Successful scleral lens wear requires the ability to apply and remove lenses from the eye as well as proper care of the lenses. This guide will review the essentials for scleral lens care.
After removing scleral lenses from the eye, they must be properly cleaned and disinfected with one of the following methods:
Peroxide system: 3% hydrogen peroxide is preservative free and has broad antimicrobial activity. Clear Care is the primary peroxide system available in the United States.
Multipurpose Solutions: Multipurpose solutions are approved for use with gas permeable lenses, including scleral lenses. These solutions are used to clean, disinfect, condition, and store scleral lenes. They utilize digital pressure (rubbing) and chemicals to clean and disinfect the lens. A thorough rinse using approved rinsing solutions is required prior to lens application. Available multipurpose solutions in the United States include Boston Simplus, Unique pH, and Tangible Clean.
When applying scleral lenses, the bowl of the lens must be filled with a sterile, non-toxic, preservative free solution. This fluid reservoir takes up the space between the back surface of the lens and the cornea and maintains contact with the surface of the eye throughout wear. Using improper solutions may result in toxicity to the cornea, leading to redness, irritation, and reduced vision.
Alcohol based cleaners: If scleral lenses deposit heavily with lipids (oil) or proteins, additional cleaners may be necessary to help clean the lens. Alcohol based cleaners are minimally abrasive and require digital pressure to remove the deposits.
Progent: This product by Menicon is a highly effective deposit and protein remover specifically for gas permeable lenses, including scleral lenses. Lenses are required to soak in the solution system for 30 minutes and require a thorough rinse before applying the lenses on eye.
Tangible Boost: Tangible Hydra-PEG is a custom coating applied to the scleral lens to increase surface wettability, reduce deposits, reduce scleral lens fogging, and improve lens comfort. The initial coating is added during the manufacturing process and can wear off over time. Tangible Boost is a conditioning solution that restores and maintains the Hydra-PEG coating on lenses.
There are several different techniques for applying and removing scleral lenses. Many patients prefer using suction cups or a ring to aid in these processes. To clean and disinfect these tools, it is recommended they soak in 3% hydrogen peroxide for a period of 3 hours and then rinsed with sterile saline or scleral filling solution. These tools should be replaced every 3 months.