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Scleral Lenses for Dry Eye Syndrome

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How we Treat Dry Eyes, Tiredness, and Discomfort with Scleral Lenses

Scleral Lenses 325x217Dry Eye Syndrome is a common condition and can be due to many factors. At times, it is due to several factors that combine to create a larger problem. Patients have a problem in either producing enough tears to keep the eyes lubricated, or the tear quality is poor. In this page we are concentrating on how Scleral Lenses can help solve this problem. Elsewhere on our website we address what are some reasons that this problem occurs; disease, hormonal changes, medications, environmental factors, computer use, etc.

Some patients complain that their eyes tear too much. It may seem strange, but a very dry eye and a very wet eye are both due to the same underlying condition.

Think of the oil to lubricate your car, and the oil you put on the bottom of your skillet so eggs don’t stick to it. They are both oil, but they have different viscosity (thickness) and have different qualities. Similarly, there is oil in your tears and it functions similarly, to keep the front part of the eye (cornea and conjunctiva) well lubricated. The lids are like the windshield wiper in your car, and their function is to spread the tears evenly so there is a nice smooth surface over the cornea so you can see clearly. When something changes the tear chemistry (thyroid eye disease, medication, meibomian gland dysfunction and atrophy, allergy, inflammation, etc.) then the quality of the tears changes and people suffer symptoms of DED, Dry Eye Disease.

Dry eyes are uncomfortable, especially for people who spend so much time on screen and cell phone. It is common for people to complain that their eyes burn, sting, or feel scratchy, like there is something in the eye. Blurry vision is another common complaint. Symptoms can become worse under certain conditions (when I am in the kitchen, or when driving, for example). It may become worse at certain times of the year; winter, when it is dryer, spring or fall allergies, or in air-conditioned rooms during the summer. The air blower in your car or the dry air when flying in an airplane can also trigger these symptoms. Certain medications, such as high blood pressure medications and other medications can cause the yes to feel dry. Certain climates are inherently dry, and certain activities, such as sailing can produce a dry eye.

There are treatments that can make you more comfortable, including lifestyle changes and tear supplement eye drops. Some are over the counter and some are prescription medications to treat dry eye. Some medications are taken orally. The Meibomian Glands at the upper and lower lids produce the tears that lubricate the eye. In some people, they atrophy and stop working. Mascara placed on the lid margin can cause the Meibomian glands to become plugged or stop working. When the oil that produces the lubrication becomes congealed it can plug up the glands. The problem can be just annoying at the start, but can lead to long term problems. Certain eye diseases, such as Stevens-Johnson syndrome, or Ocular Pemphigoid can lead to extreme dry eye.

What are scleral lenses?

Scleral Contact Lenses are special lenses that create a dome over the cornea. They are about the same size as soft lenses, but unlike soft lenses, they don’t have water, and therefore they don’t dry out like soft lenses do. It is common for people who have worn soft lenses to want to keep wearing soft lenses, but placing a soft lens on a dry eye is like throwing gas on a fire. That’s just doing the same of what contributed to the dry eye in the first place.

Scleral lenses create a space of tears over the cornea and that acts as a reservoir. It then gives relief and is a very effective treatment for dry eyes.

Regular soft lenses can be uncomfortable for patients with dry eyes because as we spend more time on computer and screens, we tend to blink less and this causes the lenses and then the eyes to feel dry and irritated. It can cause the eyes to become red, feel itchy, and give the feeling that there is something in your eye.

Scleral lenses have the benefit of being very comfortable to wear and improve the symptoms. They provide sharp, clear vision and the prescription is incorporated into them. They can even be made as multifocal lenses so you can see both distance and at near. They are custom-fit and give comfort and function.

Scleral lenses are made of a gas permeable material. That means that they let oxygen through, helping to keep your eyes healthy. A lens made of gas permeable material allows more oxygen into the eye than do soft lenses. If you have dry eyes, your cornea may be more sensitive than normal. Scleral lenses address this problem with their shape. They do not touch the cornea directly but vault over it, leaving space between the cornea and the lens for hydrating fluid to sit in and bathe the eye.

How do scleral lenses treat dry eye syndrome?

Traditional soft contact lenses absorb moisture and pull that moisture from the eye. This can make dry eye symptoms worse. Scleral lenses provide moisture by keeping tears and saline in contact with the cornea, keeping the eye more hydrated and comfortable.

When you put the scleral lens on the eye, you first fill it with saline solution. The lens creates a dome over the cornea and holds this saline solution on the surface of your eye all day long. This consistent moisture enables you to feel comfortable and see clearly. Scleral lenses also cover more of the surface of the eye, helping to shield it from external irritants.

Tips for using scleral lenses

If you are trying scleral lenses for the first time, expect some time to learn how to use them. They are inserted and removed differently than soft lenses. They are very comfortable and very easy to use and care for once you know a few essential tips:

  • Rinse and fill the lenses with saline solution.
  • Clean the lenses as instructed to eliminate surface microorganisms and debris.
  • Disinfect the lenses to kill any bacteria.
  • Rinse the lenses with saline solution and store them properly.
  • Remove your lenses at the right time. The best time to remove scleral lenses is about an hour before you go to bed. However, if you feel that you need to remove them sooner, you can certainly do so. At times, lenses may need to be removed during the day and cleaned and then reinserted into the eye.
  • It is important to wash your hands before inserting and removing the lenses.
  • Insert and remove the lenses over a clean, flat surface so that if you drop one, it won’t become damaged and will be easy to find.
  • Handle the lenses by the outer or inner curve. Handling them by the edges can cause them to warp.
  • Keep your follow-up appointments to make sure that the lenses are doing what is expected and report any problems should they arise.

If you have any questions about treating dry eyes with scleral lenses, please contact us.

Call Family Eye Care today to schedule your consultation today.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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