The Ultimate Guide to Scleral Lens Care

Struggling with scleral lens care? You're not alone. This ultimate guide is your one-stop resource for everything you need to know about maintaining your scleral lenses for long-lasting comfort and clarity.

What Are Scleral Lenses and Why Are They a Game-Changer?

Scleral lenses are specialized contact lenses primarily prescribed for patients with keratoconus, dry eyes, or other corneal conditions. These rigid, gas-permeable lenses have a wide diameter, allowing them to vault over the entire corneal surface and rest on the sclera, the "white of the eye." This unique design offers unparalleled comfort and effective vision correction.

Mastering the Art of Inserting and Removing Scleral Lenses

Inserting and removing scleral lenses can be daunting initially. But don't worry, with a bit of practice, you'll become an expert in no time. Here's a step-by-step guide to help you master the technique.

How to Insert Your Scleral Lens

1) Wash hands with a non-fragrant and non-moisturizing soap. Dry thoroughly. 

2) Remove the lens from your case, and rinse if preferred.
3) Place the lens, centered, on the inserter tool. 

• An open-ended inserter (no suction) is generally recommended and preferred by most patients.

4) Fill the lens with preservative-free saline solution making sure to overfill the bowl.
5) Secure the upper and lower lids open. 

• Lids must be open wider than the lens. Holding lids at the lash line will improve your grip.
• Dry fingers and dry lids are crucial to holding a firm grip.
• Try using the same hand as eye to hold your lids and the other hand to hold the lens inserter. 

5) Look down with your chin to your chest. Apply the lens by raising the lens inserter toward your eye while looking into the center of the lens. Keep both eyes open. 

• A mirror on the table is not necessary. If you can see into the center of the lens, your aim is spot on!

6) When you feel the solution touching your eye and overflowing from the lens, hold it there with only minimal pressure.
7) Pull the inserter away, ensuring the lens stays on your eye.
8) Raise your head, and let go of your bottom lid first, then the top lid. The top lid is heavier and will come down with more force. Releasing the lower lid first will help to ensure the lens is in place
9) Check for bubbles by paying close attention to how the lens feels. If the lens is uncomfortable, it may be due to an air bubble trapped beneath the lens. Remove the lens and repeat the application.

How To Remove Your Scleral Lens

1) Wet the tip of the remover before placing it on the lens (you can use a drop of your Tangible Clean, Saline, or rewetting drop.
2) Face a mirror and open your lids with your fingers.
3) Place the head of the remover at 6:00 on the lens with slight to moderate pressure to secure it to the lens. 
4) Rotate the lens by moving the remover left and right several times. This will help to release the seal that was made upon insertion. 
5) Pull up and away with gentle pressure.  Avoid “dragging” the lens across the eye.
6) Remove the lens from the remover device by sliding it off.
7) Dry the remover and store it in a clean, dry place.

Caring for Your Scleral Lenses

Proper care of scleral lenses is crucial to your success. When lenses are not in your eyes, they should typically be stored wet due to surface treatments, including the Hydra-PEG coating. Use only approved and recommended cleaning solutions, not all solutions are appropriate for all lenses. Use only preservative-free saline solution. Saline should be used only to insert and rinse as needed. Do not store lenses in saline solution. Never use tap water to rinse your lenses.

For more care tips specific to combating scleral lens discomfort, check out our 12 tips to avoid scleral lens discomfort. 

Contact Lens Case Hygiene is a Priority

Clean your contact lens case with your disinfectant solution and wipe dry with a lint-free cloth. Store it upside down with the lids off until the next use. Contaminated contact lens cases have been linked to rare but serious eye infections. The CDC recommends replacing contact lens cases monthly.

How to Clean and Store Scleral Lenses with Multipurpose Solutions

Multipurpose solutions clean, rinse and disinfect with a single product. They are also appropriate for storage. 

Place your scleral  lens in the palm of your hand. Place a drop of Tangible Clean or your approved multipurpose solution on the lens and rub each side of the lens gently for 10 seconds. 

Rinse the lens with Tangible Clean or your approved multipurpose solution. Place the lens in the proper well of the case and fill the case with Tangible Clean or your approved multipurpose solution. Store for 6 hours or overnight. 

Using Peroxide Solutions for Scleral Lens Cleaning and Storage

Peroxide solutions can be used to clean and disinfect your scleral lenses. This type of solution works by gently breaking up debris on the lens. The peroxide is neutralized to saline by a catalyst disc in the case. This neutralization process takes 6 hours.

Place your scleral lens in the proper side of the barrel case. Do not rinse the lens first. Fill the barrel case to the indicator line with the peroxide solution. Leave at least 6 hours for full neutralization of the peroxide to saline. After 6 hours, you may wear your lenses. Some patients prefer to rinse their lenses in Tangible Clean or an approved multipurpose solution before wear.

TIPS:

If you must remove the lenses before 6 hours, rinse them very well before inserting them! 

Never place your peroxide solution directly into your eye. 

Keep a multipurpose solution on hand for rinsing and storing your lenses for less than 6 hours.

Understanding Scleral Lens Solutions

Keeping your scleral lenses clean and free of build up is key for successful wear. It is important to use solutions that have been approved for your specific lens type. Using a non-compatible solution could harm your scleral lenses.

Your practitioner will typically recommend a cleaning system for you that will consist of a multipurpose solution, a peroxide solution, or a combination of the two. They will consider things such as allergies, corneal sensitivities, previous history with contact lens solutions, and even convenience to you, the patient. 

Both Peroxide and Multipurpose Solutions clean and disinfect your lenses very well. If your practitioner allows you to choose a cleaning system for yourself, here are the main points to consider to compare them.

• Hydrogen peroxide solutions do not have preservatives. This is why your practitioner might recommend peroxide if you suffer from allergies or have been sensitive to preservatives in the past. 

• Peroxide systems require 6 hours for full neutralization. Procedural mistakes (inserting lenses before 6 hours of disinfection) can cause temporary discomfort and even damage to the cornea.

• Multipurpose solutions have the ability to clean and disinfect with one product. They also can be used for rinsing, storage, and case hygiene. This generally results in a more cost-effective option. 

• Multipurpose solutions contain preservatives that are safe for the eye, but some patients can show sensitivities to them. 

Tangible Clean is an ultra thin contact lens solution that gives you a more refreshing cleaning experience. Less residue on the lens means more comfort and less irritation. If you prefer the convenience of a multipurpose solution or your practitioner has recommended it, read more and order Tangible Clean here: https://tangiblescience.com/products/tangible-clean

Clear Care is by far the most popular peroxide system available in the US. It has two formulations and both are compatible with scleral lenses and with the Hydra-PEG coating.

Saline Filling Solutions for Your Scleral Lenses

Scleral lenses should be filled with preservative-free saline only. This is because there is longer contact time with the cornea. Saline solutions that are indicated for scleral lenses are preferred. 

You will find both single-use ampules and multi-use bottles of scleral saline. Buffered saline has 2 added ingredients meant to raise the ph level of the solution to match the ph level of the natural tear. This can be beneficial for many patients. However, some patients find the added ingredients to cause sensitivities and prefer Non-Buffered Saline.

TIP: Multi-use bottles of saline must be discarded every 14 days.

Using Rewetting Drops with Scleral Lenses

Rewetting drops are plentiful, to say the least! So how do you know which one is right for you?

First, ask your practitioner if they have a recommendation. Most practitioners recommend their scleral lens patients use a preservative-free drop. You can not overuse rewetting drops. Moist lenses always perform better than dry lenses, so habitually using a drop throughout the day can actually improve your wearing experience. 

TIP: Not all drops that state they are approved for contact lenses are preservative-free. Look for “preservative-free” or “PF” on the box, even if it does not indicate it is approved for contact lenses.

Disclaimer: To ensure long lasting eye health and contact lens comfort, always report any new symptoms or challenges to your eye care practitioner.