Dr. Gemoules and my first Scleral Lens

[MGD666]

Thanks, that's good to know. Was anything mentioned about the possibility of having them "re-coated" after a period of time, or the expected longevity of this coating/treatment? I realize, I should probably just question him myself at this point

[miki-mama]

Hi, DID.

I've been out of touch lately, and only now read your message from a few weeks ago regarding your surgery. How are you doing??? It must have been quite a frightening experience for you and your family. What is the post-op prognosis? What do you mean by epithelial cell ingrowth? Could it be pannus? I had pannus on my right cornea that caused complete clouding in my right eye. The cause turned out to be an ill-fitting scleral lens. I really hope that you recover and regain your vision quickly.

I wanted to share my own experience working with Dr. G with everyone. Sorry it took a while. I was in Dallas in August.

To give you all a little background info, I have dry eyes (schirmer test "0") resulting from Stevens-Johnson syndrome. I also have scarring on my cornea. Right eye significantly more damaged than the left eye. I have worn scleral lenses from various providers over the years with success (meaning they provided me with restored vision, comfort and protection from further damage). A few months ago, I started to experience clouding in my right eye. We ruled out cataract and infections, but the vision became increasingly cloudy until I could no longer see shapes, just light/dark. It was as if someone had lowered a shade on my eye. Thankfully, I was able to see fine with my left eye. My local ophthalmologist ruled it as a part of deterioration caused by SJS, and offered no idea how to fix it. Another cornea specialist felt that the ill-fitting scleral lenses had caused an injury, and recommended getting the fit of the lenses checked, and possibly a corneal debridement procedure, where you literally scrape the tissue growth off the corneal surface and hope it will heal without scarring. My optometrist, adjusted the fit of my scleral lens. The originals had become too tight. After extensive research, I learned that ill fitting lenses (scleral or others) can cause pannus (growth of fibrovascular tissue on the cornea) due to oxygen deprivation. I also learned that adjusting the fit of the lens can sometimes cause the pannus to recede. The cloudiness in my right eye was reduced somewhat with the use of steroid drops, improving my vision somewhat. The photos of my eyes showed that top 1/3 of my cornea was covered with pannus, which at that time was encroaching my visual axis.

Making a long story short, I decided to try all possible treatment options, starting with the least invasive approach. I needed to get fitted with a new pair of scleral lenses. After first reading here and researching all over the internet about Dr. G and exchanging numerous messages directly with him, I went to Dallas to be fitted with Laserfit lenses. The whole experience was as pleasant as could be under the circumstances. Dr. G is a lovely, lovely man, and Ashley, his assistant is absolutely sweet and caring. They really went out of their way to make my experience of being away from home on my own as comfortable as possible. I think the worst part of the week, apart from being away from my family, was drinking coffee out of styrofoam cups at the hotel cafeteria! (note to self: remind patients headed to Dallas to bring their own mugs!) I met and bonded with other patients of Dr. G's staying at the same hotel, some of whom traveled all the way from Europe and S. America.

About the lenses: The Laserfit lenses are physically a little different from any other scleral lenses I have worn. So far I have tried 5 different variety including Laserfit. The Laserfit lenses are thinner and thus more flexible. They have less vault. Most importantly, in terms of vision correction, they far exceed any I have experienced with other brands. Despite being told my case is different from Lasik induced cases -- in fact much more challenging to correct, Dr. G managed to fit me with lenses that corrected not only my day time vision, but some of the night time issues. For the first time since SJS 23 years ago, I was able to look out into the street at night time without the harsh halos and painful burning sensation caused by street and headlights. Really amazing! I was so happy after the first set of lenses I got, I ran out of the hotel room, stood out side and looked around in amazement. To be precise, the halos around the lights are not gone 100%. It may depend on the severity of each patient's conditions, but in my case, the halos are reduced by at least 50% in my left eye, and about 30% in my right eye. To put it in perspective, I was not able to drive at night at all. Legally, I could have, since I can see through my left eye. But I was very nervous about running over a pedestrian or into another car driving at night with only one seeing eye, so I never did.

In terms of comfort, They are very comfortable. I have experienced fluctuation in the fit after I returned home, particularly with my right eye. It would start out feeling comfortable for a few days, then the eyes became inflamed and I could not tolerate the lens. It got pretty bad at one point, and I had considered keeping my left lens, and replacing the right one with another brand that worked for me in terms of the fit, but definitely not the same quality of vision. However, Dr. G continued to work with me. Neither of us would give up, and we went back and forth via email, trying to come up with the best possible solution. I now have perfectly comfortable left lens. We are working to improve the fit of my right lens, which is so close to being perfect. Dr. G admitted, in cases like mine, he needs to spend more than the standard week to get the right fit. He said in most cases, he is able to get the fit right in the week that patients work with him.

I think a few important lessons can be learned from my experience, for those who are considering scleral lenses:
(1) scleral lenses, like any other treatment options is not a 100% solution, but they can offer a significant improvement in correcting the vision and offering comfort.
(2) not all scleral lenses, and there are far greater choices available out there than even a decade ago, are created equal and one may offer more relief to one patient than another.
(3) once you find the right fitting lenses, it is important to check the fit of those lenses regularly to check for any changes, so that an ill fitting lenses do not cause more harm than benefit.
(4) and in my opinion, who you work with makes a world of difference. If you are fortunate enough to come across a doctor who cares enough to succeed in helping his/her patient, you are far more likely to find relief. And if you happen to find someone you have experienced success with, please spread the word. It could save many of us the trouble and cost of trial and error with providers who may not be as knowledgeable.

I thought long and hard before deciding to travel to Dallas to see Dr. G. It could have been a bust or a success. I had no idea of knowing, despite all the glowing recommendation by other patients. Not because I had any doubts that these patients are telling the truth, but I know from experience that every case is different and one treatment that works beautifully for one patient, doesn't necessarily mean it will work well for me.

I am happy to report that my decision to go to Dr. G was the right one for me. I have come across great many doctors in 20 some years I've had this eye conditions, many of whom have tried in earnest to help me. Some could, and some couldn't. Dr. G has made an incredible amount of effort in the sincerest way to help me. The result is, I am seeing better than I have in a long while, and the pannus on my right cornea has receded significantly, enough to avoid the corneal debridement surgery. Yeah!

For those sitting on the fence about what to do, my advise would be to take a chance and give it a try. There is a chance it may not work for you. But any gain you do make, even minor, could make a big difference in quality of your life.

I have posted earlier that I've learned that some vision care insurances cover "medically necessary contact lenses" dispensed by an OD, which is what these Laserfit lenses are. I'm actually in the middle of battling with my insurance company. Their policy says they will cover up to $2500 of the total, because Dr. G is not a "participating provider" (they would have covered 100% if he had been a participating provider of this particular insurance). At the moment, they are giving me the run abouts saying I need to provide more information, or somehow the additional information I sent over twice has gotten lost, etc. I'm so used to this. I'm pretty persistent, and have gotten insurance companies to pay up in the past.

Good luck to all of you going to Dallas to be fitted with Laserfit lenses!

[MGD666]

Thank you for posting all of your impressions on these miki, as I am one of those here definitely considering these. It's encouraging to hear this from you (as well as DID and L8rgator), as I have the same anxieties and uncertainty about whether they will help me, that you seem to have had prior to "taking the plunge".

[DryInDenver]

Miki,
Thanks for the thorough and well written write up of your experience. I read your post with great interest and relief to see you are seeing some improvement.

How are you doing??? It must have been quite a frightening experience for you and your family. What is the post-op prognosis?

Thanks Miki! I’m doing well. You are right, it was somewhat frightening. One of the worst things I’ve heard through this ordeal was when the doctor said that the thing he saw was UNDER the flap. It was like someone punched me in the gut. I’ve got to say though, it doesn’t sound nearly as harrowing as what you’ve been going through. I can’t tell you how happy I am to read that you are getting some significant improvement. When the vision in my right eye started to deteriorate throughout this whole thing, I was very very very thankful that I had another one working, but much more protective and fearful with my other eye. I’m sure you were going though that same emotion but to the 25th power. That’s really great news.

The right eye vision seems to have leveled off and is okay, but I have some double vision/shadowing and halos at night are much worse. Both of these symptoms are likely due to some scarring in my lasik interface where the white thing was. I’m excited to see if a new lens from Dr. G will help with those issues or not. I’ll be going back to Dallas sometime in the first quarter to get a new lens on my surgery eye.

As far as the dryness goes, it’s about the same as it was prior to the surgery – so far at least. After LASIK, it was at about the 1 month mark when my dryness spiraled out of control. I made it past that point without returning to that absolutely agonizing, hellish eye state which I’m pretty happy about. It’s also been an easier “recovery” from this surgery because I can close the one right eye and just use my left one that has the scleral in periodically throughout the day. In fact, I’m doing that right now as I type this.

What do you mean by epithelial cell ingrowth?

As you probably know, epithelial cells are the outer most layer of cells on your eye and are some of the fastest reproducing cells in the human body. When you touch your eyeball, once you break through the tear film (if you are lucky enough to have one) you are touching epithelial cells. Epithelial cell ingrowth is one potential complication of LASIK where these cells get under the flap and start to reproduce. Usually this occurs at the edge of the flap first and then progresses inward towards the visual access. It looks like a white sheet starts progressing across the cornea under the flap. It’s bad for 2 reasons, one it distorts your vision, and 2 it uses up the limited amount of oxygen in the cornea and starves the cornea itself of oxygen. This lack of oxygen eventually causes the flap itself to disintegrate in what is referred to as flap melt. Thus if it progresses, it is important for the doctors to remove it by re-lifting the lasik flap and scraping the cells out despite the additional risks of the re-lifting procedure. So far, my ingrowth has note progressed beyond the outer edge of the flap and doesn’t need to be scraped out, although I’m going in every few weeks to keep a close eye on it.

Could it be pannus? I had pannus on my right cornea that caused complete clouding in my right eye

Prior to your post, I have not heard of pannus before. Based on what I’ve read, I think there is little to no probability it was the cause of my problem. I want to thank you for bringing it to our attention however so that we are aware of that risk. Based on my tightness issues I’ve had, it sounds like something I may be at risk for some day. It sounds like from what you wrote that you think an overly tight lens was the cause. Is that right? If so, do you or your doctors have any recommendations on what to watch for and how to alleviate the risks? For instance, would taking the lens periodically out for 5,10,30, or 60 minutes during the day help at all?

Also, when I am in Dallas, I am going to get my left eye refitted again too to try and get that perfect fit that will carry over to this DRY Denver climate. Especially now that I know about this pannus thing and the fact that I know now that I have some tightness issues.

The result is, I am seeing better than I have in a long while, and the pannus on my right cornea has receded significantly, enough to avoid the corneal debridement surgery. Yeah!

Awesome, awesome, awesome, awesome!

I have posted earlier that I've learned that some vision care insurances cover "medically necessary contact lenses" dispensed by an OD, which is what these Laserfit lenses are. I'm actually in the middle of battling with my insurance company.

Thanks for sharing. I certainly think that the medical benefit these lenses provide are in line with the intentions, objectives, and principles of health insurance. They just seem to get too easily confused with standard vision correction and are too easy for the insurance companies to say no to. Your persistence is informative and inspirational. Please keep us updated on your progress.

The result is, I am seeing better than I have in a long while, and the pannus on my right cornea has receded significantly, enough to avoid the corneal debridement surgery. Yeah!

Seriously, that is seriously freaking awesome.

[L8rgator]

That IS really awesome! It's amazing what Dr. G can build into a lens for custom corrections - stuff that you can't even get with average regular lenses.

Personally I've been struggling as of late. The lens has made things 1000x better than pre- lens (when I wanted to physically rip my eyeball out of my head and periodically envisioned doing it with various sharp objects). But this climate has me down in the dumps. I have to be extra careful about remembering to do frequent drops for my sclera health. And on the coldest driest days I've had to seal over the lens with tape and plastic or a bandage or the sclera starts to feel very cold, then itchy, then irritated for the rest of the day. My job is walking dogs outside, so it's so terribly dry and windy and COOOOOLD. And a few times I've had allergy attacks where I can tell my eyes become inflamed and red (generally both), or what I think was a third stye starting (but I nipped it in the bud with fastidious lid scrubs), or this week I think I've got fiberglass in the skin around my eye from crawling around the attic for hours because it's red and itchy and warm. And because we are working on a some home repairs that require the house to be super dry and humidifiers to be off, the skin around my eye is getting very irritated and burned from taking my tape bandages off in the morning - sometimes to the point that it bleeds. Just so sick of it all. I got really spoiled during the warm season, and now I'm just tired of being back to wearing a patch and avoiding people and activities while caved up in my house because it's easier than to explain to people. Because it's only one eye for me and I have no fat under the eye so it looks bruised, people treat me like I'm a domestic violance victim and I have to explain the story practically every day - often to the same people I've told it all to many times and they just forgot completely. Even my shrink, argh! Doesn't help that I had to cut down the only antidepressant that has finally worked for me because I was gaining far too much weight. Winter sucks and I just want outta here so badly.Yep I'm a biiiggg baby right now. I'm so down I've been too drained to call the new doctor I'd like to try - the one that makes serum drops and seems to be more of an expert in dry eye. Just feel blahhh.

I do think planning for yearly or so refittings or check-ups is a good idea. I haven't had a problem with tightness except for a few of the allergy days. But I am seeing a bit more halos at night when I drive, and I think my prescription could probably be increased, so I think it would be worth a trip if I can swing it. And I'd love to get the other eye done if I can swing the cost. Still love being able to put my scleral in in the first try and have it be comfortable all day - unlike my other soft contact that is a real struggle and gets uncomfortable at random inconvenient times. This time I would be lazy about filing with insurance. I'll have new insurance next year, so maybe that will help. At the very least maybe I can head to grapevine just to take a vacation from the crappy weather. We did vacation in florida in October, and my eye enjoyed the mostly patch free time. As did I. Thanks for listening to me whine.

As a side note, I learned an important lesson: Always close the drain or put a napkin over it before taking out or putting in your lens. Especially in the public bathroom of your shrink's office (I take my contact out for relaxation and meditation therapy since my eyes are closed.) Or always carry a big wrench in your purse!

[miki-mama]

Thanks! I think it is really awesome, too.

I wanted to share a little information that I know of corneal pannus. It is defined in medilexicon as:

"fibrovascular connective tissue that proliferates in the anterior layers of the peripheral cornea in inflammatory corneal disease, particularly trachoma in which the pannus involves the superior cornea. Three forms occur: pannus crassus (thick), in which there are many blood vessels and the opacity is very dense; pannus siccus (dry), pannus with dry, glossy surface; and pannus tenuis (thin), in which there are few blood vessels and the opacity is slight."

It is often caused when oxygen supply to your cornea is reduced, for instance by overuse of contact lenses (mostly soft lenses) or the lenses that fit too tight. Your body's response is to supply the oxygen to the cornea by sending new blood vessels. The blood vessels cannot grow on the the hard, smooth surface of cornea, so the body "grows" extra fibrous tissue over the cornea upon which the blood vessel can grow. The result is opaque cornea.

I was taught one of the ways you can tell if your sclerals fit too tight is, if you look at your sclera, the white part of your eye through a magnifying mirror, you would be able to see a white ring around where the edge of the scleral lenses sit. This is similar to when you press your thumb on your skin, it briefly turns white as the blood flow is restricted. One of my optometrist showed me how to take pictures of my eyes looking at all directions, up, down and two sides, with his iphone camera.

[tealeaf]

Miki mama,
Is really good news to know that Dr G's lens help you. I hope both your eyes are able to be comfortable with Dr G's lens soon. In terms of dryness, are Dr G's lens able to give the same amount of comfort or better?

DID/Miki mama/L8rgator,
Do you still do warm compress and lidscrub? Do you apply eye gel to sleep at night?

DID,
You mentioned you managed to get your eyes dryness under control and not back to post lasik kind of dryness, is it due to the use of sclera lens?

Apologies for the many questions, I was about to fly down to Dr G in November but had to go for a sudden operation, thus the delay. Am trying to get as much information before scheduled to see him.

[grandsporta]

Miki mama,
Is really good news to know that Dr G's lens help you. I hope both your eyes are able to be comfortable with Dr G's lens soon. In terms of dryness, are Dr G's lens able to give the same amount of comfort or better?

DID/Miki mama/L8rgator,
Do you still do warm compress and lidscrub? Do you apply eye gel to sleep at night?

DID,
You mentioned you managed to get your eyes dryness under control and not back to post lasik kind of dryness, is it due to the use of sclera lens?

Apologies for the many questions, I was about to fly down to Dr G in November but had to go for a sudden operation, thus the delay. Am trying to get as much information before scheduled to see him.

Don't the lenses need to be tight in order to keep the lens from moving and sliding around the eye? If we all have dry eyes, won't the lens move around too much when you blink?

[miki-mama]

Don't the lenses need to be tight in order to keep the lens from moving and sliding around the eye? If we all have dry eyes, won't the lens move around too much when you blink?

The lenses need to be tight enough to prevent movement and to contain the fluid inside from leaking out, but not so tight as to cut off the oxygen supply. According to Dr. G, patients notice the loose fitting lenses more readily, because the movement causes irritation and inflammation, but not the tightness as much because they feel comfortable in the eyes. Speaking from experience, you can look at lens tightness as a "silent killer" (when it is excessively tight), because you don't notice it until it causes problems such as neovascularization and inflammation as it did in my case.

I think if we look at scleral lenses as a part of a number of regiments for offering comfort to damaged eyes, which need to be carefully monitored and maintained, it would be safer than considering it a solution which can be ignored as long as it continues to offer comfort. Before my comment scares anyone from considering the benefits of the scleral lenses, I would not live without, or more precisely, I COULD not live without my scleral lenses, because they offer tremendous amount of protection and pain relief to my eyes. My eyes cannot be fixed. Permanent damages have been done. So the only thing I can do is protect them, so that further damages don't occur. And the scleral lenses are absolutely an integral part of achieving that goal. I don't want to sound alarmist, but in my case, immediately after the trauma that caused my eye damages (in my case Stevens Johnson Syndrome) my eyes were in much, much better shape than they are in now. I thought it was pretty bad back when it first happened, but I wish I could go back to how it was back then. Because there is no cure, but things can continue to get worse, my recommendation is to do everything you can do now to protect your eyes from getting any worse.

I thought I was very proactive about my treatments. I didn't wait until things got terrible to seek help. I admit to being complacent occasionally, and that's when I got myself into hot water, frantically searching for treatments, etc. I have learned my lessons the hard way, and hopefully, I won't find myself in the recent situation I was in, again.

[L8rgator]

When my injury occured, I counted on my doctors to "take care of it". So I kept going back when I couldn't handle the discomfort a second longer (so about once every 3-5 weeks), and hearing the promises that the nerves will likely grow back, that it was temporary. Just use drops. Didn't work? Ok try ointments. Didn't work? Ok try moisture chambers.... we'll sew up the corner so your eye closes more tightly.... put in plugs... oh yeah there are top drains too so we'll do those... cauterize them permanently... recauterize because they opened up... put plugs over the cauterization to prove that they are closed... use drops (because if your regular eye doctor has had enough of you and is now "too busy" to make special appointments to see you, you get to see a new doctor who decides it's not a serious probably and you are just a baby so start back at scratch). I kept going back every month in agony, and didn't realize how much damage was being done to the surface of my eye. I just wish at any point any one of them would have at a minimum said "this is a serious dry eye problem, and it might be permanent". At that point I would have looked up desperation solutions much earlier and found scleral lenses far sooner and probably saved a year or more of letting my eye (not to mention my personality and mental health) get more damaged. I'm just so angry that nobody in the universe out here knows what sclerals - and many don't even know they exist. When I go in for a regular checkup for glasses/contacts for my other eye and the doctors and assistants look at me like "a WHAT lens? What is that for? So you wear it all the time time and never take it out?". Ok, seriously - aren't you the ones that went to school for this type of thing???!!! So that's why I come out to these boards and spill out and rehash every little details, so that others might not wait as long as I did. Or at least so they'll be more informed about their potential options then you'd get from an average optomologist/eye surgeon/optomitrist/face surgeon. Sometimes I want to scream from the hilltops.That and I want to get sclerals to be so common that insurances stop trying to jerk people around by initially denying claims as medically unnecessary, forcing everyone to have to appeal to even get insurances to take a first look at the claim.

Speaking of which, has anyone with sclerals had Humana? I had BCBS this year, and didn't even bother following up with paperwork because I was so emotionally messed up and dreading dealing with all the appeals I tried to fill out that I just could carry it through. I think Humana will be worse, but it would be interesting to find out if anyone else had luck with them.

My sclerals were definitely more snug when I got them. They were a perfect fit - just a bit of a hesitation when they came out (like an itsy bitsy pop as the suction released). I think my eyes had been inflammed from the damage I had for so long, and being bandaged over 24-7 previously with no fresh oxygen, that they were a bit swollen. When I got home and my eyes started to heal (which was very exciting) the pop went away. I think they fit even better now that they are a hair looser. no problems with loosing suction, or fogging, or moving around at all. Just feels smooth. When they feel loose and they move around on the first blink, I know instantly that it's because there is an air bubble. So I reinsert, and they are fine. That happens around once a month maybe. The liquid isn't really runny in the lens. Just the scientific structure of the fluid keeps it well seated in the lens of the eye.

I'll have to find a new doctor around here that is competent enough to watch for the signs of lenses that are too tight. I do think I'm going to head down to Dr G to see if I can get my lens made one size bigger (19mm instead of 18mm) and take my prescription. I measured 20-10 when I came out of Dr G's office at my other doctors offices and walmart. And now I can tell the prescription has gotten weaker. Unfortunately for the custom built lenses, 19mm that's the max size. He can do larger ones, but they are just stock rotational lenses - so manually fitted as much as can be, but not made for your eyes. I wonder why nobody has yet constructed a lens with a bit more of a lip in the east and west directions - like an oval. That would help cover more scleral, without adding to the difficulting if inserting them.

I also read about an electric device implant that can implanted near your lacrimal gland is in first round of clinical trials, in the US now! I'm excited about that and it really gives me hope for a long term solution in the future.

What kind of doctor do you recommend getting a scleral referral from?
OHHH I just remembered what SJ syndrom is. YEOCH that is scary scary! I know it has a big black warning on Lamical. And I just read a story today about a girl that took a bactrim and had it, and now she is burning from the inside out and may possibly go blind. Terrifying. I do count my start that I'm lucky that: It's only one eye; The eye can see fairly clearly, at least with no patch on; and there are not a bunch of other eye symptoms to treat.

[grandsporta]

The lenses need to be tight enough to prevent movement and to contain the fluid inside from leaking out, but not so tight as to cut off the oxygen supply. According to Dr. G, patients notice the loose fitting lenses more readily, because the movement causes irritation and inflammation, but not the tightness as much because they feel comfortable in the eyes. Speaking from experience, you can look at lens tightness as a "silent killer" (when it is excessively tight), because you don't notice it until it causes problems such as neovascularization and inflammation as it did in my case.

I think if we look at scleral lenses as a part of a number of regiments for offering comfort to damaged eyes, which need to be carefully monitored and maintained, it would be safer than considering it a solution which can be ignored as long as it continues to offer comfort. Before my comment scares anyone from considering the benefits of the scleral lenses, I would not live without, or more precisely, I COULD not live without my scleral lenses, because they offer tremendous amount of protection and pain relief to my eyes. My eyes cannot be fixed. Permanent damages have been done. So the only thing I can do is protect them, so that further damages don't occur. And the scleral lenses are absolutely an integral part of achieving that goal. I don't want to sound alarmist, but in my case, immediately after the trauma that caused my eye damages (in my case Stevens Johnson Syndrome) my eyes were in much, much better shape than they are in now. I thought it was pretty bad back when it first happened, but I wish I could go back to how it was back then. Because there is no cure, but things can continue to get worse, my recommendation is to do everything you can do now to protect your eyes from getting any worse.

I thought I was very proactive about my treatments. I didn't wait until things got terrible to seek help. I admit to being complacent occasionally, and that's when I got myself into hot water, frantically searching for treatments, etc. I have learned my lessons the hard way, and hopefully, I won't find myself in the recent situation I was in, again.

That's good to know.

I had TENS in 2003 and Dr. G fitted me for my lenses back in 2012 and they have saved my life. My life completely changed after I got those lenses. It's still a work in progress because there is so much damage but what a difference his lenses make! I am probably going to go back soon after the new year and have him check it out again since it's been a couple of years and have him make sure the lenses still fit properly.

[DryInDenver]

When I go in for a regular checkup for glasses/contacts for my other eye and the doctors and assistants look at me like "a WHAT lens? What is that for? So you wear it all the time time and never take it out?". Ok, seriously - aren't you the ones that went to school for this type of thing???!!!
So that's why I come out to these boards and spill out and rehash every little details, so that others might not wait as long as I did. Or at least so they'll be more informed about their potential options then you'd get from an average optomologist/eye surgeon/optomitrist/face surgeon. Sometimes I want to scream from the hilltops.

THANK YOU for screaming from the hilltops! I heard you and that's why I went to Dallas.

[DryInDenver]

DID/Miki mama/L8rgator,
Do you still do warm compress and lidscrub? Do you apply eye gel to sleep at night?

DID,
You mentioned you managed to get your eyes dryness under control and not back to post lasik kind of dryness, is it due to the use of sclera lens?

Apologies for the many questions, I was about to fly down to Dr G in November but had to go for a sudden operation, thus the delay. Am trying to get as much information before scheduled to see him.

I don't do the compresses anymore or the lid scrub however it is important to stay on top of eye hygiene since our dryness makes us more susceptible to infections. My eyes are better at night too even though the lenses are out while I am sleeping. I didn't use the night gel much before the lenses, but I would wake up at night with my eyes painfully sticking to my eyelids and that does not occur anymore. I think it is mainly because the surface of the eye is just in better and healthier condition.

My dryness was better only in my right eye but still pretty bad so I wouldn't quite characterize it as "under control" but it was much less painful. It's impossible to know for sure if it the improvement occurred because of the scleral lens, but I attribute the improvement to the lens. I just think that my eyes would have remained too inflamed without the lenses to heal at all.

[DryInDenver]

I looked a bit more into pannus and from what I can find it doesn't look to be a common risk with scleral lenses. Dr. G can decide to use different materials based a particular patient's needs, but most of his lenses are made with high DK materials with the same oxygen permeability that is used in the PROSE lenses. I think that there are enough people using this material that it would be well known if pannus was a common from the lenses.

That said, I think some of the issues above that some of us have dealt with after getting these lenses illustrate that it is important to continue to pay close attention to your eyes and maintain good hygiene. Sometimes it's too easy to get a bit to lackadaisical when the eyes stop hurting all day.

Last, as an update to my most recent surgery recovery, the epithelial cell ingrowth has mostly receded. That's great news because I shouldn't need to go back under the knife to scrape them out and start the recovery process all over again. I've asked my surgeon and a few other doctors when they thought it would be okay to put my right eye back into a scleral lens and the common answer seems to be to wait at least three months. The basic idea is to allow the flap enough time to heal and also for the vision to stabilize before getting a new lens. So once I figure out my schedule I'll most likely be going back to Dallas in Feb or possibly March.

[tealeaf]

Hi DID,
How's your eyes now? Are both eyes comfortable with Dr G's sclera lens? Do you have to take them out and re-insert during the day? I am traveling to Dr G this year and really really really hope that his scleral lens can give me relief to my dry eyes.