Incomplete lid closure, blurry vision and Prose/scleral lenses

[minaogon]

Hi - I am hoping to hear from those out there who have issues with lid closure and using Prose lens (or other scleral lens). I have had dry eye issues for year mostly manageable however with multiple strabismus surgeries and trauma, I have been left with incomplete lid closure (upper lid) on my one eye. It has created much problem with my vision - blurriness, ghost vision etc. which makes it close to impossible for me to function.. Currently I have a bandage lens 24/7 and have had so for 8-9 weeks to protect my cornea.

I mainly use this one eye (almost like being one eyed, left eye has vision but right eye my lead eye) so not being able to see clear but only blurry, white out etc. is disabling me almost completely.

Together with my cornea doctor, I am trying to find solutions so I can stop wearing a bandage lens at night with antibiotic drops. I am exploring trying Prose (not committed yet) and first consultation went well. I have also been trying piggy back soft and hard lens. I did get very good vision with both these options when tried briefly which is very good news so far but I am concerned about the continued exposure with lids not closing at night time and risk continued blurriness and developing corneal ulcers etc. when I stop using a bandage lens. I will most likely go for the Prose even if expensive, because of it does not work I sadly have not much choice but to have my lid lowered which I so hope I will not have to do. Have any of you out there started to use Prose or other scleral lenses due to lack of lid closure causing dry eye? Has it helped with Prose/scleral lens or not been a good solution? What has helped with limiting your lid exposure and helped to increase/maintain tears and protection for your cornea? I would appreciate it very much to hear from those of you who specifically tried or are using scleral lens as solution for incomplete lid closure or if you have come across other solutions that has helped with your blurry vision and dry eye.
Thank you in advance!
Marie

[Guest]

I wear my PROSE sclerals as much as 12+ hours a day, and it definitely helps with my daily functioning, like going outside, in A/C, reading, using electronic devices, driving, watching tv, etc. I also noticed if I wear my glasses instead of of my sclerals for a few days after wearing sclerals, my eyes still feel pretty good, but if I go too many days without my sclerals, my eyes start to feel dry. So I think the sclerals covering the cornea in saline all day (and I also put in a few drops of PF artificial tears and serum tears) are beneficial when not wearing them as well, at least temporarily.

Are you using moisture chambers during the day and night protection goggles while sleeping? Also Genteal Severe Dry Eye Gel was not only soothing and moisturizing, but gave me the best substitute tear film I could get during my zero tear film years.

[Guest]

This is relevant to me and I’m sure a couple other members, hope someone chimes in. I think at the end of the day however, you don’t know until you try.

[Hokucat]

Sorry, I posted above as a guest! Dowork is right, you won’t know unless you try...it sounds promising your first PROSE scleral consult went well. You must have been able to tolerate wearing the lenses, and it made your eyes feel better when you tried on the trial pair?

[minaogon]

I am glad to hear that you using your PROSE as much as 12+ hours a day and that you go about your daily functions! I will go ahead with the investing in the PROSE before deciding on lowering the lid. Yes, the initial trial (not into the fitting yet) went very well. I only had it on 15 minutes or so the first time and I started to get a little bit of fog towards the end of the session however the PROSE person thought it was from having had gel at night so at my next try where I had the lens in for 1 hour (both inside and walked outside), I saw like an eagle and no fog. It was a little strange feeling in the eye not being used to the big hard lens (Only worn soft lenses in my young years) but it was not bothering me and I started to feel it less and less while trying it. I can only hope it will work for me. I do wear cling wrap at night but will purchase goggles - I just have used cling film for years and it is soft and not in my way when sleeping but probably not as effective as goggles? Currently I am also wearing the cling wrap when I am home over the right eye the bad one only. I do like Genteal Gel a lot at nighttime just not using it now because I have a bandage lens. But if I go ahead with PROSE I will do Genteal get at night. I am glad to hear you have even been able to wear your glasses sometimes in between -- so would you say the PROSE is not just keeping your eyes at status quo helping you with day to day stuff or would go so far to say the dry eyes have gotten better with having the PROSE? I am hoping PROSE would not just help me get by but hopefully give my eye a boost and maybe long run making it a little bit better but hopefully too much to ask....I will be happy if I can only use it and it works! Thank you for replying and sharing all the info! This is all very scary the blur and white out to me and struggling in everyday activities...

[Hokucat]

Your two PROSE scleral consults so far sound very promising. Like you, I could definitely feel the lens in my eyes at the consult but it was not uncomfortable. After I got my lenses, over the first few weeks I noticed them less and less each day, then soon often forgot I had them on. However, after half a year my MGD and aqueous deficiency got really bad, so I had no tear film and the surface of my eyes became like sandpaper. That made my sclerals so uncomfortable, I could not wear them anymore. It was not until I got better several years later with probing+diet, which helped me get some tear film back and the surface of my eyes become more smooth again, that I was able to wear sclerals again. Just wanted you to be aware if your eye condition changes, it might affect your ability to wear sclerals for awhile.

If cling wrap works for you, there’s nothing wrong with continuing with that, plus it’s economical. I use EyeSeals 4.0 while sleeping, but for me it’s not a snug fit, plus if you don’t sleep on your back it does not work as well. Some people find bubble bandages or Eyeloccs helpful for sleeping or even in the daytime, as some have a clear window. These are sold in the Dry Eye Shop:

https://dryeyeshop.com/collections/nights?page=2

Yes, I’d say the surface of my eyes has improved some with PROSE. I don’t think I would be able to go with glasses for a few days and still feel decent, if it was not helping.

I don’t know if you have good medical insurance or not, but the PROSE folks are excellent at working directly with your insurance company and providing them with all the necessary paperwork, I didn’t work with my insurance company at all. In the end, I think I only had to pay a few hundred dollars for the consult plus lenses.

I’m excited for you that it looks like sclerals will help you. Let us know how it goes when you get fitted with your lenses.

[Guest]

Just a side note, I think night protection is very important. The goggles didn’t work for me, if you have the same issue, I’d say try taping your eyes shut. It’s the only thing giving me relief. Good luck with the sclerals!

[minaogon]

What do you use to tape your eyes at night and how do you do to keep it closed? I tried some soft tape the kind they use in hospitals but find it opens up. Hope to hear as to what you use and how you apply the tape.

[minaogon]

I was going to try buy the EyeSeals 4.0 but not sure it will work for me - a snug fit is important and the cling film sticks nicely if I use Vaseline to attached it with (forehead and cheeks). I am concerned what to do those times when PROSE may not work because I have not enough tear film (god knows I have almost no tear film in my right eye due to scarring and trauma in upper lid area from strabismus surgeries and damage of the corneal epithelium. What did you do to protect your eyes and function when the PROSE lens did not work? I would love to hear what you changed in the diet to get more tear film!

[Hokucat]

Stick with cling wrap if that is working well for you. I would say the EyeSeals would not be as snug.

I’ve heard of some people who don’t have any tear film who are able to wear sclerals.

When I couldn’t wear my sclerals for several years, I used the Genteal Gel day and night, with moisture chambers during the day and night gear while sleeping. That took the edge off the discomfort, but definitely not optimal.

After probing opened up my glands, the first diet change that made a noticeable difference in my tear film was adding fresh lemon juice to my daily green tea. I continue to make changes to my diet that help, but for me none has been as impactful as the lemon/green tea.
Everyone has different underlying conditions so what works for you might be different, but in general I eat a diet rich in antioxidant, antibacterial, and anti-inflammatory foods:

I limit gluten, dairy, and sugars. These three things always made and still make my eyes feel worse.

BREAKFAST - I've found I need to start off the day with my main meal:
-Drink one cup water as soon as wake up.
-Spinach or dark leafy greens salad. Extra virgin olive oil with fresh grinded peppercorns and a little salt for dressing. Recently started adding raisins and raw sunflower seeds.
-One cup fresh berries (strawberries, blueberries, blackberries)
-Small portion of protein (usually chicken or salmon, but find a good cut of steak or filet mignon for some reason always makes my eyes feel even better)
-Green tea with juice from 1/6 of medium to large meyer lemon and slice of crushed ginger
-Supplements related to eyes - Ocuvite-type eye vitamin, flaxseed oil, fish oil, vitamin A, bilberry

DURING DAY:
-One cup fresh vegetable juice (or thawed from frozen - I juice once a week and freeze it). A rainbow of colors: Kale, chard, parsley, bok choy, cucumbers, beets, carrots, butternut squash, apple.
-Snack on nuts and fruit (bananas, melons, dried prunes-for potassium & fiber).
-Drink lots of water.
-Green tea with lemon and ginger (but these days I often skip this second round of lemon/tea)
-If I’m going to eat something not so healthy like pasta or a sandwich, cookies, chips, etc. I’ll eat a small portion here in the middle of the day, as it seems to have the least negative effect on my eyes, as long as I had my good breakfast.

DINNER:
-Small portion of protein
-Vegetables (usually broccoli, asparagus, etc., something dark green)

EVENING:
-Chamomile tea
-Drink a cup of water right before bed

[Guest]

What do you use to tape your eyes at night and how do you do to keep it closed? I tried some soft tape the kind they use in hospitals but find it opens up. Hope to hear as to what you use and how you apply the tape.

I’ve used a few tapes, 3m nexcare sensitive skin, 3m paper tape sensitive skin, eyelocc...but the one hats worked best so far is this silicon mepitac take from the dry eye shop. It’s strong to keep the lids closed, but comes off so nicely. It conforms to the lid so nicely. The other takes, you can feel them. This tape, it’s much less noticeable. AND I’m not allergic to the adhesive so far.

I used the glad press n seal plus Vaseline too. If you try this method of taping the eyes, and you do it properly, you will never go back to vaseline and Saran wrap. Just one drop of gel, then I tape from my nose, just past my eyelids. Seals them completely. Only time the seal breaks, is when I use too much gel and it leaks out. Just be careful on how much gel or ointment you put on before applying the tape.

[minaogon]

Oh this is so helpful - thank you! I will order the silicon mepilac from the store. I will also try glad press n seal - I already have that at home just didn't apply it the way you describe. So you just take a narrow strip long strip and place it from nose past eyelids? How wide and long would you say about the piece is that you use! Does it not hurt your lids? This is great stuff...thank you!

[minaogon]

I just read about your diet suggestions - I am going to add lemon to my green tea. I totally agree there is a connection with the diet. I am gluten intolerant and if I do not stick to it, I suffer not only in my body but eyes too. I have tried sunflower seeds - they help....so I will try some of the other things you listed. I am taking flax seed oil and cod liver oil. Also, some supplements like COQ10 seems to help with the tear production as well as zinc for me. What moisture chambers did you use during day time? I use cling wrap but would love to hear what type you used if something from the dry eye shop? Thank you!

[Hokucat]

That’s promising you notice diet has an impact on how your eyes feel. This may mean you might be able to get at least some resolution, once you find the right diet for you.

When my eyes were severely dry, I used the Eye Eco moisture chambers. This was the only one of the many I tried that fit my small Asian profile the best (although still not optimal), because it can be ordered in size small and it has a bendable nose bridge. You can order this directly from Eye Eco.

https://www.eyeeco.com/new-small-moi...html?cat-id=52

[mbperso]

I’ve used a few tapes, 3m nexcare sensitive skin, 3m paper tape sensitive skin, eyelocc...but the one hats worked best so far is this silicon mepitac take from the dry eye shop. It’s strong to keep the lids closed, but comes off so nicely. It conforms to the lid so nicely. The other takes, you can feel them. This tape, it’s much less noticeable. AND I’m not allergic to the adhesive so far.

I used the glad press n seal plus Vaseline too. If you try this method of taping the eyes, and you do it properly, you will never go back to vaseline and Saran wrap. Just one drop of gel, then I tape from my nose, just past my eyelids. Seals them completely. Only time the seal breaks, is when I use too much gel and it leaks out. Just be careful on how much gel or ointment you put on before applying the tape.

Could you please explain very precisely how to make and apply it ?
dimension, where and how to put it?