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  • Scleral nodule

    I have severe dry eyes caused by both a deficit of aqueous tears and posterior blepharitis resulting in no oily tear layer and a very short tear breakup time. I had tried many treatment options (both medical and non-medical) with little success until I was fitted with PROSE scleral lenses. For the last two years I have been wearing PROSE lenses and they have been a life-changer for me. Before PROSE, I was extremely limited in how much reading and driving I could do because my vision would get blurry often and my eyes were extremely sensitive to light. With the PROSE lenses I have been able to read and drive. About a month ago my right eye became inflamed. I went to the eye clinic where I was seen by an optometrist; she said the problem was that I had a nodule on the sclera that was being irritated by the scleral lens. She prescribed Lotemax drops and said that I should not wear the lens until the inflammation is gone. I followed up with her weekly for three weeks. The inflammation went away, but the nodule is still there; apparently it is not going away. I had tried putting in the scleral lens again, but my eye got inflamed after a couple of hours so I took the lens out and have not tried wearing it since. I followed up with my ophthalmologist a few days ago and he said that he thought I should be able to wear the scleral lenses even with the nodule and that after I finish the bottle of Lotemax I should give it another try. The nodule does not look like a pinguecula; I asked the ophthalmologist, and he agreed that it is not a pinguecula. It is on the lower inner quadrant of my eye, completely covered by my lower eyelid, so it does not look like it would be caused by sun damage. I have mild rosacea on my facial skin and was wondering if the nodule might be associated with ocular rosacea, but the ophthalmologist didn't think so.

    I have been wearing the PROSE lens only in my left eye this past month. It is better than not wearing either lens, but makes focusing up close very difficult, and also my eyes are very sensitive to light again without the right PROSE lens in. I'm frustrated because it was so much better when I could wear both lenses. I live in northern CA (I was living in NY when I had my PROSE lenses fitted there at Weill Cornell). I was going to go to the PROSE clinic in San Francisco to see if they could design a lens that wouldn't irritate the nodule but when I called UCSF they told me they no longer have a PROSE clinic. I am considering going to BFS to see if they can fit me with a scleral lens, or possibly going back to Weill Cornell in NY, since I had such a good experience there. I will have to call each place to ask about details- cost and whether it is possible to wear a scleral lens if you have a scleral nodule. I am on Medicare now, which doesn't pay for scleral lenses for dry eyes (my insurance paid for much of the cost when I had them fitted two years ago before I was on Medicare). Before I make a decision to have a new lens fitted, I want to make sure it will actually work before I lay out so much money.

    Has anyone had experience with a scleral nodule? Do they ever go away? Has anyone had experience wearing a scleral lens if they have a nodule on the sclera? Thanks in advance for sharing any experience you have with this. Judy

  • #2
    prose at UCDavis in Davis CA

    I'm not familiar with the issue you've described but just wanted to mention that they do scleral lenses at UC Davis and it might be a more convenient location to see if they can create a lens that doesn't irritate your eye
    Betty
    Originally posted by heyjude0701 View Post
    I have severe dry eyes caused by both a deficit of aqueous tears and posterior blepharitis resulting in no oily tear layer and a very short tear breakup time. I had tried many treatment options (both medical and non-medical) with little success until I was fitted with PROSE scleral lenses. For the last two years I have been wearing PROSE lenses and they have been a life-changer for me. Before PROSE, I was extremely limited in how much reading and driving I could do because my vision would get blurry often and my eyes were extremely sensitive to light. With the PROSE lenses I have been able to read and drive. About a month ago my right eye became inflamed. I went to the eye clinic where I was seen by an optometrist; she said the problem was that I had a nodule on the sclera that was being irritated by the scleral lens. She prescribed Lotemax drops and said that I should not wear the lens until the inflammation is gone. I followed up with her weekly for three weeks. The inflammation went away, but the nodule is still there; apparently it is not going away. I had tried putting in the scleral lens again, but my eye got inflamed after a couple of hours so I took the lens out and have not tried wearing it since. I followed up with my ophthalmologist a few days ago and he said that he thought I should be able to wear the scleral lenses even with the nodule and that after I finish the bottle of Lotemax I should give it another try. The nodule does not look like a pinguecula; I asked the ophthalmologist, and he agreed that it is not a pinguecula. It is on the lower inner quadrant of my eye, completely covered by my lower eyelid, so it does not look like it would be caused by sun damage. I have mild rosacea on my facial skin and was wondering if the nodule might be associated with ocular rosacea, but the ophthalmologist didn't think so.

    I have been wearing the PROSE lens only in my left eye this past month. It is better than not wearing either lens, but makes focusing up close very difficult, and also my eyes are very sensitive to light again without the right PROSE lens in. I'm frustrated because it was so much better when I could wear both lenses. I live in northern CA (I was living in NY when I had my PROSE lenses fitted there at Weill Cornell). I was going to go to the PROSE clinic in San Francisco to see if they could design a lens that wouldn't irritate the nodule but when I called UCSF they told me they no longer have a PROSE clinic. I am considering going to BFS to see if they can fit me with a scleral lens, or possibly going back to Weill Cornell in NY, since I had such a good experience there. I will have to call each place to ask about details- cost and whether it is possible to wear a scleral lens if you have a scleral nodule. I am on Medicare now, which doesn't pay for scleral lenses for dry eyes (my insurance paid for much of the cost when I had them fitted two years ago before I was on Medicare). Before I make a decision to have a new lens fitted, I want to make sure it will actually work before I lay out so much money.

    Has anyone had experience with a scleral nodule? Do they ever go away? Has anyone had experience wearing a scleral lens if they have a nodule on the sclera? Thanks in advance for sharing any experience you have with this. Judy

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    • #3
      Thanks, Betty. Does UC Davis do PROSE scleral lenses? I can get scleral lenses by an experienced fitter close to where I live but they are not PROSE lenses. One of the options I have been considering is trying another kind of lens, but I have had success with the PROSE lenses and I hear so many complaints about other kinds of scleral lenses, that I am not sure I want to take a chance on another kind. But the other scleral lenses are much less expensive than PROSE, so it might be worth it to try. I haven't decided yet. Judy

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