My initial impressions of my new Sclerals lens.

[Kristena]

I do have a "moisture chamber" from my hospital stay and thought maybe it was time to give it a try again. Well, I actually fell asleep watching TV with it on and woke up about 90 minutes later with a sore eye, and the eyelid felt like it was sticking to my eyeball. I guess I'm not ready for that step yet! I'll stick with the Press 'n Seal for now. And I have some wind resistant sunglasses (and clear glasses too) to wear outside when it's windy. They came in very handy during the cold, windy waits at the bus stop this winter. I actually cut out some of the padding on the good side, because that side kept fogging up. Now they seem to work pretty well. I need to try them out on my bike--soon!

[Lloyd-S]

Hi All.
Thought I'd report on my initial experience. I've been trying Scleral lens in both eyes for the past ~6 weeks. They are 16.5 mm diameter "Maxim" scleral lens made by Acculens. Unfortunately it has not worked out as well as hoped. For the first ~ 10 mins of wearing them they feel comfortable. But after this short period, I've found them irritating and have required frequent use of eye drops to tolerate them. I've tried 5 different types of drops. Use of Systane gel drops is the only one which provides some lasting comfort for more than ~ 15 mins, but then my vision is blurred significantly, which defeats the purpose. I have managed to wear them for ~5 hours/day. Surprisingly, I experience similar irratation/discomfort in both my "bad" and "good" eyes.  My eyes are often very sore after wearing them. A few times my eyes remained sore for hours after removal.

For the past ~ 24 years, I have used Duolube eye ointment 24/7 in my "bad" dry left eye (tumor side). The ointment has provided convenient long lasting comfort at the expense of vision. I used to be able to wear a soft contac lens in my "good" R eye. But have experienced dry R. eye as well for the last ~ 4 years, forcing me to wear glasses majority of the time. It has certainly been satisfying to experience proper vision with both eyes and freedom from glasses. But unless I can reliably/comfortably/conveniently wear the Scleral lens for a majority of my working day (~ 12 hours), this is not practical.
 
The Eye Institute here in Ottawa, Canada is my only option and they only offer this Scleral lens manufacturer. During eye exams, I've been told the scleral lens fit me well and there is not much else that they can try. So trying a different Scleral model is not an option for me. The Scleral lens cost me 2x $700, not including fitting fees etc... If I return them within 6 months I get refunded 2 x $500. I wonder if any ANA members have had similar experience and/or ideas for me to try?

[saralynn143]

I have a few thoughts for you, Lloyd. The first has to do with what type of saline solution you use in your lenses. I have found the best one to be plain sterile saline packaged for nebulizer use (http://www.vitalitymedical.com/catalogsearch/result/?q=20059&x=28&y=7). It's nothing but salt and water so there are no ingredients that you may be sensitive to.

Second, are you positive that there are no air bubbles in your lenses when you insert them? Any air in there will make the lens uncomfortable after a short period. It took me a while to get the hang of inserting my lens properly. I put a description of my technique in a weblog post at http://www.sarahartman.com/dry-eye-triumph/ - scroll down to sections titled Solutions, Tools and Tips.

My final thought is that even if your lenses are a good fit, moving to the next step "looser" may be a better fit for you. I had this experience in the opposite direction.

You might also check out a dry eye forum at http://www.dryeyezone.com/talk/forum.php - there is a section there devoted to scleral lens users.

[Lloyd-S]

Saralynn,
Thanks for your thoughtful tips and informing me of the Dry Eye Zone website. That forum sure has an impressive scope of info.  That site gave me a few new ideas to consider. I've been using Unisol 4 solution in the lens, as recommended by the Ottawa clinic. Yes, I've learned (the hard way) to check for air bubbles and know what you mean about the resulting extra discomfort if bubbles are present. I had a follow up app't with the Ottawa eye clinic today. By the time I saw the technician I had been wearing the lens for 5.5 hours and had a moderate amount of discomfort, moreso in my L eye. I had put drops in every ~ 30 mins and thicker Systane Gel drops a few times in my bad left eye. By examination he said the outer lens surface of my bad left eye had deposits of a sticky secretion. He said the lens looked dry and lost its "wettability".  He suspects this is a reaction to extreme dryness and the incomplete blinking. Also friction between my left eyelid and dry surface of lens. The deposits also explained why the vision in my L eye is always more blurred than the R eye. He said there were no visible air bubbles. He said the fit was the best that could be done with the Maxim Scleral lens. He suggested I continue trying different drops and recommended I try "Hylo".  I'm not throwing in the towel yet, but it looks like it will be a challenge to reach my goal of ~ 12 hours of comfortable use.

[saralynn143]

Lloyd, as an experiment I filled my lens with Unisol yesterday. It was better than most lubricating drops, but not as comfortable as the sterile saline marketed for nebulizer use. I highly recommend trying it if you are able to. I was not truly happy with my scleral lens until I started using it.

I had never heard of Hylo drops until now. Are they used to fill your lens or to use after? I have not searched for them in earnest, but they are really expensive at Amazon.

I am not surprised by the buildup on your left lens. Since we don't blink correctly, our eyelids are not distributing tears or drops over the surface of our eyes. When the vision in my left eye gets blurry, I moisten a q-tip with saline and squeegee the lens while it is still on my eye. It seems kinda gross the first few times, but now I can even do it without a mirror.

I'm glad you are going to keep trying and I hope you find a regimen that works for you.

[badyellowvette]

Thought I would check in after a couple months. I gave up on a lens of any kind since every lens I tried made my vision blurry. I could get the same results using lube when my eye is bothering me.
But the last 2 1/2 months have been great. The high humidity has been wonderful. I hardly ever have to use natural tears, just a couple times a day when I think of it. Still use lube at night. Been riding the motorcycle with my goggles with no problem. But now it's getting colder and hardly any humidity and I am back in HELL. Happened over night when the weather changed. Don't really want to go back the the eye Doctor because I think she did everything she could and besides after Obama got done screwing me out of my excellent health insurance it would really cost me now. 

[Lloyd-S]

Sara-Lynn,
I tried the sterile saline packaged for nebulizer use that you recommended. Thank you. I was able to order and have it delivered to me in Canada. It seemed to work well and is conveniently packaged. However, my previously mentioned issues dominate over any benefit from this saline. I tried the Maxim scleral lens ~ 15 times over a 2 month period, but could not achieve lasting comfort. The eye institute here in Ottawa only offers this lens. Because I found the Scleral lens comfortable for the first ~ 20 mins, my opthamologist said that if we could find a different lens that is fit optimally, it may still be viable. So my opthamologist referred me to a specialist in Montreal that is supposed to have more experience with a variety of Scleral lens types. I will report back on that in a month or so. Not giving up yet...
Lloyd.

[Kristena]

I called my ophthalmologist’s office to inquire about scleral lenses. They do have experience with them, but required me to see the doctor first. It had been about 6 months since my last “dye test,” and he said the cornea of my affected eye was in really good shape and looked similar to my good eye. I thought to myself, “that’s because I put in drops 1-2x an hour!” He said he didn’t think I needed the scleral lens, but cleared me to get one if I still wanted.

So over the past month, I’ve been weaning myself off the drops. It was really hard, and I had to keep reminding myself that even though my eye felt dry, or hot, or painful, my eye was in good shape. I started setting time limits of 1 hour, then 2 hours, etc. I got myself to 4 hours without drops and went back to the doctor for a re-check. It still looks good, and I don’t have to go back for 6 months! So I’m now waiting at least 4 hours, then waiting until I feel the need—not automatically every 4 hours. I’m still taping at night, and I have a punctual plug, but I guess I’m doing better than I realized!