Dr. Gemoules and my first Scleral Lens

[L8rgator]

...sent my anxiety level spiking up during the period after I booked the trip and before I made it down there. It was this weird blend of excitement and pure terror.

LOL I'm glad it was not just me!!!

[miki-mama]

This so wonderful! So happy for you that you found something that has worked so well for you!! I have been considering a visit to Boston, but I will explore Dr. G's Laserfit lenses before I make my decision. I have also been fitted with Maxim lens (I live in Denver). I am waiting to see if the lens alleviates my problem. I have blood vessels growing over my cornea due to injury/oxygen deprivation from my last scleral lens which I got in Europe. My plan was, if the Maxim lens doesn't help with the blood vessels, I was going to Boston. Are they utilizing still utilizing "trial & error" lenses in Boston, does anyone know?

[L8rgator]

Ugh that blood vessels thing sounds awful!!! Is that a common thing? Are they permanent? Sometimes I leave this forum feeling sooooo lucky!!!

My understanding is that Boston still starts with trial kits. Or "standard iterative approach using trial devices and custom modification [via CAD] of device contours based on clinical findings." as put in one article I just googled. I've previously read from people that commented that the first trial lens days were painful- so that makes sense that the first lenses could cause painful pressure points, or tight pinching, for some.

So with PROSE they subjectively choose a starting lens, evaluate how it fits/functions/feels, make adjustments as needed, evaluate, repeat. But I'm going by the research articles I can find on the internet. They don't really talk much about the exact specifics of what level and methods of "customization" is available as far as I've found. I know some brands of scleral kits are built with "modifiable areas" than can be lathed to better fit an eye. But I don't know if that's what Boston does. Probably a good question for the PROSE forum. I know they have a ton of different lenses to start from - which is why they have been often suggested for hard to fit cases or when other non-custom lenses fail.

Gemoules's lenses are made from scratch. Your eye is scanned and the scans are digitally converted to a 3D digital map. A virtual lens design is molded on it, and further manipulated to adjust for vision - so your prescription, astigmatism, and high order aberration(?) correction, etc. I get a little lost here, but he explained it like when lasik patients talk about glare and issues at night - that's aberrations. A regular scleral lens can sometimes partially correct these, but also could even add it's own aberrations. Gemoules's has a patent on a process that cancels out eye and lens aberrations. I guess that part is unique.

The virtual lens design is then sent to TruForm to manufacture from scratch (dr g does pick a material to use also). Since it's custom contoured, the first is generally very comfortable and doesn't need any further adjustments. In my case, the edge felt scratchy on my outer upper lid so Dr. G tweaked the design to have thinner edges, and sent for another lens. He also tried a different material this time to see if there was any noticeable difference in wettablility. Unfortunately you have to travel to go Texas to get a lens made this way, because their patents prevent other fitters from using this technology.

I was in a better situation to get a PROSE because there was a fitter less than 2 hours from me. If I remember right though they would have had to send for each lens from Boston, so I would have to come back repeatedly until a good fit was achieved. I think you have to go to Boston to be able to stay overnight and get it done in consecutive days (or maybe very nearby also?). In Chicago they only did fittings on Fridays, so it would have likely taken weeks. No extra charges for fitting adjustments for like 6 months though, so that would have been a plus given a fitter was in my region.

[miki-mama]

Thanks for the information about the fitting process L8rgator. I am already liking Dr. G a lot. I emailed him last night, and he replied right away! I think it was past midnight his time! I am inclined to go see Dr. G in Coppell. Dallas is closer to where I am than Boston. I used to live in Dallas, so I'm familiar with the area.

[André Pereira]

I´ve read quite a lot about scleral lenses these last days . I think that the technology used by Dr. G. produces high quality lenses .
Reading about other scleral lenses, I always see stories about bubbles , poor fit , and some other things . Of pages I researched , I do not see anyone complaining about such things in Dallas lenses .
I am willing to spend U $ 8,000.00 to get out of Brazil and try.
He answered all my emails and sent me contact of two patients who wear lenses . One uses it for over 10 years. After all this , I was pretty confident .

Largator , you told me not to go to Texas in the summer . I was planning to go in January or February . But after everything I've read and the possibility of a big improvement in my eyes ( and get out at night and arrange a date again) made me want to anticipate the trip . Probably in July or August .
I'm here with fingers crossed . Thank you for making this topic and call my attention to the scleral lenses.

Good luck on your visit miki -mama !

[L8rgator]

Weather Averages in Coppell TX:
http://www.weather.com/weather/wxcli...ly/graph/75019

[hosanna13]

Do you guys ever feel self-conscious about the large lenses? I know that to the average person, they would just think they're normal contact lenses and they couldn't care less. However, I feel self-conscious about the lenses. It's a very trivial thing compared to having to live in pain 24/7, but just curious

[L8rgator]

It's interesting you say that. Do you feel your eyes look different with yours in? Can you tell a difference between when you have only one in? I'm wondering if it's just sclerals in general that makes you feel sensitive, or maybe the shape of the brand you are using.

When I wore the test PROSE lens in Chicago, I definitely felt self-conscious. Both my husband and I could tell it magnified my eye, and it made my lower lid sag more. I wasn't happy about it, but the relief was so magical I would have made due. The Jupiter lens looked much better - you could hardly see it was in, other than maybe a bit of lower lid sag. The Laserfit lens has been somewhat hard for people to see. They ask me how my eye is, and I lift my top lid up so they can see I have a new contact in (there are 2 dots at the top I show them). Last week my chiropractor said "wow, you really can't see that unless you are looking for it". Dr. G said that the test PROSE may have looked enlarged only because it wasn't fitted yet. I felt like it was supersmooth - like less contoured, with an even slope from middle to edge (so seemed thicker). The Jupiter felt like it had very pronounced steps, like where the vault started. Dr. G's feels in-between - but it's hard to say not having samples to compare and just going by memory.

I can see the laserfit just fine, and I do notice it when I look at myself in the mirror. But honestly it doesn't bother me. But to be fair, I've got noticeable permanent damage around my eye from my accident (scars, dimple, missing padding, wrinkles, discoloration) already, and sometimes embarrassing red blotches on my cheek from the nighttime bandages, and previously I was wearing big goggles or bandages over the eye - so the lens is really a big step up for me so it really can't make me self conscious. And I'm married so I don't have to care how I look anymore anyways

I tried to take a bunch of pictures tonight of mine for you to see, but unfortunately I could only get maybe one clear enough to really be able to get a good view of the lens. The one PROSE and one Jupiter pictures I took are even worse, so sorry they aren't much help either. I uploaded them here http://l8rgator.weebly.com/

[hosanna13]

Wow you really can't see Dr. G's lenses! That's great.

I have Jupiters and you can see them in my eyes--others have noticed, but I think they were looking to see if I wore contacts or not. I'm also detailed-oriented so I notice things most people wouldn't. With the Jupiters, you can definitely see their circumference in the whites of my eye.

[André Pereira]

L8rgator
Just like the temperature of my city. But it is more humid.

[L8rgator]

Ok I think I have picked out some new (unflattering, hence the cropped close-ups!) shots today where I think you can really see the lens - and I put them on the same blog page (second "post" at http://l8rgator.weebly.com/ )

I also added a close up of my lens alongside my spare so you can see the contour and general shape (top "post" at http://l8rgator.weebly.com/ ). Dr G had said he was "very particular" about the thickness of his lenses, so I think that contributes to the less noticeable profile when it's in. You can see the minimal smooth transition to the sclera area and the more or less even overall thickness of lens material. I also added links under to pictures of PROSE and other lenses there so you can compare and contrast.

[DryInDenver]

Interesting. Thanks for those pics too. I was always very self conscience in my goggles but it never crossed my mind n my sclerals. Most people can't see the lenses even when I'm trying to point them out unless I lift my lid to show them the black dot(s) that mark the top of the lens (1 dot for right, 2 for left). Tonight, after reading this I took one lens out and asked my wife if it looked like my corneas were different sizes. After some carefull studying, she said yes. So I think there is some slight magnification of the eye, but it is almost completely unnoticeable and can only be observed if I have only 1 lens in. So for me, no, I've never once felt self-conscience in my sclerals. Quite the opposite really.

[hosanna13]

DryInDenver, thanks for your input!! I think Dr. G's lenses must arguably be the best on the market. I'll give my Jupiters a year and consider going to see him in TX. Does insurance cover any portion of it?

[MGD666]

L8rgator - so informative and helpful with both the anecdotal info, the videos, and now the close-up photos of the lenses themselves. Thanks so much.

(And you too DryInDenver).

Please continue to post your experiences with these - it's really informative to hear about (and see in detail) these lenses - especially in the case of those (me included) who might seriously be considering them as an option.

[L8rgator]

Some medical insurance will cover it, and some won't. With mine you have to ask for pre-approval, and then have it done, and then submit, and then they decide (they rejected it for me, as expected, because I called and asked very detailed questions before visiting U of I and then Dr G's secretary also called a couple times and they clearly said ABSOLUTELY NOT), and then you file an appeal if they say no. The PROSE people made it sound like it might be not uncommon for insurance to say no when you ask, and then change their mind after all is said and done(I might be remembering that wrong though?). That prospect was a little scary for me, because if I went with a PROSE and the insurance didn't cover it, that would have been really expensive. Although my copay probably would have been 20% either way, plus a deductible, plus insurance charges were higher than self pay, so might have been expensive either way. Dr. g was much less expensive, so if the insurance doesn't cover it, I won't feel as bad (or as poor). I haven't filed it yet though to see what they say, and just requested the forms today. I kept putting it off, since I think it will be a PITA. I have 6 months to file after the date I had it done.