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Scleral Lens Fogging and What Patients Can Do About It
By Kemberly Grizzaffi, NCLEA
Scleral lenses have revolutionized vision correction and treatment for patients with irregular corneas, severe dry eyes and other eye conditions. These little miracle workers are designed to vault over the cornea, rather than interact with it. Landing on the sclera (the white part of the eye), scleral lenses can completely transform a highly irregular corneal shape and surface. However, scleral lenses do come with certain challenges.
Fogging is one of the most common complaints among scleral lens wearers. It can cause discomfort and impact optical quality, not to mention the inconvenience of removing lenses to clean and reapply them throughout the day. Learning more about scleral lens fogging causes, treatment, and prevention is crucial to having the best possible wearing experience.
Officially, scleral lens fogging is moisture forming and accumulating on the lens surface. The most common causes for scleral lens fogging are:
- Deposits forming on your lenses
- An improper cleaning regimen
- Environmental changes
- The fit of your lens
Deposits Forming On Your Scleral Lens
Deposits can form on the surface of your lens over time. These deposits can be from environmental debris or from protein and lipids found in your tears. When they start to bind to the lens they form a “build up” that leads to trapped moisture, impaired vision, and even discomfort.
Your Eye Care Provider can help to identify the various types of deposits and recommend a treatment or cleaning regimen to help mitigate the issues. Many times, a patient’s tear chemistry is the culprit and must be treated in conjunction with scleral lens wear. More and more, practitioners are adding smart surface technology to the lens (like Tangible Hydra-PEG). This does not change the quality or quantity of your tears, but, it does help to prevent the debris and deposits from sticking to the lens.
How Tangible Hydra-PEG improves deposit resistance
on scleral lenses
An Improper Cleaning Regimen
Improper or infrequent cleaning can lead to debris building up on the lens surface. It’s highly important that you follow a daily cleaning regimen that your Eye Care Provider recommends. Scleral lenses are custom made for YOUR eyes which makes them expensive!
For that reason, many people are lax in cleaning their lenses for fear of dropping, breaking, or losing a lens due to handling. Rest assured, your lenses not only can stand up to daily cleaning, they require it to continue providing the vision and comfort they are designed to give.
Environmental Changes
Environmental changes, especially in temperature or humidity can cause temporary moisture on the lens. If your lenses have started to form build up from debris or deposits, moisture gets trapped and can worsen the already maddening symptoms.
The Fit of Your Lens
Problems with the fit of a lens can lead to many issues, including fogging. Eyes can change fast, especially if you’re dealing with an irregular cornea. Since scleral lenses are custom made for your eyes, changes to your eyes’ shape or tear chemistry can impact the way the lenses fit, feel, and perform. An ounce of prevention is worth a pound of cure!
The challenges that come with scleral lenses are real. But, they can be managed and overcome with diligent care, compliance, and communication. Here’s what you can do to take control of your scleral lens experience.
- Communicate with your practitioner. Ensure all your questions about your current lenses and care regimen are answered. Ask your Eye Care Provider if there is anything new that can be done like a change to your care products or adding Tangible Hydra-PEG.
- Commit to caring for your lenses with daily cleaning and disinfection with only recommended products. When you received your scleral lenses, you may have been given or recommended to buy several different care products. This can be complicated and confusing. Ensure that you understand the recommended cleaning protocol and don’t be afraid to ask for samples! If your practitioner has recommended using a multi-purpose solution, you can purchase Tangible Clean easily online.
- Since products for scleral lenses are not readily available in drug stores, consider purchasing multiples or signing up for subscription services so that you have everything you need on hand with back-ups, just in case.
- Be mindful of your environment. Don’t let air conditioning or heat blow directly into your face in cars or airplanes. Consider protective eyewear when working in dusty or smoky environments.
- Keep your follow up and annual examination appointments. This is how your doctor not only checks how your vision is doing, but also ensures the overall health of your eyes, tests for early onset of eye diseases, and confirms your lenses still fit your eyes as they were designed to.
Speak up at your appointments and in between appointments. Ask for better vision and comfort. You don’t have to settle!
8 comments
Hi Gwen!
Thank you for sharing your experience and your question with us. The drops your practitioner has recommended are allergy drops. Many scleral lens patients suffer from systemic or seasonal allergies and reducing your allergy response can aid in some symptoms. Antihistimine eye drops can cause dryness or reduced tear production leading to a lens surface that is not as resistant to deposits. We recommend speaking with your eye care practitioner about these symptoms to review your care regimen and determine if any step or product should be altered. One thing we can suggest doing immediately and long term is using a preservative-free rewetting drop throughout the day with your lenses applied. This will keep the lens moist, more comfortable, and more likely to resist deposits from your tears and environmental debris.
Due to extreme dry eye syndrome and extensive scar from an ulcer I have been wearing Scleral lenses for almost 5 years. My I have used the Boost to help keep lenses clean but I still have to remove them several times a day due to gunk coating the lense. I clean with all your products, use Celluvisc and do the wash-rinse-repeat at least 3 times a day. Have you heard of any product being suggested to help reduce the amout of gunk the eye produces? My eye care professional has me using PatAday drops at night and even tried Lotomax without any success. And, yes we did the laser treatment as well. I’m at a dead end and feel like there must be something out there we have not tried. Looking for help!
As my Sjogren's eyes have gotten dryer, my lids produce more gunk/deposits that clouds the lense and my vision. My issue is cause by the deposits on top of the lens, not under. The deposits also cause the lid to drag the lens up distorting the prescription and causing blurriness when blinking. So far I'm trying to manage with Optase gel in the eye before bedtime to help moisturize the eyelid and that helped instantly (although that causes it's own fogginess on the lids in the morning and needs to be flushed out). I clean every couple hours still. I use the Boost hydra-peg to recoat the lenses so they are slippery which makes a huge difference and I love it – the only drawback is it only lasts well for about a week because I have to clean them so frequently so it gets expensive. I also do the iLux Thermal Pulsation once a year (it's $450 per treatment though so not cheap) and that helps improve moisture for a couple months but not a miracle. It seems like it's a journey for everyone, but I like using the Tangible Clean with Nutrifill saline solution everyday and make sure I never run out. I've had mixed results with Celluvisc, I think it helps to put a drop on the outside of the lens before inserting and is readily available at target in a pinch.
Hey Mike! Thanks for the suggestion, we’ll work on getting this made ASAP to clear up any confusion.
For context, yes you should be rinsing off Tangible Clean after you soak or clean your lenses. You can rinse off the excess solution using Tangible Clean, making sure there aren’t any deposits or residual solution left on your lens surface.
I have daily fogging as sometimes I wear them 12-13 hours a day. I read (on Reddit) about using 1 single-use Preservative-Free Refresh Celluvisc Lubricant Eye Gel in each of the (eyeprintpro) sclera lens, and then fill with the saline. I checked with my eyeprintpro eye doctor and he said Yes! And I’ve never had a problem since. I do soak with Clean Care after every use. Apparently I have a lot of protein in my tears. Hope this helps someone.