Dry eye/Scleral Lenses protein deposits

[thekiltman85]

Good afternoon,

I'm wondering if anyone has the solution here. Problem: Keratoconus sufferer who wears Scleral lenses prescribed by Boston Foundation for Sight. Midway through the day the eyes start to become Gunky (eye boogers) whatever you want to call them. Sometimes this happens within an hour, sometimes it takes a few. The lense also becomes cloudy, and the only way to remove the protein deposits is to soak overnight. This problem began when I was wearing my old RGP lenses.

I have begun restasis drops which seem to be helping the problem a bit, but not nearly enough.

What can I do to resolve goopy/gunky eye, and protein deposits on my lenses? This happens every day, even if I use protein remover such as Unizyme at night. if I remove the lenses and clean them, sometimes this helps temporarily but within 10-20 minutes the gunk is back. Thanks in advance,

P.S. I have a visit with my new eye docs in January at Duke eye center in Raleigh NC.

Best Regards,
Aaron

[DCRdryeye]

Hi Aaron,
How long have you had your Scleral lenses for? Mine are new and I can wear them up to 10 hours or more without any protein deposits, goop or cloudiness. I've certainly experienced all this with a different type of lens and a different fitter in the past. I'm wondering whether it's because your lenses have aged, if your maintaining them correctly (eg: using a protein removal solution once a month) or is it the Lens itself?

[spmcc]

Have you contacted BFS?

[thekiltman85]

happens all the time

the lenses are getting older and need to be either re-plasma coated, or replaced, however this issue has been happening since day one. I asked BFS about it and they offered some solutions. 1) perhaps it's just your eyes getting used to the lense. 2) re goopiness take the lenses out and clean them, use cotton swab to rub goop off lenses while wearing them, 3) use an enzymatic cleaner.

After leaving BFS my general Optom had started me on restasis. I've finally begun taking it and it does seem to help the pain, but not as much so far with the blurring and protein. I soak the lenses at night in Clear care, use enzymatic cleaner once a week, and clean during the day with Optimum.

[littlemermaid]

http://www.dryeyeshop.com/solutions-c96.aspx Are there enzymatic cleaners here that might do better?

Do Restasis or your other eyedrops damage or cling to the lenses? is there oily residue from the emulsion? 'Cyclosporine is a fine white powder. RESTASIS® appears as a white opaque to slightly translucent homogeneous emulsion. It has an osmolality of 230 to 320 mOsmol/kg and a pH of 6.5-8.0. Each mL of RESTASIS® ophthalmic emulsion contains: Active: cyclosporine 0.05%. Inactives: glycerin; castor oil; polysorbate 80; carbomer copolymer type A; purified water; and sodium hydroxide to adjust pH.'

Has anyone looked at your tear film to see if there is debris or mucous? do you still have oily or flaky blepharitis? which eyelid scrub are you using? do you have any skin issues around the eyes or scalp? (sorry no lens experience, trying to manage blepharitis with burning enzymes from skin condition)

There's chat in UK Keratoconus forum about this http://www.keratoconus-group.org.uk/...s=lens+deposit so maybe post up there, US and Canada groups too.

[DCRdryeye]

So it's been happening from day one? From my own experience, I've been trying different Scleral brands with multiple fittings over 4 yrs. One brand ALWAYS gooped up with debris and got cloudy, sometimes the debris occured within minutes. But with this new model of Scleral lens it does not happen at all, not even after 10 hours wear so I'm obviously extremely excited and "relieved".

Well, after paying BFS $$$$$$$$$$ you should NOT have such a problem on day one. You'd expect a more detailed and meticulous process. And who said they were the best? Guff!! Perhaps ask them for a different type of coating, if they do not cooperate, demand a refund. You cannot expect to continue taking them off, cleaning and re-filling all the time. That is a nuisance and a bit of a time waster. They aren't exactly easy to put in and it can't be done just 'anywhere'. I once had to go to a train stations rest room and ask to use their private rooms to place mine in.

[thekiltman85]

The restasis does not seem to be a problem. To be honest the problem occurred far before I used Restasis, though i have heard many mixed to negative reviews about restasis. i'm going to continue useage for a while and monitor my results. I have brought up my mucus issue at the doctors and they have been able to see it, but no one really seems to have a clear answer. Currently i am not using an eyelid scrub but I'll try it. And yes I do have a skin condition, I have Seborrheic Dermatitus (excess production of yeast on my face and scalp),and I have often wondered if these had any correlation (some resources say they can be linked). Do you have any recommendations for a good eyelid scrub? I usually just use a clean washcloth with warm water. The dry flaking skin that I get on my scalp and where my bear grows, never seems to happen on the eyelids, but that doesn't mean it's not a cause for concern.

Re: BFS I have an apointment with a new clinic (we've moved to NC) which is very highly regarded. I am going to try and be re-fit for new scleral lenses, because my current ones seem like my perscription is changing. I can only hope that perhaps it'll get better with change, however this happened with both varities of my old RGP lenses. Thanks everyone for the prompt and great advice.

http://www.dryeyeshop.com/solutions-c96.aspx Are there enzymatic cleaners here that might do better?

Do Restasis or your other eyedrops damage or cling to the lenses? is there oily residue from the emulsion? 'Cyclosporine is a fine white powder. RESTASIS® appears as a white opaque to slightly translucent homogeneous emulsion. It has an osmolality of 230 to 320 mOsmol/kg and a pH of 6.5-8.0. Each mL of RESTASIS® ophthalmic emulsion contains: Active: cyclosporine 0.05%. Inactives: glycerin; castor oil; polysorbate 80; carbomer copolymer type A; purified water; and sodium hydroxide to adjust pH.'

Has anyone looked at your tear film to see if there is debris or mucous? do you still have oily or flaky blepharitis? which eyelid scrub are you using? do you have any skin issues around the eyes or scalp? (sorry no lens experience, trying to manage blepharitis with burning enzymes from skin condition)

There's chat in UK Keratoconus forum about this http://www.keratoconus-group.org.uk/...s=lens+deposit so maybe post up there, US and Canada groups too.

[thekiltman85]

happens all the time

Might I ask you what kind/brand of lenses you're wearing now.

So it's been happening from day one? From my own experience, I've been trying different Scleral brands with multiple fittings over 4 yrs. One brand ALWAYS gooped up with debris and got cloudy, sometimes the debris occured within minutes. But with this new model of Scleral lens it does not happen at all, not even after 10 hours wear so I'm obviously extremely excited and "relieved".

Well, after paying BFS $$$$$$$$$$ you should NOT have such a problem on day one. You'd expect a more detailed and meticulous process. And who said they were the best? Guff!! Perhaps ask them for a different type of coating, if they do not cooperate, demand a refund. You cannot expect to continue taking them off, cleaning and re-filling all the time. That is a nuisance and a bit of a time waster. They aren't exactly easy to put in and it can't be done just 'anywhere'. I once had to go to a train stations rest room and ask to use their private rooms to place mine in.

[DCRdryeye]

It's a new design on an earlier version. The new design has a more flat edge and sits lighter on the eye. But the designer and his company is in Australia. The website is: http://www.innovativecontacts.com.au/page23/index.html

[thekiltman85]

Thanks for the information, I'll definitely have to check them out. Do you know if these lenses are FDA approved for use here? If I ask my Doctor about them will they be able to order them, or is it something I'll have to call them direct for? Thanks,

Best Regards,
Aaron

It's a new design on an earlier version. The new design has a more flat edge and sits lighter on the eye. But the designer and his company is in Australia. The website is: http://www.innovativecontacts.com.au/page23/index.html

[DCRdryeye]

The best thing to do is contact Lachlan-Scott whom designs the lenses and distributes them for optometrists whom have sent him precise measurements. So he sends the 'custom made' sclerals. Contact him and let him know you were referred by www.australiandryeye.webs.com and he'll know how you found out about him. He may work with you and your 'skilled' Scleral lens expert.

I do not know if they are FDA approved, they are certainly approved in Australia. Do they need to be approved? A Scleral lens is a Scleral lens, do each different design need approval?

[thekiltman85]

Thanks for the reply, and sorry for the delay in getting back to you. I will definitely drop him a line. Thanks again.