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Scleral lens and convergence insufficieny

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  • Scleral lens and convergence insufficieny

    Hey all,

    This is a very random one that sort of relates to dry eye....wondering if rings a bell with anyone. I've got medium-ish MGD; mornings are usually ok but by early afternoon they are burning. Xiidra seems to help a bit, as does heat compress. That's step one. Step two is where it gets weird. I was fitted for scleral lenses to relieve the MGD symptoms and they work marvelously. When the sclerals are in, I forget I have dry eye. My vision is 20/20 and the lenses' fit is A+. After 1-4 hours of the lenses being in (it varies), I begin to get really strained muscles in my temples and then headaches. As soon as I take the sclerals out, the issue goes away. Problem is the dry eye returns.

    I brought this up to my ophthalmologist and she kind of shrugged. Did some testing and said I have mild convergence insufficiency. Does it make sense to anyone that I would only have CI symptoms with a specific pair of sclerals in? When I'm wearing my prescription glasses or sunglasses, I have no issues. I've tried prism glasses over the sclerals with no luck. Something doesn't add up.

    Anyone have any ideas or heard of this?

  • #2
    Hi there!

    I feel like there have been quite a few people over the years who've reported things like this in the FB scleral group (which is, unfortunately, almost impossible to search). I have experienced things like this before myself though not persistently.

    Do you have your over-refraction data for each eye individually? Is there any chance you are over-corrected? or have a little too much anisometropia? some of us are more sensitive to it than others. - I have been through a couple of stretches (reasons unknown) where some kind of vision fluctuation made it really difficult to tolerate sclerals for long. Elusive kind of problem.
    Rebecca Petris
    The Dry Eye Foundation
    dryeyefoundation.org
    800-484-0244

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    • #3
      I've encountered somewhat similar experiences. After wearing the scleral lens for about 30 minutes, it tends to settle deeper into my eyes, creating pressure to the extent that I need to remove and reinsert it. Concerning convergence insufficiency, Rebecca raised a valid point. In my experience, this issue often arises from a spasm in the accommodative muscles, usually due to over-correction. You might want to try using plus glasses, or even reading/computer glasses, on top of your scleral lenses to see if there's an improvement. Additionally, vision therapy with these plus glasses, especially Base-In vergence and accommodative rock exercises, should be considered. Please keep us posted!


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