Boston Sclera Lens

[erinlins]

Hey everyone,

I was looking into the sclera lenses. I do not need them now but I am curious b/c i have read places that they can actually heal the epithelium along with protecting your eyes. The more protection the better if figure, so here it goes:

Does anyone have aqeous defficiency with scleras? I can wear regular contacts for about 12 hours or so even though my schirmer is still a 2. I swear my eyes produce more tears, I think the anesthitizing really messes the system up.

Does it take a lot to care for them?

Do they improve redness?

Are they comfortable?

Thanks so much for the responses!!

[Rebecca Petris]

My personal experience:

1) Does anyone have aqeous defficiency with scleras?

2) Does it take a lot to care for them?

3) Do they improve redness?

4) Are they comfortable?

1) I have moderate aqueous deficiency (don't know how much, haven't had a schirmer in ages).

2) Not more than with my older gas perms. I suppose it's more than with soft lenses but it's been awhile for me so I don't remember. Basically... I clean them with a non-abrasive cleaner and soak them in hydrogen peroxide overnight. I insert them using Unisol saline. That's pretty much it. They require special devices to insert and remove, so you have to be careful to always have those with you if you're travelling.

Some people have difficulty learning to insert and remove them.

3) In my case yes I think so.

4) In my case certainly. The most recent T6 design is especially so.

I'll answer one more question that you didn't ask, just because so many other people have asked me this: They do not protrude from the eye or look freaky like a lot of the internet pictures of scleral lenses.

[Lucy]

Does anyone have aqeous defficiency with scleras? I can wear regular contacts for about 12 hours or so even though my schirmer is still a 2. I swear my eyes produce more tears, I think the anesthitizing really messes the system up.

I have aqueous deficiency as my main problem. My schirmers under controlled conditions with anesthesia were 1mm left eye and 2-3mm right eye. I got Boston Scleral Lens almost two years ago and have been unable to make a successful wear of them. I've had one trip for consultation with two additional fitting sessions a year apart that just has not come up with something that will work on my most problematic eye.

I've had Sjogrens diagnosis since I've had the lens among other eye problems (not caused by the lens).

Question: since you can wear regular contacts for 12 hours, why are you looking into lens that cost $8,000? Just curious. You also must make a trip or more to Boston. Maybe I missed the reason you'd need the BSL.
Lucy

[painintheeye]

What's the new T6 scleral lens design?

rebecca,

you mentioned the new T6 lens design being more comfortable. can you elaborate on that? is it a new material or a new lathing technique or whatever it maybe?

chris c

[diggylove]

to Rebecca re: Doheny for BSL

Hello Rebecca...you met me at the Dry Eye Conference...I now have the Panoptyx; thanks for the thumbs-up. I have since been to Dohehy Eye Institute at USC where the BSL is now being fitted...however, Dr. Yiu there abruptly dismissed me as "not serious enough to consider" for the lens...something about having no corneal damage. How bad do you have to be if you're in extreme discomfort from constant burning? The Panoptyx help in limited situations, but I suffer terribly. I would like to give the BSL a try...can a patient insist on a fitting? Do you have to meet some kind of criteria being considered for them? Why wait until I am totaly non-functional? I have tried just about everything else except for the autologus tears...currently 2 plugs (no help)...4 plugs caused infection...Restasis (nothing), etc...steroids are not recommended for me due to somewhat elevated pressures. This is ruining my life, jeopardiing my job, causing extreme depression. I have both MGD & aqeuous deficiency...barely no tear film. I see the BSL as a ray of light at the end of the tunnel. How do I get the doctor to agree? I waited months to get in...& am quite dismayed.
Thanks...Susan, age 60, in So. Cal.

[VirginiaDryEye]

Insurance issue?

I've had the same question regarding scleral lenses. My doc said I'm not nearly bad enough to qualify. However, I think it's that he's advocating my insurance company.

But, what if the patient is willing to pay out of pocket. Sure, it's expensive, but for some; it might be worth it.

Dave

[diggylove]

getting an MD to prescribe the Boston lens

It is unusual to hear about a man with dry eyes, yet I know there are many out there. The lens sounds quite amazing if you can handle the cost, & you turn out to be a candidate based on extensive testing/fittings. The only 2 places I know of that fit the lens are in Boston, & at Doheny Eye Institute at USC (quite near me). Where are you? Like you, when I went to see a doctor who fits them (at SC)..which was after a long wait to get in...he basically tossed me aside, saying my eyes weren't nearly bad enough (no corneal damage). Do you have to wait to have damage to be fitted? My actual eye doctor thinks my eyes are extremely dry...not damaged per se but showing lots of wear & tear (when stained). Plus, I suffer terribly from dryness/burning. Oh well, I guess it may indeed be a last resort by today's standards, but perhaps it will become more mainstream in the years ahead. I hear there now several "imitations" of the Boston lens on the market, if you can find them. Even the sound of it sounds comforting: a bandage for your eyes. Good luck to you! Share anything you find.

[Lucy]

Just a note to say that not all fitted with the Boston Scleral lens, or probably any lens for that matter, is successful. I've made 3 trips to Boston and have the lens sitting in my kitchen cupboard. I was a viable candidate, but can't stand the lens over my worst eye. Sometimes hearing about this "miracle" just gets people in a dreaming mode. If they told you at the clinic you were not a good candidate, this is likely the case. They don't like it either when they fit lens, get paid and the patient is not happy. Lucy

[diggylove]

more of the story...

That is good to know...I just took exception with the doctor, who I waited a long time to get in to see. He basically didn't even think my eyes were all that dry, as he tossed me a sample of AzaSite & 2 packets of OsuSoft wipes, & said "use these"...& quickly dismissed me...after countless prior doctors said I was very, very dry. And...this was not the first time I went to see this doctor...I had previously seen him 3 years ago but decided to give him a 2nd (hah) chance...very unimpressed. But I had heard that he was familiar with the Boston lens...that was why I broached the subject with him...he said I have no corneal damage, period. Do you have to wait to have damage? He was less than helpful on this topic of much interest to me. Talk about having a terrible bedside manner!

[Lucy]

Diggy, I can understand how you feel. How you thought you found a fix, or possible cure and it was not to be. The doctor(s) were trying to let you know that the lens probably would not work for you. At a cost of $8,000, they just can't lightly make these lens for those who simply want them.

It is for your own good they are being careful. It may be hard to accept. Something similar is patients who want Lasik so bad and the doc tells them they are not a good candidate. Well, they just want this "miracle" no matter what, it can't be worse than wearing thick glasses. They shop for a doctor and sooner or later, they will find one who will find a reason to do the Lasik.

Getting lens is not like having surgery, but I'm using this as an analogy. I do hope you find some help with your eyes. (I probably do know who "he" is.)

Lucy

[Rebecca Petris]

He said I have no corneal damage, period. Do you have to wait to have damage?

A substantial proportion of people who have severe tear film related ocular surface pain have no corneal damage, period. BSLs are frequently dispensed for people who have no corneal damage (I am a good example, in fact). The bottom line with patient selection for BSLs is severity of disability & quality of life impact, not just absolute clinical signs. Hopefully anyone involved in fitting these lenses for BFS is aware of this.

However, it's also important to bear in mind that BFS is a nonprofit and can fit a limited number of folks so it's natural that those with severe vision disabilities (such as from keratoconus) or whose corneas are in imminent jeopardy of vision loss like in some transplant cases, SJS, etc, will be considered "slam dunks" while dry eye just isn't always because the probability of being able to help a dry eye patient sufficiently, without unacceptable tradeoffs is just plain lower than for the vision & decimated-cornea type cases.

Talk about having a terrible bedside manner at a topnotch eye facility.

Thank you for not naming names - we really don't want to get into that kind of thing here. I have a little suggestion for you if you feel like going to the trouble. In fact this is for anyone who feels that the severity of the pain they report is being dismissed by an expert on the basis of absence of corneal signs:

Download the abstract at this link and email or fax it to the doctor.

[mrdibbler]

BSL in UK?

Any chance that Boston Scleral Lenses will have a UK base anytime soon?

In other words is there anyone in UK who will do a similar service.

Just curious.

Regards

Angelo.

[RCK]

re: UK

Don't know, check with Anita at BFS. If can get to US, Angelflight and hospitality homes can help with transport and lodging, free of charge (really!, no catch!). Happy to provide more info.

Rhoda