD. Finally he said I don't need to spend for PROSE, there are less expensive options that work as well or better for MGD. They would be about $800, total cost with fittings around $1500. So if you have a good fitter I don't think you need to make the trip to Boston. Good luck!

[Santaklauzz]

Hi Santaklauzz,

I just asked my doctor the same question and he said definitely yes. I have MGD with no AD. He said he has patients with worse MGD than mine who can wear sclerals for 8-9 hours with no problem. He put me in touch with a couple of them and they confirmed it relieves their symptoms completely.

He also said he can continue treating the MGD and the sclerals won't affect it. They can be fitted so that they don't interfere with the blink reflex, which is very important with MGD. Finally he said I don't need to spend for PROSE, there are less expensive options that work as well or better for MGD. They would be about $800, total cost with fittings around $1500. So if you have a good fitter I don't think you need to make the trip to Boston. Good luck!

This is exactly what I hoped for! You only know for sure if it's any good until you're fitted of course, but your reply gives me hope. Thanks.

I believe there have been some studie that show that MGD is more present in contact lens wearers though.
But since I'm already blessed with it, I guess that would not really matter anymore...

When are you going to get fitted? I'd love to hear your results.

[patrick]

Hi santaklauzz,

May i ask Which scleral lens fitter that is?
Visser contacts maybe?
I have an appointment there in a few weeks. I have mgd to and only slightly aqueous deficient.
Btw. My mgd is caused by refractive surgery in 2005.

Patrick..

[Santaklauzz]

Hi santaclauzz,

May i ask Which scleral lens fitter that is?
Visser contacts maybe?
I have an appointment there in a few weeks. I have mgd to and only slightly aqueous deficient.
Btw. My mgd is caused by refractive surgery in 2005.

Patrick..

Yes, Visser contacts. Apparently they have been fitting contacts and sclerals for decades.
I called them today but I needed a referral from an ophtalmologist.
I'm seeing a Prof. ophtalmologist at UZ Leuven next week. I'm going to ask her to write one.

2005, that's such a long time, suffering. I really hope you will get you some relief at last.
It's so exciting you're getting sclerals. Keep us updated en veel geluk!

[Nightbird]

This is exactly what I hoped for! You only know for sure if it's any good until you're fitted of course, but your reply gives me hope. Thanks.

I believe there have been some studie that show that MGD is more present in contact lens wearers though.
But since I'm already blessed with it, I guess that would not really matter anymore...

When are you going to get fitted? I'd love to hear your results.

I agree it's hit or miss with sclerals, you never know until you're fitted. My doc says some people only get 4 hours or so out of them, and some can't tolerate them at all. But he said if I can't tolerate them I'll know before I have to pay for them. Even if I get 4 hours a day it's worth the $1500 for me.

It's true there is a link between MGD and contacts. That's my big concern as well. It's all about the blinking. My doctor fits them so that the outside of the lens drys out and gets blurred, and that triggers the blink reflex. I think you should ask the lens fitter if they can do that for you.

I have an appointment next month for treatment and I may have my first fitting then as well. They said it usually takes 3 fittings but could be more, and they need 2 weeks in between fittings for the lab to make corrections.

Let us know if you decide to go ahead with them!

[spmcc]

I agree it's hit or miss with sclerals

That's great that you get the chance to try sclerals before you have to pay. I didn't get that option... So now I have a very expensive pair of contact lenses sitting in a drawer. I recommend that anyone interested in trying sclerals find out beforehand if you're committed to pay.

I found that my lids and facial rosacea were more annoyed by the sclerals... especially insertion. That's the main reason why they failed for me. Also my eyes didn't feel any better with them in. It could be that the saline didn't stay in the reservoir.

Good luck.

[Santaklauzz]

I believe Visser contacts in the Netherlands offers free fitting too.
I'm certainly going ahead with them. Unless a miracle happens between now and a few weeks...
I hope I will be able to use them all day, but if I can only tolerate them for say 4 hours, then it's still worth it for sports, public transport, courses etc...

[patrick]

Hi santaklauzz,

Visser contacts has a branch in the hospital where i go for my appointments with my opthalmologist.
Thats convenient! My opth has already referred me to visser and they have discussed my situation already to.
Its all on the same floor.
I haven't qualified for the sclerals yet,but i'm sure i will when they have assesed my condition.
I have been on topical antibiotics for the last 3 months and it absolutely did nothing at all to clear up my mgd.
For my opth the antibiotics were the very last resort before trying sclerals.
Like many mgd sufferers i experience the fact that most clinicians do not believe the pain i'm in! I so often hear 'your tearfilm is not that bad' well it is bad. I'm suffering a lot of pain on a daily basis for years now.
My refractive surgery was in 2005, but frankly i haven't had problems with my eyes since the very beginning.
It started about 3 years later. It is a really stealthy disorder and when you become sympthomatic it is nearly impossible to reverse the condition. Not 100%sure, but thats my experience til this point.
I also have good days. No pain at all. Never quite understood how that is possible. I enjoy those days to the fullest.

I hope for you ( and myself of course) the sclerals will offer the relief we're looking for.
However i am a bit concerned about the blinking rate with these sclerals. Its mentioned in this thread already. I really do not need the mgd to worsen due to wearing contacts. If it does i have to reconsider if i want to take this route.

I'll of course keep you and the others here updated about my experiences.
I hope you do to.

Het allerbeste! Ik hoop dat je succes hebt met het vinden van een passende oplossing voor dit buitengewoon vervelende probleem...

Patrick.

[Santaklauzz]

Hi Patrick,

I'm in the same situation. I've tried a lot of different treatments, probing, Lipiflow, allergies, cortizosteroids, antibiotics...
In a few weeks I'm going to try Restasis. If that doesn't help, I'll try Diquas. The only thing I haven't tried then is IPL.
So I'm also hitting a dead end with my treatments. Even if Restasis works, it would take half a year and I need improvement now.
I need to get my degree and it is getting increasingly difficult to study, go to classes, do group projects etc...

I know, it was very hard to find a doc who takes me seriously.
The signs of dry eye are just not that prominent in MGD patients.

I wish you good luck.

[Nightbird]

That's great that you get the chance to try sclerals before you have to pay. I didn't get that option... So now I have a very expensive pair of contact lenses sitting in a drawer. I recommend that anyone interested in trying sclerals find out beforehand if you're committed to pay.

I found that my lids and facial rosacea were more annoyed by the sclerals... especially insertion. That's the main reason why they failed for me. Also my eyes didn't feel any better with them in. It could be that the saline didn't stay in the reservoir.

Good luck.

Thanks, and I'm sorry to hear the sclerals didn't work out for you. I know that may be the case for me and I will then have to find another way to deal with this, I hope you have. Can you tell me what brand they gave you?