Sclerals For Dry Eyes?

When do you recommend Scleral Lenses for a dry eye sufferer? (ie. very mild, moderate, severe)

When someone is suffering from dry eye, your Complete Eye Care optometrist will first try drops. Then, we will add punctal plugs, known as tear savers, which allow the natural tears in the eye to remain in the eye longer. The issue with dry eyes is the delicate tissue of the cornea needs a smooth surface to see clearly.

People who wear contact lenses often have trouble wearing contact lenses for more than a few hours when they suffer with dry eyes. Scleral lenses can easily be worn for people with dry eyes. The reason scleral lenses work so well is that before inserting a scleral contact lens, a small amount of artificial tear solution is inserted into the scleral lens.

So, when wearing a scleral lens, the eye is bathed in a fresh hydrating tear and the comfort levels are very high with scleral lenses. Sometimes, I have a patient wear a soft contact lens in one eye and a scleral lens in the other eye. Then if they fan themselves with a piece of paper they can see how the eye with the soft contact lens gets dry but the eye with the scleral lens does not.

This shows how sclerals work well for people whose eyes dry out easily when wearing soft contact lenses and they are near air vents or fans or when the heat is on in the car. Scleral lenses can be used for people with mild dry eyes to help them have comfortable vision all day long.

They can also be used for people with extreme dry eyes. I have fit people in Gastonia with Sjogren’s Disease which causes a severe drying of the mouth and eyes. One gentleman I fit with a scleral was blind in one eye due to a child hood injury.

We still fit him with scleral lenses in both eyes because even though the eye was blind, it was so painful due to dryness he could not leave his house or drive. Now he wears scleral lenses and he sees well out of his one good eye and does not have any more pain in her blind eye.

What kinds of advantages should a dry eye sufferer expect when they start wearing Sclerals?

The dry eye sufferer will notice right away that when wearing scleral lenses, their eye does not feel so uncomfortable. They will not be so aware of their eyes. There should be less tearing and burning as well has irritation when around any air vents or wind.

Does it matter what is the cause of your dry eyes in determining whether to recommend Sclerals?

Sclerals can be used for many types of dry eyes. They can be used for extremely severe dry eyes such as in Sjogren’s disease. They can also be used effectively with people with Bell’s palsy related dryness.

I recently fit a woman who had a facial nerve paralysis due to a brain tumor removal. She could not blink her left eye after her surgery. She was fit in a scleral lens and her vision went from 20/200 due to extreme dry eyes to 20/25. She says her scleral lenses really improved her quality of life.

What is the success rate with Sclerals for people with dry eyes?

The success rate for sclerals for dry eyes would be in the high 90’s. Most people do very well with scleral for dry eyes. They are able to tolerate air currents better from wind, fans, air vents in the car etc.

I am thinking about traveling in from out of town, how long does the process take?

We design sclerals by taking a topography reading of the front surface of the cornea. This reading gives 11,000 points on the cornea and the scleral lens is mapped exactly for each person.

This would be similar to a fingerprint where each person would have an individual lens designed just for them. This is one reason the success rate is so high with sclerals designed this way.

This form of scleral lenses is called Wave design. Only very select few practitioners in the world are certified wave designers. Dr. Barbara Marcussen has been using the Wave system to design lenses since 2004.

The first visit is when the readings are taken. The lens is then designed and the next visit is when the lens is dispenses. There is then about 2 more follow ups so the total time to be fit and monitored can take about 3 weeks.

Other eye doctors recommended that I try special daily disposable contacts for dry eyes, but I stopped using them because of discomfort.
Are Sclerals better than dailies for dry eyes?

Daily contact lenses are better for dry eye then lenses that are work longer but they are not custom fit like scleral lenses are. They do not vault over the cornea like scleral lenses do.

Soft lenses lay directly on the cornea and can dry the cornea out. This is especially true when exposed to certain environments such as wind, or air vents etc.

Sclerals have the advantage of the artificial solution in the bowl of the lens to gently bathe the cornea all day in a nice refreshing solution and it also vaults the cornea so nothing touches the cornea. This keeps the eye comfortable all day while wearing sclerals.