Scleral Contact Lenses

Your Guide to Scleral Contact Lenses 

What are scleral contact lenses?

Scleral contact lenses are large-diameter gas permeable (GP) contact lenses that rest on the sclera (white of the eye) and not directly on the cornea. They contain silicone that is oxygen permeable, so oxygen can pass through the lens giving greater comfort and better eye health. Scleral lenses can also provide clearer vision, durability, deposit resistance and can be easier to clean.

Are scleral lenses comfortable to wear?

Yes, because they rest on the sclera which is a lot less sensitive the the cornea. It may take between 5 to 10 days before they settle in completely. Scleral lenses provide initial comfort similar to soft lenses, especially for sensitive eyes or irregularly shaped corneas. Because of their size, scleral lenses are more stable on the eye than conventional GP lenses, so they are less likely to accidentally dislodge from the eye. This stability also can make them more comfortable than conventional GP lenses.

scleral contact lenses compared to GP lenses

scleral contact lenses compared to               GP lenses

 


S
cleral lenses are larger than GP conventional lenses. They are called “scleral” lenses because, instead of covering only a portion of the cornea (like conventional GP lenses), these large lenses vault over the entire corneal surface and rest on the “white” of the eye (the sclera).

 

 

How do scleral contact lenses correct distorted vision?

If you have had previous eye surgery/trauma or have a condition called Keratoconus then your cornea may be irregular in shape. A scleral lens vaults right over the top of your cornea to provide a new clear, regular surface for the light to refract on. Between the back surface of the scleral lens and your eye, your tears and moisturising gel fill in any irregularities resulting in clearer vision with reduced glare and haloes.

How long will scleral lenses last?

If the lenses are well cared for and kept clean they can last for up to 2 years, in some cases even longer. We recommend regular 6 monthly checks and as long as the lenses are fitting safely, providing clear vision and are comfortable, there is no need to change them.

Daily wear time:

Many people who wear scleral lenses are able to wear them for 12-14 hours daily. However some people may need to remove the lenses, clean them, and reapply them with fresh moisturising gel periodically throughout the course of the day in order to maintain the best possible vision and comfort.

How do I insert my scleral contact lenses?

1) Remove the lens from its case.

TheraTears gel for scleral contact lenses

TheraTears gel for scleral contact lenses

2) Attach a suction holder to the front surface of the lens or hold the lens with 2 or 3
fingers.

3) Fill the lens to the top with TheraTears Gel.  If it is not full to the top you might let air bubbles into the lens.

4) Lean over until the face is parallel to the floor, keep both eyes wide open and look straight ahead.

5) Pull back the upper lid with your left thumb or forefinger, make sure to hold right near the eyelashes. Pull the lower eyelid out of the way with your left fourth finger whilst holding the suction holder and lens with your right hand.

6) Apply the lens to the middle of your eye and SQUEEZE the barrel of the suction cup. This will gently force the lens onto the eye. Do not allow any air bubbles to get into the lens.

7) Release your lower lid first, then SLOWLY let go your upper lid and blink.

8)If the lens does not feel comfortable, remove it, clean it and re-insert.

Note: The suction holder should be cleaned regularly with your contact lens cleaner rinsed with preserved saline and left to air-dry.

 Inserting scleral contact lenses with suction holder

Inserting scleral contact lenses with suction holder

 

 Inserting scleral contact lenses using the tripod method

Inserting scleral contact lenses using the tripod method

 

Inserting scleral contact lenses with 2 fingers

Inserting scleral contact lenses with 2 fingers

How do I remove my scleral contact lenses?

1) Look upwards. Pull down the lower lid with your right index finger so that it is just below the inferior edge of the lens.

2) Pull up the top lid with your left index finger so that it is just above the superior edge of the lens.

3) Push gently but firmly into the sclera (“white” of your eye) through the lid margins so that the suction at the edge of the lens is broken and a large air bubble is introduced into the post-lens tear layer.

4) The lens can then be lifted off the eye.

Note: It is normal for the eye to feel slightly dry following lens removal. This should only last for 5 minutes. Lubricants can help. It is also normal to see some reflex conjunctival redness for a few minutes, with the presence of an edge compression ring on the conjunctive similar to a tight soft lens. This will also resolve in a few minutes. If this lasts for more than 30 minutes please let us know.

How to take care of your lenses – General tips for successful contact lens wear

Always wash your hands before handling your contact lenses or eyes

Wash your hands with soap and running water, remembering to rinse your hands thoroughly. Dry your hands with a towel.  Ensure your nails are clean and not too long.

Cleaning of your contact lenses

It is important to clean your scleral contact lenses daily to maintain the highest standards of comfort and visual clarity. Each day after you remove your lenses, you must digitally clean them prior to overnight storage.

ALWAYS use the prescribed cleaning solution, which serves as a cleanser and disinfectant. It also increases the comfort of your contact lenses.

NEVER use saliva, saline or water of any type. Tap, distilled and bottled water (and particularly saliva) contain bacteria and viruses which may be absorbed by the contact lens and cause eye infections.

1) For rinsing your lenses, use only BioTrue.

Bio True solution for your scleral contact lenses

Bio True solution for your scleral contact lenses

2) Place the lens bowl-side up in the palm of your hand and apply a few drops of biotrue. With the pad of your finger gently rub the entire lens in a circular motion against the palm of your hand. Be sure to thoroughly clean the entire lens and then rinse it well in a steady stream of biotrue.

AO Sept solution for your scleral contact lenses

AO Sept solution for your scleral contact lenses

3) For disinfection use AOSept Hydrogen Peroxide Disinfection System. Carefully follow the instructions for the specific disinfection system you use. Always soak lenses in the provided lens case for at least six hours prior to inserting into the eye, so we recommend you do it overnight.

4) Use only the case provided with the AOSept disinfection system. Be sure to soak the lenses a minimum of 6 hours before inserting again.
NOTE:
Never put AOSept directly into the eye.

5) Never rinse lenses with AOSept prior to insertion into the eye. Solution must be neutralised.

6) Never use AOSept® Plus in a flat lens case.

7) Always use fresh solution when storing your lenses. Never “top off” or use old solution.

8) Always discard the old lens case to avoid contamination and ensure proper neutralization.

Expiry date of solution

Always check the expiry date of the solution. When you open a new bottle, write the date you need to discard it (generally 3 months after opening) on the container in a felt tip pen. Do not use out-of-date solution.

Contact lens cases

Bacteria can accumulate in contact lens cases. After putting in your contact lenses, the case should always be emptied and air-dried.. A new contact lens cases is included with every purchase of contact lens cleaning solution so you should throw away the old case and use the new one.

Never wear a contact lens for longer than it is designed for

The use of the contact lenses past these dates is NOT recommended as the lenses are not structurally or functionally designed to last any longer. The material often breaks down after this date, causing irritation and poor vision.  

Do not sleep in your contact lenses

In most cases you should remove scleral lenses before sleeping. Stagnation of the tear layer behind the lens could lead to a higher risk of eye infection. Since most of the people who need scleral lenses have already had some trouble with their eyes, further challenge to the surface of the eye would not be advisable.

Water sports

The safest option for waters sports is to wear goggles. Water contains germs, which may then contaminate the contact lens. Wearing your contact lenses after these activities would be the same as wearing your wet swimsuit.  In the event you get water splashed in your eyes, make sure to remove your lenses and clean them thoroughly.

It is not recommended to swim in fresh water even if it’s flowing freely due to the risk of infection from Acanthamoeba, which can cause severe loss of vision.

Contact lens use when in hospital or unwell

Avoid wearing contact lenses in hospital or while unwell. Hospitals are often sources of infection. When you are sick (even just with a cold or flu) you risk spreading infection to your eye via contact lenses. You may also find it more difficult to manage your contact lenses safely while you are recuperating.

Avoid wearing contact lenses on a plane

The humidity in aircraft cabins is very low.  If you wear your contact lenses they will become very dry and uncomfortable and you will arrive at your destination with sore eyes.  Please wear your spectacles for flying if at all possible. Ideally insert your contact lenses just after arriving at your destination.

FAQ’s

What are the normal adaptation symptoms I can expect?

While you are first getting used to your lenses you may notice some or all of the following:

  • Variable vision due to increased tear production
  • Stinging, itching and abnormal blinking
  • Lens edge awareness particularly felt with your eyelids
  • Increased glare sensitivity – wear sunglasses
  • Initial discomfort with lots of close work/computer work – use more lubricant eye drops
  • Dryness in air-conditioning and smoky areas – use more lubricants and try cleaning your lenses mid way through the day
  • You may also notice a slight blur to your vision when you wear spectacles straight after removing your contact lenses. This should clear within 30 minutes.   

What is abnormal?

Persistent redness, discomfort, pain, blurred vision or if bright lights hurt your eyes. If these occur stop all lens wear and make an appointment to see us. “If in doubt take your lenses out.”

One of my contact lenses is suddenly uncomfortable, what should I do?

The first thing to do is to take the lens out. Does that fix the problem? If so, it is probably due to the lens rather than your eye itself. Now clean the lens thoroughly and put it back in. If that fixes the problem then there might have been something on the lens. If not then remove the lens again.

Now you need to carefully examine the edge of the lens in bright light. You might notice a small chip out of the edge of the lens. The lens would need to be replaced so please contact us.  

In the above scenario if you remove the lens but your eye is still hurting it is likely that there is something wrong with your eye. That means it would be best to come and see us straight away to have it checked.

Aftercare schedule for your scleral contact lenses

We normally like to see you about 1-4 weeks after picking up your lenses and then again at 3 months, 6 months and at least every 6-12 months thereafter. This is so we can review the health of your eyes and suggest any improvements in your contact lens prescription, lens design or material.

If you do not return for regular after-care checks, we are legally unable to supply you with contact lenses, as they are a health appliance.

Always wear your contact lenses to your contact lens appointments, having had them in for at least 4 hours. Please remember to bring your case and spectacles with you.

Consultation Fees

Initial examination – $299

Follow up examination – $50

Teaching insertion and removal of contact lenses – $125

Cost of scleral lenses

$1350 per pair

Please note, all prices are subject to change at any time.

Warranty

You have 3 months to change the parameters until we find the perfect fitting for your eyes. We offer a 50% store credit if lens is unsuccessful and the lenses are returned to us. Sorry, we do not provide warranty for loss of lenses.

What happens if I break my lens?

New lenses are covered by a warranty against breakage for the first 3 months (Please note: you will need to ensure you return the broken lens). After this time we will replace the lens to the same prescription at a 30% discount.

Should I keep a spare set on hand?

It is a good idea to have a spare set of lenses on hand because a new set can take 10-14 days to be made. We can offer a 30% discount on all duplicate lenses purchased. Please speak to your Optometrist for the details.

Refunds

We can give a 50% refund on scleral contact lenses. Please note we do not give refunds on fitting fees. Please see our office policy or speak to your optometrist for further details.