Scleral Lens Tutorial 6 - Lens removal - Tips, techniques and troubleshooting

 

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Removing your lens with a plunger

What is a removal plunger?

Usually when anyone refers to a removal plunger, they mean the DMV Ultra, which is by far the most commonly used type. There is also an angled version called the DMV 45.

Basic steps in plunger removal technique

  1. Set up your space
  2. Wash and dry your hands
  3. Wet lens and plunger
  4. Spread one or both lids (depending on your needs)
  5. Attach plunger to edge, NOT center, of lens
  6. "Break the seal" (suction) of the lens. This can be done with the plunger or with the fingers.
  7. Lift the lens off the eye

Video examples

Two hands for lid spread:

Another example

Breaking seal manually first 

Tips

  • Most people look straight out, but for some, looking down works better.
  • Experiment with the use of hands and the lid spread process that works best for you.
  • Don't forget to wet!
  • Twist and rotate the plunger slightly if your lens seems very "stuck".

Remember: We're all different!

Many examples on YouTube show people with their arm over their head holding their upper lid up. I've never done that and it feels extremely awkward to me. I always use the index and middle fingers of my left hand to spread my lids - on both sides. We are all different and there are no right or wrong answers.

Removing your lens without a plunger

If your sclerals are small relative to your eyes, removing them without a plunger is usually not difficult (assuming the lens is not too tight). The larger the lens, the more likely a plunger is the most practical method for daily removal. However, even if you normally use a plunger, knowing how to remove your lens without a plungers is helpful in emergencies.

Removal without a plunger is all about wedging your lower lid under the lens to "break the seal". 

Video examples

Smallest sclerals

 A little larger

 Full size

Removal technique mistakes

  • Failing to get the lens & plunger wet
  • Attaching plunger to the center of the lens
  • Pulling too hard and too long
  • Tugging hard without first breaking suction 

HELP! What do I do now?

Lens won't come out: Don't panic. Relax - you've got this, you really have! You've gotten your lens out before and you can do it again. Take some deep breaths, go back to the beginning, and walk yourself slowly through the steps. If the plunger isn't working, try the manual method. If you are getting stressed, TAKE A BREAK. 

Lost my plunger: If it's still business hours, find a local optometry office that has them. If that's not an option, use the links above to watch videos of the manual method of removal.

There's a ring around my eye after removal: A slight compression ring is normal after removing scleral lenses. If you have concerns about whether your ring is "normal" or whether it's acceptable in your particular eye situation, take close-up pictures to send to your doctor.

My eye is very red or painful after lens removal: Call your doctor's office. And take pictures. Do not continue wearing your lens without first getting your eye doctor's instructions.

REMEMBER: YOU'VE GOT THIS!

Some people master it in days - for others, it takes months. We have different eye anatomy and a host of factors that affect our technique. Don't sweat if you don't pick it up right away. But do be assertive about getting extra help and supervision from your dr's office.  

Are we there yet?

If you have been properly trained in scleral lens handling and use, you will:

  • Be confident that you can successfully insert and remove your lenses by yourself, even if it may take you some time at first;
  • Know what steps to follow for insertion and removal;
  • Know what not to do;
  • Know when to call the doctor's office.

Scleral lenses are not like regular contacts. They are a medical treatment as well as a specialty lens. They have many special handling requirements, and these requirements may vary from person to person depending on individual medical considerations. There may also be important safety considerations that apply to patients with particular medical conditions. A professional scleral lens fitter should be investing plenty of time in your training and support and should not allow you to take your lenses home until you can meet established safety standards for ongoing use. 

If you don't feel confident of your ability to take your lenses out safely, (1) don't wear them until you do, and (2) call your doctor's office to schedule more training time. If they are unwilling or unable to provide you with full support for this process, you may want to reconsider whether they are the right scleral lens partner for you.

IMPORTANT NOTE

FOR INFORMATIONAL PURPOSES ONLY. THIS GUIDE IS COMPRISED OF PEER-TO-PEER SUGGESTIONS, NOT MEDICAL ADVICE. CONSULT YOUR EYE DOCTOR WITH ALL YOUR EYE CARE AND LENS QUESTIONS.

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