Scleral Lens Acclimation Period

[CJ L.]

Hi all,

Just picked up my Boston PROBE scleral lenses the other day. Can anyone who's used them with any luck tell me how they used them to get going as far as hours for the first few weeks? I must say, they feel amazing but after an hour they do begin to cloud. I wore them about five hours on day one and almost ten yesterday (gulp) as I'm on a short vacation in a very dry climate.

Any insight into peoples' experience would be much appreciated.

CJ

[CJ L.]

Sorry, after a deep dive into the fine print this is what I found.

[Hokucat]

I've worn Boston PROSE for several years now, I wear then 12+ hours a day. That's pretty good that already you've been able to wear your sclerals so many hours and they feel good, except for the clouding. That gradually increasing wear-time schedule is recommended, however like you, the first week I got my sclerals I wore them 10 hours a day and it was fine. Clouding is common, especially in the beginning until you find ways to mitigate that. Definitely mention this to your fitter, as there could be multiple reasons, but some common reasons and potential solutions are:

-You might need a better seal and/or more cushioning. My PROSE specialist recommends putting a few drops of Refresh Celluvisc preservative-fee artificial tears in the lenses with the saline to make a better seal to keep out any debris and provide more cushioning than saline alone. Several people in this forum also find adding Celluvisc helpful. A few months ago I was using my eyes more extensively, and towards the end of the day my sclerals were getting a little cloudy (I do not remove, clean, refill and reinsert during the day), so I tried the adding the Celluvisc when I insert them in the morning and it definitely helped eliminate the clouding, at least for me.

-Your lens fit may not be optimal. Sometimes a slight adjustment can reduce/eliminate clouding.

-The saline and/or cleaning products might be bothering your eyes. If you went to a PROSE specialist, am assuming they recommended you use Purilens PF buffered saline to fill and rinse your lenses, Lobob ESC to clean your lenses, and Clear Care to soak your lenses overnight. So perhaps need to make changes to one or more of these, for example, some people prefer unbuffered saline.

-Make sure to wash your hands before inserting and removing/cleaning your lenses with soap that has no moisturizers, fragrances, etc. These can bother your eyes.

And there are some people who do just need to remove, clean, refill and reinsert their lenses a few times a day to manage the clouding. But I think it looks hopeful for you in the long run using the sclerals, given it feels good and you can tolerate the lenses. Some people cannot tolerate having them in their eyes at all. Good luck, and let us know if you have any other questions!

[CJ L.]

Hokucat Thanks so much. My follow up is next week to talk about the fit after having been wearing them for a couple of weeks. I want to do whatever I can to make them work as I feel I'm running out of options and, of course, the fact that I almost had to take out a second mortgage to buy the pair. The price is incredibly hard to justify without seeing some positive results. Thanks again for the info!

[Hokucat]

You’re very welcome. I forgot to mention if you have clouding on the outside of you lens, my PROSE specialist told me to put a few drops of Boston Conditioning Solution on a Qtip to clean the outside surface of the lens while wearing them. I’ve actually used a modified version of this where I soak the Qtip in saline to clean the surface of my lenses. Also, sometimes just putting several drops of saline or a less thick preservative free drop like Genteal Tears around and over the lenses while wearing them helps with outside clouding and with dryness.

Did you have them look into whether your medical insurance covers some of the costs of your sclerals? Am assuming you did, but just wanted to mention it in case you didn’t.

Make sure to be very particular about the fit, even if it takes several lens fittings. That’s a big reason for the high costs, as they assume they may need to make at least a few lens adjustments. My specialist made one slight power adjustment to both lenses, and she let me keep the other set as a spare, which was great given the cost of sclerals. So get your moneys worth.

Even if the sclerals help, keep doing things and looking for treatments to help the underlying condition of your dry eyes. For example, if you have MGD, keep doing blinking exercises (you can do these with your sclerals on too), IPL, gland expression, diet changes, etc.