My Sclerals have started burning.

[Nevil]

So, I have been a scleral lens wearer for 4-5 months. Had stopped it later as I wasn't able to wear them comfortably for more than 2 hours.
Post some investigations I was put on DMARDs(Disease-modifying antirheumatic drug) and cyclosporine little later.

A little after starting DMARDs my eyes have started burning when I put in my usual lubricant drop - hydroxy methyl cellulose based. Fluorescein staining revealed no dry spots/anything else.

After having been on DMARDs for 1 month and cyclosporine for around 10 days, When I wore the sclerals, it burned and my eyes went very red. Even putting eyedrops on top didn't help and had to remove lenses in 5-7 minutes.

So I switched to another lubricant eye drop based on Sodium Hyaluronate as that's highly recommended for damaged ocular surfaces.
This worked well and doesn't burn my eyes anymore.

However, my sclerals still burned when i put them in recently( 1month 15 days of DMARDs, 25 days of Cyclosporine) , many days after comfortably using the new eyedrops based on Sodium Hyaluronate. Eyes started watering, getting irritated and burning.
So its something to do with Cyclosporine or DMARDs Or something else?

While this can happen due to not handling solutions right etc, i have done this long enough to not make a mistake here .

Any thoughts on why this can be happening?

I think I don't have dry spots otherwise the new drop also should have burned, at least a little. Also my ophthalmologist had checked eyes under slit lamp for any dry spots.Even though Sodium Hyaluronate is recommended for ocular surfaces that are damaged, surely it doesn't work right away

[Cissou]

Bonjour, cela peut arriver que les lentilles brûlent par période. Je ne pense pas que cela soit lié à votre traitement.

[Nevil]

Thanks..i am trying mine again after sometime..hope it goes better

[Hokucat]

Hi Nevil,

When I first got sclerals, I was able to wear them fairly comfortably for several months, but then my eye dryness and burning got so bad, I could no longer tolerate wearing them.

It’s possible the DMARDs and/or cyclosporine contributed to burning and discomfort. I’ve never been on DMARDs even though I’ve been diagnosed with Sjogren’s Syndrome (an autoimmune disease mainly causing dry eyes and mouth), which my doctor tells me is the “sister” to Lupus and Rheumatoid Arthritis. But I recall several years ago when I was offered methotrexate as treatment, one of the many side effects I read about was dry eyes. I don’t know if your DMARDs is methotrexate or not? I was not able to find a recent article on this, but did find this old one:

https://pubmed.ncbi.nlm.nih.gov/7296...20chemotherapy.

My experience with cyclosporine was I used it for at least five years, and during that time my severe dry eyes got worse. I don’t know if it added to my problem, but it certainly did not help.

As far as preservative-free artificial tears, the ones that gave me the most comfort when wearing or not wearing sclerals were drops made with Hypromellose, like Genteal Tears. When I was still able to wear my sclerals, I would put a few drops in with the saline for added comfort when filling the scleral lens bowl before inserting the sclerals. I also would put a couple drops above and below the lens while wearing them, as needed, to help with discomfort. Drops with hydroxy methyl cellulose bothered my eyes, and Hyaluronate and other drops did nothing for me. But different drops work for different people.

https://dryeyeshop.com/collections/g...SAAEgK9_fD_BwE

Since I did not want to take methotrexate, ultimately what worked for me was probing to open up my meibomian glands, while finding the diet changes which I think helped my meibomian oils and tear production. After this I got a thin tear film back, so I was able to wear my sclerals again 10-12 hours a day, and I’m also fine wearing glasses instead of sclerals. Here’s my dry eye story in case anything here may help you:

https://www.dryeyestories.com/new-bl...ous-deficiency

I hope you find some thing(s) that help you soon!