Scleral contact lenses are a type of RGP (Rigid Gas Permeable) lens. These are used for conditions such as keratoconus, pellucid marginal cornea degeneration and corneal grafts. They require careful cleaning, insertion and removal to ensure your eyes stay healthy and your treatment is effective.
Always wash and rinse your hands thoroughly and dry them with a lint-free towel/tissue before handling contact lenses. All traces of soap, perfumes, hair-spray, creams and lotions should be removed from your hands and around your eyes.
You may experience some discomfort if the lens is not in place correctly on the eye or if a foreign body, such as an eyelash or make-up pigment, is trapped underneath the lens. If this is the case, remove the lens and reinsert.
CAPTION:Tripod method. A rubber inserter can also be used to hold the lens if dexterity is a problem – ask your optometrist about this.
CAPTION: Different suction tools available for scleral lenses.
If you do not have a suction tool you can remove the lenses manually:
Always clean your lenses after wear. An effective cleaning process is vital to ensure comfortable, hygienic and infection-free contact lens wear. With correct cleaning, contact lenses will feel better on your eyes, allow better eye health and vision, and dramatically reduce bacteria and other contaminants. There are two types of scleral lens cleaning solutions: Peroxide base systems like AO Sept (with Hydraglyde), and multi-purpose solutions like Menicare and Boston Simplus. There are several steps involved with cleaning and storing scleral lenses depending on your system:
These solutions work by having your contact lenses immersed and sterilised in 3% hydrogen peroxide. Over the course of a 6 hour period the catalyst in the case converts the hydrogen peroxide into water and oxygen gas. This cleaning solution has the advantage that when your lenses are removed from the case they require no rinsing as they are covered only in sterile, non-preserved water. They also generally require no rubbing step, which decreases the risk of accidental breakage. The case can be left to air dry when not in use, and should be replaced with each new bottle of solution. AO Sept now had the addition of Hydraglyde, an ingredient which improves the wettability of your contact lenses, making them more useful for scleral patients with long day-wear times.
To clean your lenses fill the case up to the line, place your lenses in the correct cage-holder. Most scleral lenses will generally fit into this case, ask your optometrist if the holder does not close easily. Then submerge the case and screw closed. Take care when transporting the case as sometimes the small gas-release hole can leak solution.
Care should be taken not to get the un-neutralised peroxide in your eyes as this will sting painfully. If this occurs rinse thoroughly with water and contact your optometrist if the pain persists or your vision is affected.
Find Aosept with Hydraglyde at our shop here.
Place a few drops of rigid contact lens solution on the palm and the lens, then rub with your finger-pad for at least 10 seconds on each side. The back surface (concave) is best cleaned by moving your thumb across the surface. This step removes material deposited on the lens during wear. Whilst RGP lenses are strong, with incorrect technique or too much force they can break. Some patients benefit from using a dedicated detergent cleaner such as Lobob rather than their storage solution for this cleaning step.
Place the lens in fresh solution in your lens case, ensuring the lens is completely submerged (you can purchase a scleral contact lens case from our shop). This step kills microbes on your lenses and prepares the surface of your lens to stay wet throughout wear, increasing comfort. Store your lenses in this solution for at least 4 hours for the cleaning process to be complete. NEVER rinse or store your lenses in tap water, as micro-organisms are plentiful and can cause infections in your eyes.
Find Menicare from our shop here.
Scleral lens wearers are advised to use a deeper protein removal product like Progent every 2 weeks. To use Progent combine the A and B vials in a lens case and submerge your lenses in this for 30 mins. Ensure your lenses are thoroughly rinsed and cleaned after using Progent before inserting into your eyes. Find Progent at our shop here.
Scleral contact lenses are made of a strong polymer which resists damage in normal wearing circumstances. However, they can still break if mishandled. There are some tricks you can learn to minimise this chance.
To increase comfort and oxygen permeability, scleral lenses are designed to be as thin as possible without compromising their structural integrity: most are 0.3mm thick. Because the lenses weigh very little, if you drop one it should not break unless it is then trampled on. If a lens falls on the floor, keep your feet still until you have spotted it. If you cannot see well without your lens, call to a friend or family member to help and remember to caution them to be careful where they tread!
The lenses can be prone to falling into difficult to retrieve places such as down the sink-hole! Especially when you are learning how to insert and remove your lenses, make sure you use your lenses in a controlled environment such as a quiet bathroom with the plug inserted, or on a table with a clean towel laid flat. This way, if your lens drops you can find it easily and reduce the risk of breakage.
CAPTION: Mishandling a lens: Pushing down on the lens; Removing from suction tool too firmly; Forcing lens to bend while cleaning
It is very rare for a lens to break in your eye unless something hits your eye or your removal technique is incorrect/very forceful. The solutions you use to clean your lenses will not weaken or degrade them ‒ not even the powerful Progent fortnightly deep cleaner.
We understand that when you are learning how to use your lenses you may be inadvertently forceful during insertion, removal or cleaning. Because of this we offer a 1 month manufacturer’s replacement warranty on accidental breakages. Outside of this period, your lens is not covered by a warranty and the lens will need to be replaced at your cost if damaged or lost. If you break a lens within 1 year of its original purchase/fit then we are happy to offer 50% off the price. Outside of this 12 month period the lens will be full-price.
Normally a lens will take 1-2 weeks to arrive from the lab when ordered. If you are very dependent on the lens, we will of course ask our lens company to manufacture it as soon as possible. Because of the inevitable waiting time, we encourage all rigid lens wearers to have a spare set of lenses available for a situation where a lens is lost or broken. We also offer 50% off the full price for a spare lens if purchased within 12 months of the original.
If you do lose or damage a lens, please don’t fret, just give our friendly team a call and we will arrange a replacement as quickly as we can.