Scleral Contact Lenses
Scleral contact lenses were the first type of contact lenses that were made. It was later on developed when high oxygen permeable material became available for manufacturing.
They are called scleral contacts because of their large diameter and because they cover the cornea (clear dome-shaped membrane covering the colored part of the eye) extending onto the sclera (white part of the eye). Their diameters range from 14mm to 20mm.
Advantages of Scleral Lenses
1- Scleral lenses stay stable on the eye and they rarely dislocate.
2- Due to its large diameter, scleral contacts may be more comfortable to use compared to corneal lenses. As the lens rests primarily on the conjunctiva (the clear membrane over the sclera) which is much less sensitive than the cornea, the wearer may experience less sensation from the lens.
3- For patients with corneal damage, the saline solution applied on the lens prior to application soaks the cornea which may improve comfort and promote healing of the corneal surface.
Conditions that may benefit from Scleral Contact Lenses
Conditions causing irregular corneas:
Pellucid marginal corneal degeneration
Post corneal transplant/surgery
Conditions affecting the quantity or quality of tears:
Severe dry eye syndrome
Stevens-Johnson syndrome
Graft versus host disease
Neurotrophic keratopathy
Refractive errors especially those who are unable to use other types of lenses:
Nearsightedness
Farsightedness
Astigmatism
Some inflammatory conditions:
Limbal stem cell deficiency
Ocular cicatricial pemphigoid
How to Apply Scleral Contacts
1- Hold the lens with your thumb and 1 or 2 fingers forming a tripod. The lens should sit on top of your fingertips. You can also place the lens on a plunger/inserter if available.
2- Fill the bowl of your lens with unpreserved sterile saline.
3- Lean forward until your face is parallel to the floor to prevent the saline from spilling during application.
4- Open your eyelids widely with your free hand and apply the lens to the surface of the eye. Supporting the lids is essential during application so make sure not to release hold until the lens is fully in place.
How to Remove Scleral Contacts
1- Place your fingers on your lower and upper lids. Gently push your lower lid under the edge of the lens to release suction. Take the lens off the surface of your eye or catch it as it pops out with your hand or a towel.
2- If using a plunger, wet the plunger’s tip with saline and attach it to the bottom third of the lens. Place your fingers under your lower lid and gently press the eyelid in as you pull the plunger out.
How to Clean Scleral Contact Lenses
1- Daily cleaner – Add several drops of your daily cleaner solution on the lens and gently rub both sides with your fingers.
2- Rinse – Rinse your lenses with the appropriate solution or sterile saline after cleaning.
3- Soaking solutions – Place your lens in its case with an appropriate soaking solution. Do not use water.
4- Enzymatic cleaner – A periodic treatment with enzymatic cleaner is recommended to remove protein build-up on the surface of the lens.
A variety of products are available in the market, discuss with your eye care professional what can be recommended for your use.
