My Eye Dr is against Scleral Lenses

[Katewest]

Hi Everyone,

I have been dealing with DE forever now and I'm only 30! Just came back neg for Sjogrens via a blood test. I've been told Ocular Roseaca and MGD. I have tried everything...even IPL....and its just getting worse. The hardest is at work with the comp, ac, lights, and most of all stress. My dr has tried everything and I just had to get my upper plugs taken out after 4 days because they were way too watery. So I asked him what he thinks about the Boston Institute's Scleral (Prose) lenses and he starts shaking his head immediately. He said "Why would I want huge uncomfortable lenses in my eyes" and that I would be at great risk for getting an infection. He said he would not fit me for them. OK....I knew that HE wouldn't but when I asked him to sign the referral paperwork to get the ball rolling he did but very stubbornly. (He was also against serum eye drops, the only other thing I have not tried) He said my eyes are not "bad enough" for the lenses and only a "little bit red". Ok, well I can barely function at work and have meltdowns every other week from the stress that they are getting worse. I have permanent red veins in my eyes now too. Ok, this is getting pretty long so I'll wrap up. Not really sure what I'm looking to hear from you guys but....

[hirentherock]

Well im from India with SJS as my main problem including mgd..I also have permanent red veins.
I was considering scleral lense from past 6/7 years,but all local doctors were against it so cud not think to get the lenses.
i had taken trial in 2005 and was happy with the vision from 20/60 to 20/25 in that trial.But as u said my doc said the same thing.Infections, non suitabilty etc,

Recently i got over the doctors opinions and convinced my dad for it.he was also against sclerals as docs frighten that i may get worse with sclerals.im also 30 now.

I went for trial to the clinic and was suggested the scleral by the docs.I bought the sclerals.It has been a month since i got.Myeyes r still trying to adjust to the sclerals.

After getting the scleals i visited same doctor with sclerals on, who was opposing(not stubbornly) me and he said cornea is better with the lense.

Within this 1 month i found:
1-My optometry numbers have changed due to change in shape of cornea.(im sjs patient with keratoconus)
2-there is no change in redness.Infact eyes get more red right after removing the lense.
3-Lenses needs more care as its a costly device and delicate one.
4-As long as saline stays within the lense eyes feel soothing but what if im traveling and suddenly saline dries out?(Need emergency kit always with me).
5-Photophobia is relived to a certain extent but not fully yet.
6-My vision used to keep varying everyday before sclerals due to surface irregularity.With sclerals my vision is stable.Every day i can see things as clear or as blurry as i had seen a day before.
7-No idea what to do for redveins.

I will be visiting clinic soon for a followup check up where they may change my scleral lense and also the power of the lense too.

These reviews r on the basis of 1st 20days of my scleral.Final reviews can be considered after 4months of usage of the lense as im in a stage of trial and error for size of lense and its suitability on my eyes.

U can probably go for a trial first and then decide what to do.We here do not require any letter to get the scleral lenses.Clinic itself has a team of cornea specialist to refer to bsl.
All the best

[DCRdryeye]

Your doctor (like most of them) are not familiar with dry eye treatments. When I showed my local doctor my scleral lenses he was amazed at their size and wanted to know if my eyes would get enough oxygen. He knew nothing about them. But that was my normal GP.

An ophthalmologist who is 'recommended' to treat dry eyes gave me restasis and DuraPlugs but said my eyes were not bad enough for serum drops. He only prescribes the serum drops for damaged ocular surfaces such as erosions.

Last week, I went to yet 'another' ophthalmologist in Sydney who has the ONLY DRY EYE SPECIALIST CLINIC IN AUSTRALIA and he is definately better than most others I've seen. He said that serum drops would be extremely beneficial for my eyes.

So two ophthalmologists, one saying serum drops won't help me and thus refused to prescribe them, the other saying they will help. The latter, who says they will help is the better dry eye specialist, so I trust his word better. I was surprised with his clinic, they had equipment set up to test various parameters for dry eyes such as TBUT, Osmolarity, etc that were not present at previous clinics. I was diagnosed with MGD and ATD and was given doxycycline and steroid drops (non-preserved in vials).

Previous ophalmologists said I do not have MGD, but the best dry eye specialist in the country diagnosed me with it. What does that tell us? Most of them are misdiagnosing us!!

[bakunin]

Katewest,

The last doctor I had an appointment - a cornea specialist - didn't think scleral lenses were for me either. My clinical signs are mild (I don't have stains or redness). He didn't talk about serum drops with me either. He has no other options to offer me besides drops-restasis-plugs.

I think those doctors just can't figure out the symptoms we feel and the ordeal we live. I think we deserve trying sclerals and serum at least.

[Faith1989]

Bakunin I totally agree. I think patients have the right to at least try medications or procedures if they won't do any harm. I mean we are the ones paying for it neway! lol I could understand docs not allowing patients to try things that can be potentially dangerous but serum is more natural than steriods or restasis! I am going to see a specialist in a week and want to get off restasis and just do plugs/cautery (either one) and serum, I also want to ask about preservative free steriods. Maybe doctors are just "against" things they don't know much about. :S Just an opinion....

[Katewest]

Dcrdryeye- what do you think of your lenses and did they help with redness?

[bakunin]

Maybe doctors are just "against" things they don't know much about. :S Just an opinion....

Yes, I think mostly they are against because they didn't hear about the use of them in such cases. And they don't hear about because they are not in touch with what is going on in the dry eye scientific field.

[Amyfloor]

I got my scleral lenses about a month ago from BFS and feel like I must weigh in on this discussion. The good news is that my vision is excellent. I ams seeing 20/20 in both eyes and the only draw back is not being able to see close so I am constantly taking the reader glasses on and off. I am going to my optician tomorrow so I can have glasses made that will rectify this problem. The bad news: I cannot get used to the lenses in my eyes. Simply said, they hurt. My tear layer is extremely thin and I am still using drops constantly. My eyes are extremely dry and I guess that is why I still "feel" the lenses. This was a last resort for me and I know it's not what people want to hear but I must be honest.

[Katewest]

amyfloor-whats your diagnosis?

[Amyfloor]

+ bloodwork for sjorgens

[DCRdryeye]

Amy, it's interesting to hear from a BFS patient who has a painful experience wearing their sclerals. I got my sclerals in Australia and have had multiple modifications and new lenses and I'm at the point where they are more comfortable. However, when my eyes are drier they certainly do feel more uncomfortable, grainy, etc and I have to apply drops over the top of the sclerals. But they never hurt.

[Amyfloor]

I know-- I am not happy about it. Please don't get me wrong, the doctors and staff at BFS are angels and I am praying I just need to get used to the lenses. I may try to go back in December if things do not improve. I was there for 5 days but perhaps there are more modifications that could improve my comfort level.

[m.jen]

Amy,
I don't know where you're at now, but if you're still interested in trying scleral lenses you should contact Dr. Gemoules in Texas. He makes amazing lenses that are made to perfectly fit your eye. I've heard from so many people that they fit much better than the Boston Scleral lenses. I had them for awhile and it was the only relief I experienced from my dry eyes. I'm now not able to wear them...I'm not sure why But most people are able to with no problem. He's an amazing brilliant doctor

[DCRdryeye]

I'll second what m.jen said about Dr. Gemoules in Texas. I too have read lots of successful fittings he's done with scleral lenses and apparently has developed his own unique strategy for fitting. Obviously it seems to work. So is it Dr. Gemoules or BFS? perhaps a poll on here would provide an answer but that would be contravening the rules and not allowed.

[Amyfloor]

Thank you very much for the info!! Definitely something to consider. I am in PA -- a little bit of a trip to TX!! Wishing everyone a very happy Thanksgiving!