You may not have heard of Scleral lenses, but in fact they were the first ever lens invented, back in 1888. They were also the only lens available up until the 1950s. They were fitted to cover the entire eye and rest upon the sclera, creating a dome over the eye and the corne that is filled with saline solution.
In the old days, they used to take an impression of the eye in order to fit the lens. Nowadays, thankfully, this is not the case. They are very big, scarily big some may say, reaching a diameter of 25mm in some cases. But this initial impression should be overcome as they are an extremely effective and useful lens for Keratoconus sufferers. They do not fall out, you cannot get bits of grit or dirt behind them, and they are surprisingly comfortable. Also, the problems with oxygen reaching the cornea have been overcome with the use of gas permeable materials.
The capacity to correct vision is also high and they can be worn for all stages of Keratoconus, from slight cases to the very advanced. They are also useful for Hydrops patients, as the cornea remains untouched while the lens is in. On the downside, learning to put them in is extremely difficult (but possible) and you do spend a large amount of money on saline solution!
The trouble is keeping the saline in the lens as you insert the lens in the eye. Failure to do so means bubbles of air get in and these float in front of your vision. The lens itself is also expensive to fit and make, meaning some practitioners are put off offering the service. However, its benefits mean that you should push for this type of lens as it really is an ideal option for Keratoconus.
Scleral lenses have transformed my life. They are comfortable, I get great vision from them and they are so much easier to wear and control than other lenses. They do look intimidating and the size can be troublesome for some, but you really should persevere. It took me around 2 months to get used to putting them in without getting bubbles in the saline solution – so that gives you some diea of the commitment you need. The pay off is great vision and great comfort.
The saline lens kit, for me, looks like this:
You store the lenses dry. So each morning, you take them out of the container, clean them with the peroxide cleaner between your fingers, rinse with the saline solution, then comes the tricky bit. You hold the lens between your thumb and first two fingers, fill the lens with saline solution, bow your head down to the lens, and insert into the eye. To get the lens out, you flip it using the top lid. It takes a lot of getting used to. Below are a couple of videos to help you get a better idea of getting the lens in and out.
The storage box has to be cleaned every two weeks using the cleaner and saline then wiped dry with tissue. Two weeks is a minimum. The lenses also have to be cleaned using a protein remover tablet every couple of weeks. My choice of protein remover is Amiclair. You stick the lens and a tablet in saline in a container over night and then clean as usual in the morning. This prevents the build up of gunk that can cloud vision when it floats around in the saline, and cause conjunctivitis. I also changed bedding and towels every 7 days for the same reason.
When the lens is in the eye it looks like this from the side: