Scleral Lenses with vision correction?

[Susie28]

Hello everybody!
I'm from Germany and I've been reading the articles in this forum for several month.
I have severe dry eyes. I've seen a lot of doctors, but no treatment did help. (I've tried plugs, restasis, autologous serum, tranquileyes, drops, lid hygiene and so on)

Now I think only sceral lenses could help. I've read the articles about theses lenses in the dry eye talk, but I've still one (perhaps stupid) question:

Can I get the scleral lenses with vision correction? I've -8,0 diopters and it would be a nice side effect if i would not have to wear glasses any more

This would be quite perfect for me:-)

Can you help me and answer my question?
Thank you very much!!!

Regard from Germany,
Susie

[gz9gjg]

Hello Susie,

Yes, scleral lenses are available with prescription.

I wear custom Rigid Gas Permeables which are smaller than sclerals, about 12 mm diameter. My correction is about -5 in each eye. I had LASIK in 2000, and had myopic regression sinced then. Even though my eyes are rather dry, I have been using the custom RGPs since 2002 with great success.

I think rigid lenses like mine, or the larger diameter scleral lenses, are quite good for people with dry eye problems. The lenses hold a pool of tears against the cornea, keeping the cornea surface moist. The lens material does not contain water, so the lenses won't dry out and change shape like soft lenses do. The oxygen transport through the rigid lens material is better than for soft lenses, so the rigid lenses are better for eye health also.

Sclerals are pretty expensive, so you might want to check out smaller lenses like mine which cost less. See this website for more information:
http://www.wavecontactlenses.com/
There is a doctor locater service on the website, so you can find out if there are providers near where you live.

The challenge with sclerals and custom RGPs is in finding a doctor experienced in fitting rigid lenses. Start by looking for a doctor that does specialty contact lenses or fits keratoconus patients - those doctors will have the necessary experience to get you good fitting lenses very quickly.

Good luck,

Lynne
Phoenix, AZ

[odydnas]

Lynne,

How are custom RPGs different from regular RPGs? I've worn RPGs for 10 years until DE made it impossible. I think sclerals or some type of specialty CL might be in my near future, so I'm looking at all my options. Of course, the main one is should I go to BFS vs. private optometrist.

[Rebecca Petris]

With dry eye a key consideration of a gas perm is its diameter. A corneal lens rests on the cornea. A corneal-scleral or intralimbal lens partially vaults the cornea. A scleral lens completely vaults the cornea.

I used to have 14.5mm lenses for my vision problems and they were an effective shield for my corneas for quite awhile but I eventually concluded I was going to end up in worse corneal trouble from them if I continued so I moved up to full sclerals.

Some people can do fine in a corneal lens - or in a hybrid like the synergeyes. But it depends a lot on their existing tear layer. For someone severely dry I don't know that a lens with only a natural tear layer between it and the cornea would be practical.

Sandy - in an email from Judi who runs the SoCal support group she mentioned someone in their group has had good success from sclerals done by the optometrist who will be presenting at that Sept. meeting. You might want to give her a call for more info. I think there are others in the Bay area though too.

Susie - just an fyi the original reason for scleral lenses was for correcting extremely high prescriptions and those whose corneas were distorted so no prescription would fix their vision. So that is their key strength.

[Susie28]

Hello!
Thank you so much for your advice. Thats wonderful. Now I'll try to get sceral lenses. Then I'll get relieve to my dry eyes AND I won't have to wear my ugly glasses:-)
So I have to find some place in Germany or Europe, where I can get them. That could be exciting, but I won't give up.

[gz9gjg]

Hello odydnas,

I wear custom Wave RGPs - they are designed using topography, then cut on a computer-controlled lathe. The design is very complex, to fit my LASIK'd eyes and to correct my HOAs. You can check out the process at this web site:
http://www.wavecontactlenses.com/

I am not certain how other RGPs are made. I was told sclerals are also custom lenses.

Lynne
Phoenix, AZ

[wetEyes]

Hello Susie28,
greetings from another German person ;-)

Please tell me, has any of the doctors told you which kind of "dry eye" you have? In other words, is it because of an oil deficiency (-> Meibomian glands), "water" deficiency (-> lacrimal glands) or because of your mucous membrane (-> goblet cells)?

[Susie28]

Hello there!
Meanwhile I were at Ken Pullums in Bavaria/Germany (Ken travels two times a year from London to Würzburg in Germany to fit sclerals - that's great) and had a scleral fitting. Ken is a great guy, he took as much time as we needed to find the best lense with the best prescription for me. And when I didn't understand him (because he is used to speaking very fast;-)) the very nice optician from the university hospital (Ms. Hess) translatet everything for me. I can only recommend the university hospital of Würzburg for all German people who want to get scerals and who don't want to travel to London. The only disadvantage is the long delivery time of the lenses. Ken told me that it will last 2-3 month until I'll get my lenses. Now I'm very exited if the lenses will help me. I have blepharitis (not in the inner eyelid, but my lids a very swollen and red on the outside) and I've read in this forum that patients with blepharitis often have problems with lenses. But I hope that I won't have these problems. the test lenses from ken which I hat for half on hour in my eyes didn't cause any inflammation or something like that.
I'll tell you my experiences when I get the lenses!:-)
@all german people: the next sceral fitting termin in Würzburg/Bavaria is in December!

@wetEyes: I think I have Meibomian glands. My Schirmer Test is good, I have enough tears but I don't have enough of the oily part of the tears. Wy do you aks? Are only patients with lacrimal glands capable for sclerals? Did you get sclerals? When not -> travel to Würzburg!:-)

[wetEyes]

Hello Susie,
as far as I know, it doesn't matter which kind of dry eye you have for wearing scleral lenses. How much will the lenses cost you? Did he say if all the dryness will disappear?

[Susie28]

Hi wetEyes,
the lenses cost 985 Euro. Ken said that the effect of the lenses are different from person to person. There are persons who can't recognize any improvement and then there are persons who say they don't want to be without these lenses any more. You can wear the test lenses for ca. half an hour and then decide, if you think these lenses could help you. Prof. Geerling (a dry eye specialist at the university hospital in Würzburg) makes a motion to your insurance company and if they don't bear the expenses you don't have to buy the lenses. In my case I decided to buy the lenses in every case even if the insurance company won't bear the costs. So I've orderd them two weeks ago and now I'm waiting until they are delivered:-) Parallel I'm waiting for the response of the insurance company. I hope that they will bear the cost but if not it doesn't matter. When these lenses bring relief to my severe try eyes they are worth the money.
I'm a little bit afraid if I can wear the lenses because of my severe blepharitis. But I hope the blepharitis doesn't matter because I have it only on the out side of my lids, not on the inner lids...
Where do you come from? Is Würzburg a option for you?

[wetEyes]

Hello Susie,
thank you for the information. I live in Northern Germany but Würzburg is definitely an option for me. I would travel to Hongkong if that would help me.

[wetEyes]

Oh, and two questions:

How to get an appointment in Würzburg with Ken Pullum? Do I have to get an appointment with Prof. Geerling first or how does that work?

Why did you want the Ken Pullum scleral lenses and not other scleral lenses, such as those from Visser in the Netherlands?

[Susie28]

You have to call Ms. Hess for an appointment with Ken Pullum. The is the optician at the university hospital. (For more information look at the homepage of "Uniklinik Würzburg")
But normally you have to get an appointment with Prof. Geerling first. So I don't know if that works til December... But it's worth to try!!
I wanted the Pullum lenses because
1. the aren't so expensive (1000 Euro)
2. I can get them in Würzburg (130 km away from me) and I can get a translation there. My English is ok, but not so good that I can understand everything, especially special technical terms of optics or medicine. I think it would be very hazardous to get fitted in a foreign country when you don't speak the language perfect.....

[sus]

I wear them for nearsighted

I just wearing sclarals today. I have to wear them for my -11 nearsighted prescription.