Long term Schleral lens wear

[gregjohnsondsm@gmail.com]

How long have people been successfully wearing their Schleral lenses? I mean in terms of years. I have had mine for 1.5 years now ( not the same lens, I replaced them every year) and have noticed that they are starting to be less tolerable than they were at first.
Have people succesfully had schleral lenses for many years? Without complications?

[edmunder]

What are the reasons you wear sclerals? Ive seen some people in the facebook - big fat scleral group - they wear them for decades.

But i think many are not truly terrible dry eye. Though some are.

Im going to get sclerals within the next few weeks so im eager to know myself.

This is a very small forum though, few active members. Better to ask that facebook scleral group.

[Rebecca Petris]

Hi there,

I've worn various scleral lenses since 2006. It's a process; there are hurdles and issues to overcome, but for those of us who need them, they are a lifesaver.

I think it's helpful to be aware that there are many different types of things that can affect 'tolerance' i.e. comfort, visual clarity, etc of sclerals:
- SIZE, SIZE, SIZE. An awful lot of the lenses being peddled as sclerals are really mini sclerals at best. For people with advanced ocular surface diseases including dry eye in various forms, having the lens lie too low, too close to the cornea or even putting a little pressure on the limbus just won't work. (Discovering that in practice is what drove me into sclerals personally, way back when, and I've observed it in others repeatedly over the years especially recent years when far more optometrists are fitting sclerals.)
- Coatings. Plasma treatment... hydra peg coating... all those things that make the surface of the lens "wettable".
- Cleaning and disinfection solutions. These can make it or break it. No matter how well you rinse off cleaners, if it's a cleaner that is irritating to your eyes it can affect lens tolerance.
- pH as well as viscosity of the solution used to fill the lens. If it's too acidic (as straight sodium chloride solutions are), some people will not tolerate it well. This is why a lot of people end up basically making their own little preservative free 'cocktails' in the bowl of their lens.

Edmunder is right about the Facebook group. However, I'm hoping to get more of a scleral lens community on this site because I think this forum is much more conducive to in depth discussions and heaven knows we need more of those about sclerals

[Hokucat]

Hi Greg. When I first tried sclerals ~8 years ago, they worked great for half a year. Then they started getting less and less tolerable, as my tear film was making its descent to virtually zero...Schirmers reached zero and TBUT ~1 second. With this lack of tear film, my scleral specialist said the surface of my eyes, including my sclera, were like sandpaper. I had to stop wearing my sclerals. Then several years later after I was able to find some resolution and get a thin tear film back, I was able to wear my sclerals again. Do you know if your tear film has become worse, and/or your eye surface has become further compromised?

Also, my scleral specialist said sometimes the shape of the eyeball can change, which might require an updated fitting. Have you told your fitter your sclerals are becoming uncomfortable?

My fitter said the lenses can also warp if certain non-preserved drops or other things not meant to touch the lenses are used. I’m assuming warping is not applicable for yours since it sounds like you recently got new lenses.

Rebecca has several great suggestions above. Making my own “cocktail” of what I fill the lens bowl with has increased the comfort for me. I put in a few drops of PF artificial tears (Genteal Tears), a few drops of serum tears, them fill the rest of the bowl with Purilens PF saline. I’ve read many find using Refresh Celluvisc PF (a thicker drop) with the saline helps a lot with the comfort.

If you’re not doing so already, sometimes it helps to take out your lenses, clean them, and reinsert a few times a day. Also putting PF drops (not the thicker drops) while wearing the lenses can provide some comfort...I used to lift my upper eyelids and put three drops from right to left above my lens edge, then do the same by pulling down my lower eyelids and put the drops below the lens edge. This would moisten my entire eyeball and outside of lenses, and also the drops would get in between the lens edges and my sclera, which felt better temporarily.