Help? Trouble Inserting Scleral Lenses

[dryeyesmtl]

Hi all,

I'm a long time dry eye sufferer who has recently been fitted for scleral lenses but I can't get them into my eyes. My optometrist has successfully inserted them a few times and once they are in I have been able to wear them comfortably but I cannot get them in on my own.

The problem seems to be that I am blinking them out at the last second and I can't control my lids enough to prevent this.

Does anyone have any advice? I'm really hoping I can get these to work because I've been told they'll really improve my quality of life...

Thanks for reading

[PhoenixEyes]

Hi, I'm waiting on a referral for scleral lenses so have been checking out advice on insertion and removal. One person linked this video which has some tips:

https://www.youtube.com/watch?v=h0dl2P6qyZU

As shown in the video some use plungers, DryEyeShop sells some:

https://www.dryeyeshop.com/lens-inse...vers-c163.aspx

There's also a device called the See Green stand which is hands free, you bring your eye to the lens rather than the lens to your eye, so you can use both hands to keep eyelids open.

https://dalseyadaptives.net/store/

Hope you figure out what's the best way for you.

[m4shore]

Hi all,

I'm a long time dry eye sufferer who has recently been fitted for scleral lenses but I can't get them into my eyes. My optometrist has successfully inserted them a few times and once they are in I have been able to wear them comfortably but I cannot get them in on my own.

The problem seems to be that I am blinking them out at the last second and I can't control my lids enough to prevent this.

Does anyone have any advice? I'm really hoping I can get these to work because I've been told they'll really improve my quality of life...

Thanks for reading

Hey,

It takes time. It gets much easier over time.
Try to hold down your lids as best you can, and look directly at the lens.

When I first started wearing my lenses, it took e many tries to get them in.
These days, it's quick and easy.

Practice makes perfect!

[Hokucat]

Hi dryeyesmtl. You've gone over a huge hurdle being able to wear the sclerals comfortably, as some people are not able to tolerate the lenses in the first place. Just about all of us have initially had difficulty inserting sclerals, but soon you will be able to insert them in seconds.

What works for me to securely insert my lenses is, while sitting down I:
-Put the lens on the insertion plunger and overfill it with saline. See link below on this plunger, if you are not using one.
-Look face down to the table or counter surface, which helps if covered with white towel (so you can easily see the lenses if you drop it during insertion process).
-Pull the upper eyelid up and lower down so the eye ball is wide open.
-Approach the eyeball with the plunger/lens parallel to the eyeball, while looking at the center of the lens or focusing on the plunger hole. It's Important to relax while doing this, otherwise tendency is for the eyelids to shut before you get the lens in.
-As soon as saline from lens first makes contact with eyeball, push lens firmly to eyeball with plunger, then quickly release eyelids, while still holding lens against eyeball with plunger.
-Then with eyelids securing lens, squeeze plunger to release it from the lens.

Most of the above process was how I was taught by my PROSE scleral practitioner, with a few adjustments that I made myself over time that further helped me. Perhaps something here may help you.

Also, in case you are not using an insertion plunger that allows you to control the suction by squeezing it, this is the one many scleral wearers use:

https://www.dryeyeshop.com/mobile/dm...-cup-p183.aspx

Good luck, am sure you will get the hang of it soon!

[dryeyesmtl]

Thanks for your advice all. I will persevere and let you know how it goes...

[SueG]

I wear rigid gas permeable lenses and am considering sclerals. Compared to RGP lenses are they more difficult to insert and remove?

[Hokucat]

Hi Sue. I wore RGPs for years too, before getting sclerals. Likely you will be more relaxed then, about putting a hard lens on your eyeballs, which should help you get the hang of it quicker.

What I had to work on was manipulating such a large lens, and getting comfortable using plungers for insertion and removal, when with RPGs I used my fingers. But with practice, seems most everyone gets the hang of it.

The bigger hurdle will be whether you can tolerate scleral lenses in the first place. Having worn RGPs may help, but it also depends on the current condition of your eyes, and the expertise of the practitioner fitting you. So would recommend you go to someone who specializes in fitting sclerals for the best chance of success.

[SueG]

I understand that there are ways of inserting and removing without using a plunger, have you tried this. I’m also wondering anout mini sclerals

[Hokucat]

Hi Sue. Yes, I have heard of people inserting and removing sclerals without a plunger. Well, I was taught with plungers and am totally used to them now, so will stick with it. Plus I feel like it's more hygienic. But the down side of using plungers is misplacing it or accidentally throwing it away, which has happened to me a few times! If you end up using plungers, make sure to have spares handy :->

If you go to a true scleral specialist, they would likely recommend whether mini or regular sclerals are optimum for your prescription, severity of your dry eyes, shape of cornea, etc. Going to a practitioner with significant scleral expertise to get the fit right will be key to your success wearing sclerals.

[SueG]

Thank you for the advice. The bit about breaking the seal when using a plunger is a bit freaky. Does it make the eye sore. I have a very thin retina so want to avoid any type of eye trauma.

[Hokucat]

Hi Sue. When you say breaking the seal, I'm assuming you are referring to removing the lens from the eyeball with the plunger? If so, putting a few drops of preservative-free saline over your lenses and blinking a few times can help loosen the lens first, then the lens should come out a lot easier with the plunger. The plunger cup should also be wet with saline, otherwise it will not grip the lens.

The lens does have the tendency to stick to eyeball, especially if ones eyes are very dry and/or after wearing the lens several hours. But it's important the lenses do seal well while wearing them, in order to keep in the saline you fill them with (when inserting) all day. And yes, sometimes the eyeballs feel a little sore after removing the lenses, but would say that could also be due to wearing the lenses several hours, not necessarily the removal process.

Given your thin retina, make sure to let the scleral specialist know about that at the consult and during the fitting process. There may be special precautions or tips for your situation.

[SueG]

Thanks for the added advice