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Not fitting well and was expecting more customization - does this make sense?

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  • Not fitting well and was expecting more customization - does this make sense?

    Hello all.

    It has been about 3 months since I started to get fitted for sclerals. The relief from whatever that irritated the surface of my eyes was wonderful when I have them on, but my tolerance for them went down when I tried wearing them on a daily basis - from 8 hours down to 4 hours if I wear them for several days in a row.

    My first pair was 17mm and my upper eyelids got quite irrirated from them. I was told either they moved around too much, or my eyelids are "tight" because I am of Asian descent, and the lens caused excessive friction.

    After 2-3 alterations, the eye doctor suggested a smaller size (16mm) by another manufacturer. While the new ones are being sent over, she also suggested trying to piggyback a regular lens (Oasis) in each eye before putting on the 17mm sclerals, to see if it will give a better fit. Surprisingly, it helped, although my tolerance still tended to go down when wearing a few days in a row. I suppose it helps the lens from moving around too much.

    The 16mm's were less irritating to my lids, but again, I thought I could do better. So I was surprised when told the 16mms cannot be customized further for better fit. I am told they fit well according to her inspection. Also, my eyes feel irritated after 4-6 hours of wearing and I had to take them off, although often the lens would still have solution on them.

    I was also offered to try the mini hybrids (15.5 mm I think) when I asked about them, after hearing about it from another optometrist. I only tried them on for about 10 mins so did not have a fair chance to evaluate, but the fit felt weird - if given the chance to wear them longer, it might settle to feel more normal, or...

    So, it sounds like I am at the end of the road for sclerals, from this eye clinic. I used to wear regular contacts 10+ years ago and compared to then, the sclerals give the sensation that there is always something in my eyes that i have to tolerate. I suppose soon, I need to decide whether I should keep them or get the refund on the lens (minus the CAD1400 fittig fee), or if keeping, which one to keep.

    Although hard to prove, I believe it is my work environment that is contributing to the majority fo my eye irriration, and the lens do help protect my sclera from that. A smaller size, to me, means less protection. What should I do? Should I settle for one of these, or look further?

  • #2
    Hi ltree. Sorry to hear the scleral fittings are not going well.

    At this clinic, did you ever get to see the specialist listed on that Scleral Lens Society website, or did you continue to see the associate? Am wondering if your practitioner did not have enough expertise fitting sclerals. My sclerals are 18mm which I believe are more the typical size, and I've read larger sclerals can be more comfortable, but everyone is different. If you think the experience level of the practioner is the issue, finding a more experienced practitioner may help.

    Did you try putting a couple drops of preservative-free artificial tears in the lenses and rolling it around to cover the entire inside of the lenses, before adding the saline when inserting? Several people find using Refresh Celluvisc helps make the sclerals more comfortable and they can wear them for longer periods, and I've read in this forum some people use more than a couple drops of it in their lenses. Personally I find Genteal Tears (formerly called Tears Naturele) soothing in the lenses.

    Have you also tried using artificial tears while wearing your lenses? This may help with the friction from your upper eyelid. For saline, are you using Purilens preservative-free saline?

    It may be that given the current condition of your eyes, you just might not be able to wear sclerals at this time. That doesn't mean you won't ever be able to wear them, but your condition may need to improve some first. There was a period of several years when my eyes were so dry, I could not tolerate wearing the lenses, it was uncomfortable as soon as I put them on. After I started getting a little better, I was able to start wearing them again, but by then I needed to get new ones to update for the power.

    Your work environment may indeed be contributing to your eye problem. I recall you use the computer a lot? Excessive computer use was likely a secondary cause of my MGD. Unfortunately, if you have to extensively use the computer like I did, it's a vicious cycle and difficult for your eyes to get better. I had to quit my job. I know it sounds unreasonable, but is there any way you can take a break from work for awhile (perhaps short term disability, which at least in the U.S. your doctor needs to approve), or change to a job with less computer use?

    I hope it all works out. Been wondering how you were doing. Do you still have the blepharospasms?
    Last edited by Hokucat; 12-Jun-2017, 17:52.