corneal neuropathy

[Brian234]

Hi,
I am a 28 year old guy and have always worn soft contact lenses which was troubled by dry eyes. This excacerbated by meibomian gland dysfunction which resulted that I have red burning eyes the whole time. By lots of warm compresses, the MGD has been much better with OK oil quality at the moment. But this didnt fix the burning and scratchy feeling which is likely caused by neuropathy of the cornea. Many treatments (artificial tears, steroids,xiidra, plugs, doxyciclin, ointments) did not provide any benefit. I am currently using scleral lenses and serum eye drops, and have tried also a prokera lens. Does anyone have experience/recommendations how to combine serum tears with scleral lenses? Fill the lenses with it, or not? Or how to further reduce the redness/inflammation? Thanks a lot!

[pythonidler]

Hi and welcome to the forum.

I use both serum tears and scleral lenses. Initially, I filled the lenses with serum tears, but after talking with my doctor he convinced me to stop doing that. He thinks there is an increased chance of bacterial infection if you fill with serum tears.

So instead I fill the lenses with saline. For the serum tears, I use four drops over the course of a couple hours before I put the lenses in. Likewise, I put four serum tears drops for a couple hours after I take the lenses out.

[Hokucat]

In my sclerals I first put in two drops of Refresh Celluvisc and roll it around so it coats the entire inside of the lens. Then I put in two drops of serum tears and fill the rest with saline. The Celluvisc seems to provide an addition cushion and seal that lessens the debris that gets under my lenses, however it’s not perfect. Many scleral wearers find the thicker Celluvisc drop in their lenses helps with comfort, and it is also recommended by several scleral specialists including mines. And similar to Pythonidler, before and after wearing my sclerals I use serum tears. I put in one drop soon after I wake up, another a few minutes before inserting my lenses, another right after removing my lenses, and one or more before sleeping (depending on how soon after I remove the lenses I go to sleep).

My PROSE scleral specialist said it was fine to also use a few drops of serum tears in the lenses. However I am very careful to only use serum drops recently thawed from frozen in the refrigerator in my sclerals and at all times, to limit chances of bacterial infection.

Also, a good forum friend who is no longer in this forum was recently prescribed Healon (preservative free, key ingredient Sodium Hyaluronate) to put in his sclerals. He had been using a few drops of Celluvisc up to this point, and for one week swapped the Celluvisc in one eye for Healon and kept Celluvisc in the other eye. He said his experience was with the Healon it was superior to Celluvisc because the feeling of the lens, lens irritation and eye burning was reduced, and it was also easier to remove the lenses and his eyes were not was red. I have ordered Hylo Forte which is a PF Sodium Hyaluronate drop more viscous like Celluvisc to see if swapping this for Celluvisc is superior for me as well.

Of course any changes you make to what you use with your sclerals should be run by your scleral specialist first.

[Brian234]

Hi thank you very much for your detailed answers. Yes I think it is not very clear yet what the optimal approach is with scleral lenses and serum drops and the risk of infection. If you do not put the drops in the lenses you will limit the amount of times you can put it into your eyes. My eyes become red and uncomfortable with the scleral lenses I will try the celluvisc whether that helps. For some reason I also think that scleral lenses may not be the right option with nerve regeneration. It may prevent the stimulus (binking over cornea) that is needed for nerve regeneration. best