Scleral lenses comfortable?

[prototype86]

Hi, I've been looking through this SCLERALS forum and found an interesting yet discouraging post that says Sclerals lenses cause neovascularization and discomfort

I was a patient of Dr. Cotter's and she is aweseome - no doubt about it.
I too thought that scleral lenses were a good solution for dry eye - what could be better than constant fluid on the cornea all the time?

There were 3 problems which made them unwearable:

1. If you have dry eye, it is unliekly you can tolerate a contact lense of any sort even though the scleral lens vaults over the cornea. It is still in contact with a (dry) conjunctivia - which causes persisent irritation, vessel dilation and discomfort.

2. If you have dry eye, you likley do not have enough tears to keep the surface of the lens wet. That is, your upper lids will tend to move the lens due to friction as you blink.

3. If you have MGD or blepharitis, you are likely to have increased lid irritation. Due to the size of the scleral lens, your lids are in constant contact with the lens. This contact futher irritates the lids - and for me, caused increased lid bruning and irritation.

*** You should also be concerend with neovascularization (albeit to a lesser degree).

I offer you these thoughts since I did invest a considerable amount of money and time to learn the above lessons. I'm not saying that the scleral lens wont work for you, but they did not for me and the only reason I pursed them was as a cure(patch) for my dry eye condition.

Could anyone please comfirm that scleral lenses don't cause this? I have moderate dry eyes with MGD and am about to get Scleral lenses as treatment.

Thanks
Wayne

[Rebecca Petris]

Hi, I've been looking through this SCLERALS forum and found an interesting yet discouraging post that says Sclerals lenses cause neovascularization and discomfort



Could anyone please comfirm that scleral lenses don't cause this? I have moderate dry eyes with MGD and am about to get Scleral lenses as treatment.

Thanks
Wayne

You would have to find out specifically for the type of lens being used if possible. I don't recall neovascularization being among any complications listed for Boston sclerals but I wouldn't necessarily remember. To find out specifically I'd call Boston Foundation for Sight and get the latest study results that they have, or if it's a different lens type, call the manufacturer.

As for comfort, that has to do with design and fit and other factors and will vary by patient. All I can say is mine are perfectly comfortable. I get calls at least once a week from fellow scleral wearers, usually keratoconics, who are very happy in their lenses.

[Lucy]

All I can say is mine are perfectly comfortable.

I cannot wear mine because I have not gotten a comfortable fit in one eye. That eye is the one that needs it the most. Sclerals work sometimes, sometimes not.

[kurt]

I know of a person who had dry eye pain for eight years and the first relief they got was with the BFS scleral contact. I know of another patient who had dry eye from an auto-immune disorder, but who also had hyper-sensitive scleras (unrelated to her dry eye) and who couldn't tolerate the BFS lenses very well for this reason.

[inthedark]

I tried the Boston Lens a few months ago. The people there are wonderful and sympathetic to dry eye sufferers. However, my problems with the lens were exactly the same as the three problems described above. It was incredibly irritating to have the lens in my eye, not to mention how painful doing the eyelid spread was for me.

But you don't know if you don't try. If you're in a lot of pain, I'd say it's definitely worth a shot.

[untkicker29]

I was curious about how comfortable the scleral lens would be for someone with aqueous deficiency?
I suffer from meibomian gland dysfunction, but alot of my discomfort in my right eye is because for some reason that eye does not produce as much aqueous tears. If someone is aqueous deficient, is it just assumed that they will not be able to wear the scleral lens?

[Rebecca Petris]

If someone is aqueous deficient, is it just assumed that they will not be able to wear the scleral lens?

No - in fact the earliest dry eye cases treated with sclerals were Stevens Johnson Syndrome cases, which is about as dry as it gets.