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Could Scleral Lenses Combat Dry Eye?

Almost 5 million Americans over the age of 50 suffer from dry eye, driving eye care professionals and manufacturers alike to continually seek out better treatment options. But are we overlooking scleral contact lenses? These lenses are usually used to treat corneal irregularities, but because they hold a liquid reservoir (developed to mask irregularities and return patients to near normal visual function), they may provide relief for dry-eye sufferers. 

For mild dry eye, there are other treatment options, but a 2007 recommendation from the International Dry Eye Workshop did suggest the use of contacts for treating Grade 3 dry eye. Grade 3 patients experience chronic dry eye symptoms that affect their comfort and vision and which can potentially limit activity. Often Grade 3 dry eye presents as lid disease, central cornea staining, filamentary keratitis, mucus clumping and increased tear debris. 

In 2012, researchers tried treating moderate to severe dry eye with mini-scleral contact lenses. Seven of the patients fitted with the scleral lenses reported reduced discomfort and dry eye symptoms, decreased use of artificial tears and improved visual acuity. Other studies conducted in 2007 and 2008, although not specifically focused on treating dry eye also yielded encouraging results. 

However, fitting scleral lenses for a dry eye patient is somewhat different than fitting them in hopes of treating corneal irregularities. For patients who suffer from dry eye, smaller corneo-scleral lenses should not be sued. It’s important that the scleral lens completely vault the cornea to avoid mechanical injury, particularly when the cornea is already compromised by dryness. Mini-scleral or full-scleral lenses are a better choice because they provide increased vaulting capabilities. 

If trying scleral lenses to combat dry eye, your doctor may recommend cleaning them more frequently than you would a normal pair of contact lenses. Usually patients with moderate to severe dry eye produce more mucus and exhibit excessive tear debris. This excess debris will be pumped underneath the lens and does build up during wear time. It will not diminish wearer comfort, but it can cause cloudy vision. 

It’s also very important to properly clean and store your scleral lenses to ensure no residual preservatives become trapped under the bowl. These could become toxic to the anterior ocular surface. Your doctor may also advise using a particular brand of contact solution or occasionally using an extra-strength solution, and it’s important that you follow these directives. 

If scleral lenses are effective, not only should you experience less discomfort due to dry eye, you may be able to lessen or discontinue use of other treatments or medications you had been previously using. If you’re interested in discussing scleral lenses with any of our four doctors, please make an appointment at your convenience. 

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