Proper Care and Use Are Essential to Avoid Scleral Lens Abuse
If you wear scleral lenses to correct your Keratoconus or other Corneal Dystrophies, be sure to follow your doctor’s instructions about caring for your lenses because the results of mistreating your lenses can be worse for you and your vision than you think. Among the most common types of scleral lens mistreatment — also called scleral lens abuse — are improper storage and cleaning, overwear, using the wrong scleral lens care products, sleeping in your scleral lenses, and waiting too long between scleral lens checkups, which also generally means waiting too long to replace your lenses.
Why does this matter? Abusing your scleral lenses in these ways can lead to discomfort, inflammation, infections and not being able to wear your scleral lenses for several days to a week or more until any damage to your eyes is corrected. Worse than that, scleral lens abuse can even lead to loss of vision.
Improper Scleral Lens Storage and Cleaning
Among the most common ways you can abuse your scleral lenses is to use fluids other than the solution prescribed by your eye doctor. We often see patients who have used water or saliva to clean, store and lubricate their lenses. Please don’t do this! If you do, you are likely to introduce foreign matter, bacteria and even viruses into your eyes. In a very short amount of time, your eyes may get red, “gunky” or “crusty,” and you may feel like you’ve got something in your eye.
Unfortunately, once these symptoms begin, they will not get better on their own. The natural progression is the inevitable cascading effect of inflammation and infection.
Eventually, you will need to visit our office for treatment, which is likely to consist of a course of antibiotics and anti-inflammatory eye drops. Since the medications cannot be applied over the lens, you will be unable to wear your scleral lenses while your eyes heal. In extreme cases, it may take several weeks for the medicine to work and for your eyes to heal. For many Keratoconus patients recovering from their scleral lens abuse, that means no driving, working, reading, or participating in most of their daily activities.
You can avoid these treatments and long periods of time without your lenses by only using the correct cleaning fluids as prescribed by your doctor. Have plenty of this solution on hand and use it liberally, as instructed. The key to success with your scleral lenses is having your supplies nearby when you need them, so you aren’t tempted to use something else. Carefully follow the lens care directions provided by your doctor or follow our instructions for cleaning your scleral lenses with Refine OneStep.
Scleral Lens Overwear: Wearing The Lenses Too Long During The Day
People wearing scleral lenses for their Keratoconus often have to wear them all day. During long days of scleral lens wear, you should remember to properly lubricate your lenses to avoid the second kind of scleral lens abuse, overwear. Improper lubrication can lead to irritation, inflammation, and infection.
We recommend that our patients use a high-quality artificial tears solution. Your doctor will recommend the highest quality brands to you, but if you find yourself out of town and out of drops, you need to look for products that are preservative-free.
The artificial tears product we use that meets all these requirements is Oasis Tears.
Using The Wrong Products While Wearing The Lenses
Because Scleral lenses need to vault over the cornea, they are very large lenses that only come in contact with your eyes on the sclera — the white part of your eyes. Between the lens and your eye is a very clear, very pure saline solution, which enables the intended vision correction and protects the corneal tissue.
You can abuse your scleral lenses by not using the saline solution recommended by your doctor.
We’ve seen cases where people have used generic contact lens solution or artificial tears instead of the recommended saline solution. Please do not do this with your lenses. Those products are not made to remain on your eyes all day, and often those products can contain preservatives.
We cannot overstate the importance of preservative-free products. Preservatives can quickly irritate the eye, kicking off the inflammation – infection chain reaction. If you wear scleral contact lenses, and you are considering using a product that comes in contact with your eye or lenses, and the packaging does not say “preservative-free,” do not use it.
Sleeping in Your Scleral Lenses
We also see patients abuse their scleral lenses by sleeping in them. Never sleep in your lenses. When you sleep, you are not blinking, which allows the debris that is typically flushed by your tears to collect on or around your lenses. These can include dust, bacteria, protein and lipid deposits, and allergens. The debris can fester while you sleep and lead to an inflammatory reaction or infection. Another negative aspect is that some of this debris can adhere to the eye.
Regarding allergens, if a patient complains about “gunkiness” during the day, we recommend using drops such as Pataday, Azelestine or generic Olopatadine. These products, which are used without the lenses in your eye, have preservatives. Any drops you put into your eyes with the lenses on, or any products you use on the lenses, should always be preservative free.
Extended Time Between Checkups and Lens Replacement
We sometimes see another type of scleral lens abuse when patients postpone visits to their Optometrist for checkups. We recommend a scleral lens checkup every 4 to 6 months, but some patients unfortunately wait much longer before making an appointment.
Long delays between checkups will also mean that your doctor cannot check on the health of your eyes, how they are changing, and whether your current prescription is still giving you optimal vision. That also means that you may be using the same lenses longer than is healthy for you.
We understand these delays because scleral lenses can be expensive, and patients often think that by not visiting their Optometrist they can avoid being told it’s time to get new lenses.
However, because Keratoconus is often a progressive disease and your eyes can change, scleral lenses are intended to last for a year, more or less. Scleral lenses are made with such precision that even microscopic changes in your cornea could affect the fit and comfort of your lenses, or cause other issues.
If you wait to visit your eye doctor until after you are having issues, there is a very good chance that you will need to undergo a round of treatment, which may include the same antibiotics and anti-inflammatories we mentioned earlier. And it may also involve not being able to wear your lenses for days or weeks until your eyes heal. Because we need to wait for your eyes to heal before we can prescribe new lenses, the treatment can further delay getting your new lenses.
That is why an important part of our cKlear Method™ is a 4 to 6-month follow-up exam: an exam when your eyes are healthy is preferable to when they are not.
The Real Danger Of Scleral Lens Abuse
The real danger of Scleral Lens Abuse can be a total loss of vision.
- If your eye changes radically between appointments, the effects can be much worse than if we catch it early. The shape of the cornea could change to a point where we cannot correct it with lenses.
- Scarring can occur if the lens touches the cornea, or if the cornea does not get enough oxygen.
- Hydrops Cloudiness and Scarring happens when the cornea just gives out. It “de-laminates”, allowing fluid in between the layers of the cornea, causing the cornea to turn white.
In all of these cases, if the damage is too severe you are likely headed for eye surgery — most likely a corneal transplant. Take care of your scleral lenses to help avoid a transplant.
Worried About Scleral Lens Abuse?
You don’t need to be worried about abusing your scleral lenses so long as you take the advice offered in this article. Scleral lenses for Keratoconus are marvelous and life-changing, but scleral lens abuse can rob you of their benefits.
Having the right doctor can be key to treating any medical condition, including your vision. Here at the California Keratoconus Center, we specialize in Keratoconus and other Corneal Dystrophies (abnormalities).
Patients visit us from all over the country at our office in the San Fernando Valley in Los Angeles. If you know you have Keratoconus or simply know that you have an eye condition that no one else has been able to properly treat, visit the California Keratoconus Center in the offices of Dr. Barry Leonard and Associates. Call 818-891-6711, or make an appointment online.