Dr. Gemoules and my first Scleral Lens

[L8rgator]

I first heard of Dr. G actually on this forum. If you use the search box to search for "Gemoules", you'll find lots of posts over the past year or more. You can also try "Coppell" (where he does the fittings). One of those links has a link to another forum site with more conversations about lenses he has done (including those for conditions other than dry eye).

[André Pereira]

Anyone else ever heard of Dr. G?
I sent an email to him and he replied on the same day.

L8argator, I'm very happy that you have found a relief. Good luck on your motorcycle ride. I can't wait until that day for me again!

DryInDenver.
I sent a private message to you. But I'll ask here too!
The lenses you helped with the redness of the eyes?
And with inflammation?
I was very interested because I saw that you are a LASIK patient. If you can tell us more about the positives, negatives and about your routine with the lens, I will be grateful.

Thanks man!

[L8rgator]

I definitely notice that on the computer my eye with lens gets drier (by dry it feels like the lid is catching on the lens in different areas when I blink, and sometimes feels colder than average) than if I'm doing other activities. I KNOW I don't blink nearly as much as necessary. I suspect I also get lazy about putting the drops in regularly, because time flies and I just don't notice when I'm so into what I'm doing. Or I lose my bottles and vials under the massive pile of papers and junk that is my desk.

One think that surprised me was now I look in the mirror and think "I don't look as old as I thought I did". Not sure if it is because there are no more googly goggles and patches, or just because I'm not squinty all the time any more like I used to be

I am considering getting a second lens for my other eye. Having one eye feel "cold" is a little bit annoying at times (NOTHING like dry eye pain, but still distracting), so I'm wondering if having a lens in the normal eye might balance the feeling. I'm unsure though, because I don't know if the "cold" feeling is due to having a liquid filled lens on the broken eye, or just due to the evaporation of tears from the uncovered parts of the broken eye (in which case adding a lens to the 2nd eye would not help any). Any thoughts or opinions on this?

Either way, my husband prepped my honda scooter last week, and I'm looking forward to getting out on our first motorcycle ride now that I can do that again! I'm so excited!

[DryInDenver]

I suspect I will need the Echos when I ride a bike (unthinkable before these), but that's probably it. My clear Echos are in my glove box as a fall back, and I use the sunglasses but have taken out the foam insert. I still use drops through out the day but at a much slower pace. This is to wet the corners of my eyes because they get dry and itchy as they are unprotected by the lens. But even that, the dry and itchy corners, isn't even close to the pain and discomfort I'd get from dry eye.

Work has been very busy for me this week. Lots of computer time and long days followed by logging in from home after dinner and working to midnight and waking up early. My eyes have handled it in stride. I've also sat through a couple 2hr business meetings without the distraction of drops or goggles. That is another big milestone for me. Conference rooms are so dry and always seem to have significant airflow (only noticed by the dry eye sufferer). I'd often try to rough it without my Echos and would get weird looks as I ended up putting in drops every few minutes.

[MGD666]

Really great to hear about that DryinDenver. Please post updates about how these work out for you in the future. Are you still wearing the oakley wind jackets or wiley x echos?

[DryInDenver]

I went to Dallas after reading this, and wallah, I AM ALMOST NORMAL AGAIN!!!

Dr. Gemoules is a genius. He used to fit people with the kits of various sized scleral lenses offered by various makers of lenses and peck through them like a chicken pecking through dirt for food trying to find the best fit. The system just wasn't good enough and he didn't like not being able to help his patients more. So he developed his own system to craft a lens customized to each individual eyeball. He's designed and patented this incredible system where he gets a digital scan of your eye to get the perfect shape, combines it with wavefront technology to get the perfect correction (stigmatism and high order aberrations included!), and builds a file that he sends to a lab near his office. The next day the lab delivers the lens. Once you get the lens he goes through the same process again and again until he finds the perfect fit. My first lens was uncomfortable, but tolerable - or at least better than the intense and debilitating dry eye my lasik left me with. That was on Tuesday. Wednesday was a bit better, so was Thursday. Then on Friday, bam, he nailed it. I couldn't even feel the lens in my eye! It amazed me what a huge difference such miniscule changes in the shape of the lens made. I think that by far, he offers the very best chance of a successful outcome with scleral lenses.

On my way out the door he extended his arm to shake my hand. I pushed his hand aside and gave him a huge man hug. I was choking up with tears in my eyes. "This is huge for me," I said. I felt liberated!

I can't thank Dr G. enough for the personal time, investment, and tireless persistence he put into his researching and developing these lenses. I suppose I should thank his wife too for putting up with the countless late nights he spent at the office. I believe he has only been up and running with his full blown system for a year or so now so I want to help spread the word and recommend his services. If you want to look into it, he calls it LaserFit and has a good description of the process and costs on his website LaserFitLens.com

[L8rgator]

I've now tried the addipak vials of sterile saline in place of unisol to fill my lenses, at the recommendation of a number of posts on various boards. For the most part it feels the same I think. I do like that they are more transportable (albeit not recloseable) than the bigger unisol containers. And that I'm opening a fresh vial with no chance of contamination often. They are like $8 for 100 5ml or 3ml vials- so cheap. They don't really "squirt" though, so when I'm looking just to rinse something I still use the nice stream that comes out of a unisol bottle (for lenses) or a knock-off walmart sterile saline (to rinse plungers).

I have also decided that my favorite drop is Theratears in the bottle with "disappearing preservative". It is a bit longer lasting. I also still use blink contacts, and sometimes just the Addipak vials for drops. I've stopped using everything else, including refresh and refresh optive preservative free because I was seeing clouding consistently.

One thing that was important for me was to get a paper towel holder installed on the wall. I go through alot of paper towel now since I'm trying to be extra "clean" (i.e. wash and dry hands and tools frequently) when working around my eye supplies. I give my husband a pat on the back for getting that task done

[L8rgator]

Glad to hear you are improving. I'm surprised you are still using drops every 30-60 min with the sclerals tho. I thought trapping that moisture would prevent the need for drops.

P

Ok, please excuse me if I use the wrong words or didn't get this quite right but I'm going by pictures I just googled...
The lens keeps moisture on the cornea, which only covers the iris. This part has the major nerve endings, so keeping it bathed takes away the pain of dry eye. And I never worry about my vision getting blurry from being dry like I had to 24-7 before (that used to REALLY scare me.) The lens also covers some of the sclera (over the whites). But the outer edges are still bare.
Sometimes when I do not add drops, after a while my eye feels has a sort of barely noticeable sticky feeling periodically as I blink. I think the dryness on the outside of the lens and on the uncovered whites get a little tacky.

I think that if I don't lube it back up with drops, the next day it'll feel a bit 'off' right after I put the lens back in. By 'off' I mean a chilled and a little itchy around the corners of my eye. However, honestly I haven't let it go more than a couple of hours without drops since leaving Texas or getting my new lens so I can't say for sure if that would still be the case. And when I was wearing my airrages or other chambers, I had to use very few drops at all. I'm planning to buy a new pair once they bring the old foam back and start using them again when I'm not in public.

I still have alot of trial and error to do. I did try the new vials of saline i purchased on amazon in bulk. I do like them, and have even been using them as simple drops over my sclerals.

I also found a soap that works well http://www.amazon.com/s/ref=nb_sb_no...20hand%20scrub
I cleaned out a bath and bodyworks bottle and used the vista-prep to refill itl

Good luck!

[patientpatrick]

Glad to hear you are improving. I'm surprised you are still using drops every 30-60 min with the sclerals tho. I thought trapping that moisture would prevent the need for drops.

P

[bonedrye60]

Sorry, i responded to incorrect blog.

[Gil]

Thanks for the info.

[L8rgator]

L8rgator,

What solutions do you use to clean and disinfect your sclerals? Do you use the Unisol 4 to rinse the cleaner off before disinfection?

Clear Care is a hydrogen peroxide based solution. The case it comes with has a neutralizing disk. So I fill the case with hydrogen peroxide, and put my lenses in for at least 6 hours to bubble clean. After that the solution turns to neutral saline, so the lenses don't need to be rinsed. I usually squirt with Unisol 4 just to make sure any lint or cat hair hasn't floated on from my clothes or anything like that. Or I rinse with the knock off sensitive solution from walmart, and finish by filling with Unisol
http://www.clearcaresolution.com/how...ear-care.shtml
Just watching the video for the first time now, I just figured out I was putting them in the case wrong - I was putting them in the door and closing it instead of in the center. Oops.

[DryInDenver]

I just booked a trip to Dallas! I hope I have as good of an outcome as you! I hear you on the dry winters. Thanks for all of the fantastic info and detailed review of your experience.

[Gil]

L8rgator,

What solutions do you use to clean and disinfect your sclerals? Do you use the Unisol 4 to rinse the cleaner off before disinfection?

[L8rgator]

I forgot 2 other downsides. You aren't supposed to go in hottubs or shower with scleral lenses in. I go in a hottub most days (it's so cold here in WI!) and like to shower at night sometimes, so I've had to put that off until after I take out the scleral.