"bandage" lens vs sclerlal lense, if one fails will the other fail?

[autumnn]

Hi All! I have exhausted all of the treatments for dry eye (restasis, plugs, doxy, steriods, scrubs, tranquileyes, supplements, on and on- depressing!) and have found a doctor who has a good reputation for sclerel lenses near me who thinks (along with my out of network optometrist) that the lenses will help me....the problem of course is the cost. My insurance said that I need an out of netword authorization for them to help me with the cost, but that it can be covered....but my in network doctors think that the lens is too "experimental" and dont seem to want to give me the out of network authorization. So, right now, as I am typing this, I am wearing what they think is similar, a "bandage lens" in my left eye (o2optix). It feels terrible.

This is horrible! I am not sure how to "convince" these doctors to let me take a chance with scleral lenses....is it that they dont want to loose my business and send me out of network? They have agreed that clearly I have given the available treatments adequate time and diligence (for over 3+years) and basically said that I have to "live with this"....well, I cant. Like most of you, my quality of life has become terrible.

So, I am wondering if anyone has advice about this. Also, does a failed "bandage" lens trial mean that the sclerals will be bad too? I know that they are compleately different but I am just feeling down, yet another thing that was supposed to help didnt. uggh! I'd love some advice if anyone has some. Thanks in advance!

[Rojzen]

not at all!

Especially if your bandage lenses are soft, I cannot imagine they would be any indicator AT ALL of how you might do with a rigid scleral! I wore soft bandage lenses, by the way, for a stretch, and they were just awful. . .I couldn't keep my eyes open most of the time. . .They just added to my raw, menthol-type sensation. . .Others, though, shall have done better with these. . .

I will let our scleral lens veterans and experts here advise on how better to access the lens, and get around recalcitrant providers. . .Boston Foundation for Sight, the nonprofit developer of the revolutionary therapeutic scleral, definitely has a program involving charitable subsidies for qualified applicants, but I don't know how that works. . .Contacting them directly will get you the needed info. on that. . .The insurance coverage issues escape me, for now. . Apologies. .

There are private practitioners who are dispensing therapeutic sclerals, one of whom has been a participant here, in the past. . .But I will let the more knowledgeable among us write on that . . .I mention this only because insurance analysis might change depending on where you seek out the lenses. . .But, of course, sclerals vary across type, and the goal is to get the right one for you, if indeed sclerals are a solution for your condition.

Please share with us which eyedrops you use on a regular basis, if any. . .I am an example of someone for whom prosthetic lenses were once considered useful, but who, instead, fared much better by using high oncotic pressure drops (written about here often), developed by Dr. Frank Holly. My tear film stability was restored after 10 years of instantaneous break-up time, just by my sticking to high oncotic pressure drops for 7+ months, and not using other kinds of drops that could disrupt film stability. . .Please forgive if you know all about this, and have even written about it. . .I'm just popping in quickly tonight, and didn't look in Archives for prior entries. . .

RSVP...

[Lucy]

So, I am wondering if anyone has advice about this. Also, does a failed "bandage" lens trial mean that the sclerals will be bad too? I know that they are compleately different but I am just feeling down, yet another thing that was supposed to help didnt. uggh! I'd love some advice if anyone has some. Thanks in advance!

A failed bandage lens trial would not rule out sclerals. It also doesn't mean that sclerals will help, either. Autumnn, you're in a pickle. I don't want to dash your hopes, or give you false hope. I'm not going to address your "doctor dilemma" because only you can work on that and see what can be done.

I have had bandage lens several times on my left eye. Once after lasik (8 years ago), once more recently after corneal scraping, a couple of other times just because I asked to try it. My left eye is still mulch. In other words, it didn't fix my problems. That, however, doesn't mean it won't others. I have the Boston Scleral Lens. I can't wear the left lens, which is the one I need so badly. I've made 3 trips to Boston for fittings over the past couple of years, but still no fit. My insurance paid for one set of lens, and then the BFS charged another $5,000 for a re-fit of the left lens. Ins paid, but it didn't fit either. I have $13,000 worth of scleral lens in my kitchen cupboards.

My right scleral lens fits just fine. That eye is "perfect' compared to the left. It actually doesn't make sense for me to wear just the right because I'm in constant pain with my left eye. It was a huge leap of faith for me to finally try the BFS, but I had nothing more to try. But, I'm back where I was, minus the costs of my travels and my time in Boston. I had to try.

I'm not opposed to trying "another doctor" with whom I'm "acquainted" for another go at a lens for my left eye. Sometime in the future, though, as I have a multitude of health stuff going on. You/we have to accept the risk of failure along with the risk of success with any of this stuff.

As for insurance. This I can tell you: I did not know IF my insurance would pay for my scleral lens or not until they actually did so. I could not get a confirmation prior to ordering the lens. That is hard to do, going on blind faith (bad pun) trusting an insurance company. They would not even consider it until I actually had the lenses. This is Boston Foundation for Sight and I don't know about other providers and the insurance companies policies with them.

If you want to ask me anything else, you can PM me if you like. Lucy

[autumnn]

You guys are all so great. This forum is so darned helpful. Thank you SO much for your thoughtful responses. It is a dillema. Rojzen- I cant tolerate drops- any. I have tried them all, it seems- even dwelle and Dakrina....I can only tolerate ointment and I refuse to use that as I know it will contribute to MGD. Lucy, my insurance is the reverse....I need to get everything submitted before I go to the lens appointment- darned HMO....but, again, they would be willing to help- if the doctors make the authorizations. My in network opthamologist- the last one I saw- said that some of my meiobin glands arent producing oil and my corneas are constantly exposed.....my optometrist verified that the glands havent atrophied and no one can figure out why they arent producing oil (again, I have done the doxy, steriods, restasis, omegas, lid scrubs etc.....) the one thing I have not been absolutely stellar at is compresses- mainly because they feel like they make things worse. I will do them though, religiously, now. So, they say my eyes look healthy- just no oil....i have heard there is a chance the scleral lenses will keep them protected and moist- I guess I have to try otherwise I will always wonder.....until then- well- this is the first time I have been put on blephamide- maybe that will help....but I HAD to take the lens out....it was killing me!

[ronny]

sorry to hear you are having such a hard time, i have tried the bandage lenses, and also went to boston for the sclerals, the bandage lenses werent bad and i could tolerate them fairly easily, they were soft. the sclerals that are sitting in my bathroom closet, i never got used too, and i wore rigid gas perms for 20 years. as far as your insurance goes, i fought with my insurance company for over a month, without getting a definate answer, i finally said screw it, and went to boston. it took several months after my appointment before my insurance compant paid for half. a few months later i got a check in the mail for the other half, so you may just have to take a chance, as hard as that can be.

[Rojzen]

more detail?

Could I trouble you, Autumnn, for more detail on your intolerance of liquid eyedrops?. . .Do you get visibly inflamed (i.e. red) on instilling? or is there just pain/stinging? or is the effect a delayed one, in which you experience a worsening of symptoms some hours after putting the drops in. . .

[autumnn]

Rojzen, thank you for asking when I use drops it feels like within five to ten minutes I am bone dry, much worse than before. This is with pres free, regular preserved, antibiotics, steriods, restasis, etc. I seem to feel a lot better with nothing, which is frustrating because (of course) the worse I feel the more I try....then, when I just "give up" and do nothing- well, that is when I seem to make incraments of improvement....in fact, since this started years ago- my only remissions (which were for months) were after I gave up and stopped using anything! But, then the symptoms come back, slowly but surely and I am at square one. This is why I want to focus on lid hygine (oh, and I do okay with ointment...erythromycin was recently prescribed....ever use this?) and maybe something that isnt a drop....like the sclerals. I have been told I have the eyes of an "old lady"- nice term for a doc to use huh (this was not from the one I mentioned earlier....he is GREAT- this is from the one on my HMO). Anyway, I am only 33....but my TBUT in my left eye is 3 and my right is 5. Funny that the right eye is often OK, even with the low TBUT. The doc that locally fits the sclerals seems really compassionate- at least on the phone (he called me back once after 8pm just to let me tell him my situation!) and seems to think I am a good candidate because otherwise my eye is healthy....uggh! I am so frustrated. I have spent the whole weekend at home....the depression relating to this is getting really bad. I noticed the dog in your pic....my dogs are what pull me through, they are pretty much the only creatures that make me forget about my eyes for moments at a time.....thanks everyone for taking the time to post, I appreciate it.