Handling and care of scleral contact lenses

About scleral contact lenses

Scleral contact lenses are larger than average contact lenses and are designed to rest gently on the white part of your eye (the sclera) and bridge over the central part of your eye (the cornea).

You should always wash your hands before handling your contact lenses and follow the instructions for handling, lens care and lens wear given by your optometrist.

Insertion of the scleral lenses

Scleral contact lenses can either be inserted using your finger tips or an insertion plunger (a plunger with a central hole). The method that best suits you will have been discussed with your optometrist before the contact lenses are issued.

When inserting your lenses, it is best to work over a clean surface. This will allow the lenses to be easier to find if dropped and is unlikely to cause damage to the lens.

After washing your hands, remove the lens from its case and either balance on the tripod of your fingertips or on the insertion plunger (which ever method you have practiced with your optometrist).

Most patients find it easier to hold the contact lens with the hand on the side of the eye you are about to insert the lens in to. For example, use your right hand to hold the contact lens for the right eye.

For details about contact lens solutions and preservative free saline, please refer to the Care Systems section below.

• Fill the lens with preservative free sterile saline solution.
• Bring your head forward, parallel to the surface you are working over. With the non-lens holding hand; use your index finger to hold the top lid up and your thumb to hold the bottom lid down, separating the lids as far as possible to allow a large enough space to fit the lens on to the surface of the eye.

Keeping the contact lens full of saline level and holding the eyelids securely out of the way, move the scleral contact lens towards to the surface of the eye. Keep your point of focus in the centre of the lens so that the lens intercepts (lands on) your eye centrally between the eyelids and over the pupil. Once the lens is in place, remove your finger tips or the plunger, if used, and slowly release your eyelids.

After inserting the lens(es), the lens case should be rinsed with fresh contact lens disinfecting solution and left open in the air to dry.

Removal of the lenses

Most scleral lenses require a plunger to remove them from the eye; this is a solid plunger without a central hole.

Using whichever hand you prefer; hold the lids firmly out of the way using the technique described above. With the other hand, place the plunger firmly on to the surface of the scleral contact lens.

When the plunger is in place/attached to the surface of the contact lens, gently pull the plunger away from the eye in the opposite direction to which you are looking. For example, pull the lens up and away while looking down. Some patients can pull them straight off/forwards away from the eye while staring straight ahead.

You should have already established the best technique with your optometrist, but further advice is available if you need it from the Optometry Department.

Cleaning

Lenses should be cleaned immediately after they are removed from the eye. This must be done with a suitable rigid gas permeable lens cleaner, as advised by your optometrist.

Rub the lens gently both inside and out for about 15 to 20 seconds; then rinse thoroughly with sterile saline.

Scleral lenses can be stored dry or in an appropriate solution as recommended by your optometrist. If you are storing the lens dry; gently dry the lens with a soft tissue, (that the type you would use to blow you nose) after cleaning (hard tissues, such as kitchen paper may scratch the lens) before storing overnight in the contact lens container.

After inserting the lens(es), the lens case should be rinsed with fresh contact lens disinfecting solution and left open in the air to dry. It should also be thoroughly washed out once a week.

Regular, monthly replacement of your contact lens case is essential for trouble free contact lens wear. A new case is supplied with each new bottle of solution.

This is due to the high risks of serious contact lens related infections associated with tap water and contact lens wear.

Care systems

You should use the contact lens disinfection system recommended by your optometrist. Make sure that you do not use solutions beyond the expiry date shown on the bottle. Discard solutions that have been opened longer than the recommended time marked on the bottle. As a reminder, it is useful to write on the bottle the date it was opened.

If the lenses are removed for any length of time, they should be rubbed with your contact lens cleaning solution and disinfected before wearing again.

Contact lens disinfection solutions and preservative free saline are not issued on prescription. They can be purchased from either a pharmacy, supermarket or registered online retailers.

Wearing time

• You should not wear your contact lenses for longer than the time recommended by your optometrist.
• You should not wear the lenses if your eyes are red, painful or your vision has become blurred.
• You should never sleep with the scleral lenses in your eyes. If this happens remove the contact lens on waking and install ocular lubricants; these can be obtained from your local pharmacy. If you are concerned about your eye contact Eye Casualty.

How to avoid problems with contact lens wear

Inappropriate contact lens wear and not following the advice of your optometrist can result in contact lens related complications, a number of which are potentially sight threatening.

To minimise problems, it is important to follow the advice given by your optometrist and always wash your hands before handling your lenses.

Swimming, showering and using a jacuzzi or sauna while wearing contact lenses are all known significant risk factors for complications. You should therefore avoid these risks when wearing contact lenses.

Eye infection rates are also higher in contact lens wearers who smoke.

It is advisable to have a pair of spectacles available that can be worn if you have any eye health complications that prevent lens wear. Spectacles can also be worn to allow your eyes to have a break from the contact lenses.

Contact information

Eye Casualty

Tel: 0300 422 3578

Available 24 hours

For general contact lens queries and ordering please contact the:

Optometry Department

Tel: 0300 422 3190