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  • New Scleral Lens Wearer

    I am wearing the Boston scleral lenses right now. I just got home from Boston a few days ago and have been waiting to write about my experience because I wanted a little time to adjust to the lenses first. With all contact lenses (even soft lenses) there is an adjustment period. The adjustment period with new RGP wearers is much longer than with soft lenses, especially in terms of comfort. I am definitely still adjusting to them.

    The reason I got the lenses is due to idiopathic dry eye. Most the other patients while I was at Boston Sight had dry eyes. The other patients dry eyes were due to cancer (leukemia), Stevens-Johnson syndrome, anesthetic cornea from shingles, and one lady with both keratoconus and dry eye. There was also another lady there who had idiopathic dry eye like myself. I was in Boston for a total of ten days (they do not see patients on weekends) and it took the entire time to ensure that I got the proper fit. I was fitted by Dr. Johns and Dr. Rosenthal, who are both excellent and very caring. The clinic is very nice and has a kitchen, quiet room, and media room to relax in while you are there. There is a CVS, a small grocery store, and a Starbucks within walking distance. Also within walking distance is the "T", which is public transportation to various places in Needham and Boston, etc. I spent most my time in either the kitchen or quiet room and just talking to other patients. I could not see very well and at times was quite uncomfortable with the trial lenses on, which is part of the fitting process and what you will have to wear before you get lenses made with your actual fit and prescription.

    While in Boston I stayed at the Sheraton Needham hotel and took the free shuttle to and from the clinic or caught a ride with patients who had a rental car. The free shuttle will take you anywhere within a 5-mile radius of the hotel. The Sheraton is a very nice hotel with free continental breakfast and in the evening free hors d'oeuvres on the 5th floor (not all hotel guests have access to this, but this is a perk for being patients of Boston Sight). There is a great exercise room with treadmills that have a built-in-tv (take your headphones to plug into it..the hotel has earbuds but it took me two days to get some), stairmaster, and bikes and free weights and also a heated swimming pool. They have a lot of cable channels to watch and movies you can order. They also have room service, but it is very expensive. I only ordered room service once. You can also eat at the clinic for free. You should have a refrigerator at no charge in your room since you are a patient, if not request one. If you want a microwave I am sure you will have to pay a fee. I did not have one. The Sheraton is $99/night for patients. If coming from the airport you will need to either take a taxi (about $60) or make reservations for The Airporter ($45). You can stay at a hospitality home for free if you can't afford the hotel. You will need to make arrangements for a hospitality home with Bill Rosenthal.

    In the short time I have had the lenses, I can say my attitude has changed dramatically for the better and I am not having any more burning eye pain. These lenses also have a therapeutic effect because when I remove them my eyes feel great for a few hours and better than normal when I wake up. I had some issues with clarity of vision in my left eye, but I do not know if that is due to debris getting under the lens or if it is because I am adjusting to the lenses. Dr. Rosenthal said I may need to have the plug in the left eye removed. I do not have a plug in the right eye and vision has been fine in that eye. The lenses were feeling very tight and uncomfortable at first, but today they actually are starting to feel more comfortable. I am very happy right now that I went to Boston. I will continue to update. If you have any questions, feel free to ask.
    Cause of dry eyes: Meibomian Gland Dysfunction

  • #2
    I am exited to see this post! I'm happy for you that you made the trip. It's great to have a fellow dry-eye sufferer take a step in the right direction! What exactly is idiopathic dry eye?
    Never play leapfrog with a unicorn.

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    • #3
      Hi DianaT.. Idiopathic is a medical term that just means of unknown cause. It can apply to any condition. I have no clue (nor does any doctor I've ever seen) as to what could be the cause of my dry eyes, as thankfully I am otherwise very healthy.
      Cause of dry eyes: Meibomian Gland Dysfunction

      Comment


      • #4
        Originally posted by green eyes
        In the short time I have had the lenses, I can say my attitude has changed dramatically for the better and I am not having any more burning eye pain. These lenses also have a therapeutic effect because when I remove them my eyes feel great for a few hours and better than normal when I wake up.
        Love to hear this... very encouraging and long may it continue!

        Sounds like you are experiencing exactly what I do after removal.

        Interesting about the plugged eye - keep us posted! And thanks for all the detail on the visit. Posts like yours and Erik's are so helpful to people who want to know what it will be like.
        Rebecca Petris
        The Dry Eye Foundation
        dryeyefoundation.org
        800-484-0244

        Comment


        • #5
          Question

          I wonder if the Sceleral will work on people who have lower ducts cauterized?

          Billye

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          • #6
            The sclerals should work if you have your ducts cauterized, but you may have to remove the lenses after a few hours of wear and refill them with saline depending on if enough debris accumulates in the lenses to cloud your vision. This can happen because if you have abnormal tears there is debris present. If you have excessive debris it will be sucked up into your lenses and cloud your vision. That's why some people have to remove the sclerals and refill them. The waiver you sign at the clinic states it may be necessary for you to remove and refill the lenses periodically throughout the day. Yesterday, my vision in the left eye did not cloud so I'm not sure what is going on..adjusting to them or tear quality better yesterday..very confusing. Honestly, I can't really tell any difference between my eyes and my Schirmer without anesthetic was 12 in the left eye (which has one lower plug) and 5 in the nonplugged right eye, so it wouldn't hurt anything for me to have the plug removed.
            Cause of dry eyes: Meibomian Gland Dysfunction

            Comment


            • #7
              so it wouldn't hurt anything for me to have the plug removed.
              Green eyes, if this plug is not bothering you, I'd leave it in place. Eventually, it'll come out on it's own, or you'll have it removed on purpose. Why mess with something that is working, at least this early in the game with your new Boston lens?

              Last winter, I had a foreign body in my eye and I was going crazy. I didn't know there was a foreign body, though. I went in and told the doc to remove the upper plug and look under my eyelid. Unfortunately, he removed the plug and THEN flipped the eyelid revealing a speck of sand (or similar). This simple move took a big toll on that eye. He has not been able to get another plug in there and I've been cauterized since. I don't think the cauterization healed because I notice no improvement. I am going back tomorrow to see if he will re-cauterize that upper duct again.

              After you've become accustomed to your new lens and how you wear them, then you might want to consider it at a convenient time. I just hate to see you have a plug removed "just because" and then have your tear balance go south on you.

              Lucy
              Don't trust any refractive surgeon with YOUR eyes.

              The Dry Eye Queen

              Comment


              • #8
                Hi Lucy,

                I have a SmartPlug in the left lower punctum. It is not likely that it will come out on its own because it is an intracanicular plug that has to be irrigated out. The plug I had in the right eye was just a silicone plug with a cap and that one had popped out. The SmartPlug does not bother me at all. I do not even know it is there and my Schirmer is normal in that eye (though my TBUT is not). The reason I want the plug removed is because I believe it is causing cloudy vision in my left scleral lens and Dr. Rosenthal concurred that is the probable cause. He also mentioned that the plug is contributing to a low-grade inflammation allowing the inflammatory mediators to be retained on the eye, which does not sound good to me at all. I will wait before deciding, though, as my vision did not become cloudy today.

                I hope your recauterization went well. If not, have you ever considered asking for a SmartPlug? They work really great. The doctor doesn't have to dilate the punctum and it's very easy and painless to have inserted, there is no cap sticking out and it expands to perfectly fit in your punctum and should stay put.
                Cause of dry eyes: Meibomian Gland Dysfunction

                Comment


                • #9
                  I saw my doc and he said that the cauterization was intact. So, no re-burn. My puncta will not accept SmartPlugs, or it seems now, any other kind. I'm pretty scarred in the area from multiple pluggings.

                  You explained very well your reason for having your plug removed. I'm so far into the process, my natural scarring has pretty much taken over.

                  I do have a plug or two still in place. Not sure which. Also cauterized in one and a "natural cauterization" in one.
                  Don't trust any refractive surgeon with YOUR eyes.

                  The Dry Eye Queen

                  Comment


                  • #10
                    Considering Sclerals

                    Hi I'm new here. I'm 43 and had a sudden onset of menopause a few weeks after the birth of my son in Jan. 06. In July 06, I started feeling a foreign body sensation in my right eye and saw an optomotrist who diagnosed me with bilateral dry eye. Restasis helped initially in the first 4 weeks but I started to develop acute irritation and dryness from the restasis and stopped it. I started DHEA drops which may be helping some but it's difficult to say as I've only been on it for 6 weeks and some days symptoms flare up.
                    I'm interested in sclerals because they seem to give some people symptom- free time during the day. I would like to get back to feeling better and working (I'm a pediatrician) without thinking about eye discomfort all the time.
                    I'm interested in knowing how Green Eyes is getting on with the sclerals. Are you able to exercise outside with them without panoptx glasses? How many hours per day are you able to wear them?
                    Thank you for sharing your experience and knowledge.
                    Eileen

                    Comment


                    • #11
                      Hi Eileen,

                      You havenít had dry eyes very long, so hopefully you will be able to get them under control with other methods. You mentioned Restasis and DHEA drops. Have you tried punctal occlusion? The scleral lenses are very expensive and it is a time-demanding process to be fitted with them. Most people who get these lenses have severe dry eyes or severe eye pain and/or visual problems uncorrectable by other means. However, this being said, if your dry eyes are very negatively affecting your life and your livelihood and you are still interested in them, then by all means look into it. If you are suffering badly enough they are definitely worth the relief they provide, at least to most people.

                      I have only had the scleral lenses a short time, but so far they do give me relief of the burning dry eyes while wearing them. I try to wear them almost all day (from the time I wake up until the time I go to bed), but I do fit in a few hours break midday when my eyes are getting tired from them. When I remove the lenses my eyes feel so much better than they did before sclerals. I canít really say for how long I have relief without sclerals since I have been trying to wear the lenses as much as possible, but my eyes feel tremendously better when I wake up in the morning.

                      With the sclerals I have been able to be outside playing with my children for up to two hours without any sunglasses and have no burning dry eye pain. Before the sclerals, I could barely stay outside for 30 minutes without terrible burning pain and then I would pay for it all day with my eyes feeling even worse than usual.

                      Even though my sclerals arenít perfect (i.e. I am aware of them and can feel them and feel a little disoriented while wearing them) the discomfort I feel from the sclerals is much better than the pain from the burning dry eye! If someone doesnít have severe dry eye/eye pain or severe visual problems requiring these lenses, then they may be easily frustrated over these things and give up. I have read that the discomfort/awareness of the lenses usually diminishes over time.

                      Regarding the disorientation: Dr. Rosenthal said I was one of the only patients he has ever had to get 20/15 vision from a scleral lens. He said something about the optics of the scleral lenses usually donít produce that even if you see 20/15 with glasses like I do. I believe the reason I am having disorientation is because one eye is 20/15 and the other is 20/20 with these lenses and also since contacts are right on my eyes and glasses are farther away it is also something I have to adjust to and contributing to this disorientation. Maybe I am a more challenging patient than normal and more sensitive to visual change and the lenses, but I'm not really sure since I don't have a lot of people to compare notes with.
                      Cause of dry eyes: Meibomian Gland Dysfunction

                      Comment


                      • #12
                        Hi Green Eyes,
                        Thanks for your informative reply. I do have lower punctal plugs which have not helped and may try restasis again. I know the scleral lenses are expensive but I think my insurance will cover it. If they help me, they will be cheaper than restasis and DHEA drops in the long run but without the as yet unknown side effects of restasis. Although I wish the sclerals could be a cure all, I consider them just another tool in the treatment arsenal and I would probably continue other treatments as well.
                        Let me know how your adjustment period progresses and if you come up with any more major issues both positive and negative. I probably won't be able to make it up to Boston until January. (I'm a native Bostonian and grew up only a few miles from Needham).
                        Eileen

                        Comment


                        • #13
                          How are you doing with your Scleral lenses?

                          Hi Greeneyes,

                          I was just wondering how you were doing with your Scleral lenses? How long are you able to wear them during the day? Are you able to do more things that you could not do now that you have the Scleral lenses? Did you get your prescription mix-up worked out? Keep us posted as to how you are doing.

                          Julie

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                          • #14
                            how much does sceleral lens cost?

                            I'm 25 and suffering with dry eyes since ages!!!!!!!!!

                            I live in germany, and if things get worse, I'm seriously thinking about sceral lens! not right now, but maybe later on?!

                            how much does it cost? 7000 $???

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                            • #15
                              problems with scleral lenses clouding over after about 4 hours

                              I've been wearing scleral lenses fitted in Pittsburgh, PA at the UPMC eye center for about 2 months now. It does take a lot of perseverance at first. Just getting them in the eye filled with saline is a challenge.
                              However, it is frustrating to me to find that the outer surface clouds over or tuns white where my eyelids come together after about 3 to 4 hours. I have no other choice than to remove them and let them sit for an hour or two, then scrub them, rinse them, and place them back into my eyes. Could it be mucus? I stopped wearing eye makeup and even scrub my eyelids, rinse my eyelids with saline, etc. prior to inserting the lenses.
                              Does anyone have a suggestion for me? I have sjogrens and severe dry eyes where my corneas and ocular surface was being compromised. I would find specs of debris stuck to my eyes by early evening daily without my lenses, burning redness of my eyes were very painful in addition to blurry vision.

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