Scleral Lenses - How do I get them?

[DKott27]

Do I just go to the optometrist? I can't really find much information online.

*EDIT* I just read they cost thousands of dollars?

[Hokucat]

Usually your current eye doctor (optometrist or ophthalmologist) refers you to a scleral specialist, if they feel it can help your condition. More local optometrists are starting to fit sclerals, but would recommend going with a practitioner who has a lot of expertise fitting these lenses, as the right fit is key to give you the most success in wearing sclerals.

If you doctor is not familiar with sclerals or any specialists, here are some resources (these websites also include finding a fitter by location):


Boston PROSE

http://www.bostonsight.org/PROSE/PRO...y-Eye-Syndrome
Many in this forum use PROSE lenses, including myself. Have read PROSE has ~80% of the scleral market. I have been very happy with both the lenses and the expertise and experience of my doctor there. PROSE are on the higher end of the cost spectrum. What's nice is they also check with insurance and file all the paperwork.


Dr. Gemoules

https://laserfitlens.com
Several people in this forum have had success going to Texas to get his LaserFit sclerals. I don't think they process insurance paperwork, but maybe one can file themselves. Have read the costs, including lodging for a week, is much less than PROSE, although sounds like most people pay out-of-pocket for everything.


BostonSight Sclerals

http://www.bostonsightscleral.org/
This system fits sclerals based on a kit with several sizes of common sclerals, and was just rolled out a few months ago. It's supposed to reduce the time and costs of fittings, and enable more practitioners like local optometrists to fit sclerals. Since it's new, have not read anyone's actual experience with it yet.


Scleral Lens Education Society

https://www.sclerallens.org/scleral-fitters
This is a general resource (not brand specific) for scleral fitters. Many are also listed in the other resources above, like my PROSE practitioner is also on this society's list.


And yes, sclerals can cost anywhere from a few thousand to several thousand dollars. But if it is deemed a medical necessity, it could be covered by medical insurance almost completely, like my PROSE were.

Hope this info helps.

[MGD1701]

Hi Hokucat
Since now you dont need drops nor warm compress.
WHY you wear sclearl lens? - just for comfort?
Does it mean even your glands are now healthy, they still can not function well enough??
Do you know WHY? Maybe glands are short or not sufficient? Just curious! Thanks!

[Hokucat]

Hi MGD1701. Good question! I still wear my scleral lenses because:

1) I have some meibomian glands that were permanently lost/atrophied. And it's also possible my now functioning glands are producing oil, but not as much as they used to before I got MGD. So even though oils are flowing in the functioning glands which provide a thin tear film (vs. no tear film during my worst years), I still have some remaining dryness which wearing the sclerals 12+ hours a day help with, both when I am wearing them, and while I'm not wearing them. The reason I say the sclerals seem to help even while I'm not wearing them, at least for a day or so, is a few months ago I didn't wear my sclerals for several days in a row and my eyes started to feel a little drier than normal by the third day without the sclerals.

2) I need the vision correction, but want to limit the potential cornea damage studies are finding regular contacts that lay on the cornea may be responsible for. This actually happened to one of my friends who wore contacts for many years, and doctors are saying the likely reason for her is long term regular contact lens use...she currently cannot see out of the damaged eye, and may potentially need a cornea transplant to get her vision back. So sclerals are starting to be recommended for patients without cornea or dry eye issues as a preventative measure, as well as sclerals do provide superior vision correction in most cases.

[MGD1701]

Thanks Hokucat
Do you need to apply drops/Gels/ointments before bedtime?

How do you 'monitor' your glands/MGD status to ensure NO further damage/loss, visit doctor every 6 months?

Thanks again!

[Hokucat]

MGD1701, I do not use any drops/gels/ointments before bedtime or ever anymore, except I do put a couple drops of preservative-free artificial tears in my sclerals with the saline when I insert them at the beginning of the day. I do however wear TranquilEyes moisture goggles at night, but am not sure I need them anymore, so may try taking a break from them. I still use the Ocusoft Lid Scrub Plus Foam morning and night.

I do see a few eye specialists at least a couple times a year, and they check my tear film, look for dry spots on the surface of my eyes, and take a cursory look at my glands. I should make an appointment with my probe doctor to get a more in-depth status of my glands. But the main way I also know I'm doing well is my eyes continue to FEEL better.