Aqueous deficient and MGD experience with the Boston Scleral Lens

[YGB]

I know that I am not ready for the Boston Scleral Lens (BSC) at this point, but I am curious to know if anybody has tried the BSC who is both aqueous deficient with MGD/inflammation.

I know Rebecca is not aqueous deficient and has had success with the BSC. I believe Erik was aqueous deficient (I'm not sure about MGD) and the BSC gave him some discomfort. I'm not sure about others.

I think I have read on two separate posts that it may be difficult to wear the BSC and be aqueous deficient since the eye needs some of its own lubrication to avoid discomfort between the lens and the eyelids (especially if they are swollend MGD lids). At least I think I've read this. I've read so much that it's hard to keep up sometimes. Hopefully some folks can shed some light on this question based on their experience. Thanks.

[Lucy]

I would fit the aqueous deficient for sure. I also have MGD. If you want to talk to me, give me a PM on this. I do have the Boston Scleral Lens.
Lucy.

[Silverlady]

Me too

Lucy,
I'm interested in this also. Can you discuss it on the forum?
Billye

[Rebecca Petris]

I know that I am not ready for the Boston Scleral Lens (BSC) at this point, but I am curious to know if anybody has tried the BSC who is both aqueous deficient with MGD/inflammation.

I think that describes many patients treated with sclerals including Phillipp who used to be an active participant here.

I think that Erik and I are not necessarily good representatives of what sclerals are or aren't good for. I'm different from others here in that vision is my highest motivating factor, and Erik had explained that his need itself has changed due to increasing success with other treatments.

It is true that the lens top presents challenges, but I'm not sure it's clear whether that the balance of aqueous vs lipid deficiency is going to be a predictor of success. Each situation is unique. For those of us who are successfully fitted, probably each one of us has a very different regimen of what they need to do to make it work, including frequency of re-filling, lubrication over the top, and protective eyewear to keep the top surface from drying out.

[YGB]

Thanks Rebecca. You are more knowledgable on dry eye than any MD I have ever spoken to. Also, your answers are logical (kind of like an "oh yeah ... that makes total sense").

[Rebecca Petris]

Very kind of you to say, YGB. Of course I'm ignorant as a stone on the actual medical details - I do wish sometimes that I had some relevant background. The only thing I have going for me is this: I get to sit back and watch all these diverse people writing and talking about their eyes month after month, year after year, and in those circumstances you simply cannot help but start to see patterns emerge. I guess pattern-gleaning is my pastime.

[YGB]

Rebecca - I believe your post accurately describes the concept of "book smart" versus "street smart". We go to the MD's and get "book smarts", but we come to this BB to get "street smart".

In the world of DES, I have learned in an all too painful way that it is better to learn all you can from those that are street smart than to solely rely on those that are book smart.

[Lucy]

It is true that the lens top presents challenges, but I'm not sure it's clear whether that the balance of aqueous vs lipid deficiency is going to be a predictor of success. Each situation is unique. For those of us who are successfully fitted, probably each one of us has a very different regimen of what they need to do to make it work, including frequency of re-filling, lubrication over the top, and protective eyewear to keep the top surface from drying out.

With people from this board going to Boston just recently, we should have some sort of consensus of how the lens will work/does work for dry eyes. Certainly not in a case study sense, but in the few cases of us who actually have the lens, with others following.

This is not rocket science. You either get the lens or you don't. I doubt if anyone will say they are 100% yippee better because of the lens. You are either going to be able to wear the lens comfortably, or not. You may wear it less than comfortably - which is likely to be the case. What simply we may need to do is say how the lens has/has not helped us and I think the very few of us using the lens have done that. We cannot give our "testimony" as a guarantee of anything.