Scleral Lens User Guide: 2 - Appointments

1. Introduction
2. Appointments 
3. Prep and setup
4. Rinsing & filling
5. Lens application
6. Lens removal
7. Cleaning & disinfection
8. Midday fogging & debris
9. Storage & replacement
10. Traveling with sclerals

2. Making the most of your scleral lens fitting & follow-up appointments

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Preparing for your appointment

Send an email first

All too often we forget important questions we wanted to ask. Make it easy on yourself and your doctor by writing down your most important questions and concerns and emailing them to the office the day before. 

Take copious notes

No matter how good you think your memory is, be smart and write things down. No one remembers everything accurately afterwards, even if it seemed clear at the time.

Choose your time of day for follow-up appointments

Some users may experience issues that only arise after wearing the lenses for many hours. Schedule an end-of-day appointment so your doctor can see you under realistic conditions.

Bring a friend or family member?

Stressed? You're not alone! The scleral lens process can be taxing in many unrecognized ways. Bring someone along who can be your eyes, ears and support! 

During your appointment

What to ASK when you're just getting started

  • What should I expect, in terms of how long it might take to get successfully fitted?
  • When you have to order more lenses, how long till the new ones come?
  • Who will train me on lens insertion, removal, and care?
  • Who do I call if I have questions or concerns?
  • Will I need to wear reading glasses (or progressives)?
  • Please explain my financial commitment. What happens if things don't work out as planned? Are there any manufacturer warranties that can reduce my cost?
  • How much will it cost to purchase a replacement or back-up set in case of loss or breakage?
  • When I take home my first lenses, how long can/should I wear them? How will I know if/when I ought to remove them?
  • What is the brand and diameter of the lenses you will be fitting for me?

What to TELL during a follow-up appointment

  • Changed any solutions? Did you start using a different filling, cleaning or disinfection solution, or rewetting drops? Tell your doctor.
  • 3R patterns: Are you having to remove, rinse and refill during the day? If so, how often and why?
  • Insertion troubles: If it is taking you a very long time to put your lenses in, or if you can't get them in without bubbles, or if you have a lot of discomfort, redness, etc after the process, it is important that you tell your doctor so that they can help you improve your technique - bearing in mind that there is no single technique that works for everyone. "Practice more" is not always an acceptable answer. Without correct technique, you can get corneal abrasions or other injuries.
  • Removal troubles: If your lens does not come out readily, and/or if you have pain or excessive redness after removal, this could indicate your fit needs to be re-assessed. Make sure you schedule an afternoon appointment so they can see the fit after you have been wearing the lenses for several hours, unless instructed otherwise when making the appointment. If you ever have a serious concern about the appearance of your eye(s) after lens removal, take a picture with your phone and email it or bring it to your appointment.

What to EXPECT...

...and why, and what to do if you need more help than you're getting.

Written instructions

Scleral lenses are complicated, and learning to use them can be stressful. Written instructions are essential. These instructions should include:

  • all steps in cleaning, disinfection, rinsing and filling
  • a list of the supplies you will need and what each is for
  • instructions for lens insertion and removal

If you are not provided with written instructions, ask for them, and/or bring a pen and paper and insist on enough time to write everything down. Everything you are told will probably make perfect sense while you are there, but after you get home, well, many of us just blank out!

Training

Some people find scleral lens application and removal easy - but many people struggle with the learning curve or have special challenges. It's not just about practice at home. It's about supervised practice and training sessions to help troubleshoot technique issues and, where appropriate, find the right tools for you. Don't hesitate to advocate for yourself if you feel that you need more training.

Guidance on who to call and when

What issues warrant a phone call? Should you ask for the doctor, or contact lens technician? You can get lots of tips from your Facebook group, but only your doctor knows your whole picture and what constitutes a serious enough concern to call before a scheduled follow-up appointment. You should feel comfortable calling their office if you have concerns. If a follow-up appointment is needed, they'll tell you. Ask them to clarify whether you should continue wearing the lenses till that appointment or not.

Worries, doubts or concerns?

Maybe it's taking a lot longer to get a successful lens fit than you expected.

Maybe you're just not getting the hang of lens insertion, and are so frustrated you wonder whether it's worth continuing.

A little perspective:

Scleral lenses are emerging medicine. The diseases that scleral lenses are being used to treat are complicated. Not very many optometrists fitting scleral lenses are seasoned experts in every possible disease. No one has all the answers, and no one can get from 0 to 60 in no time flat. So you may need to cut your doctor some slack or talk yourself into some patience if things aren't moving along as efficiently as expected.

On the other hand, if you don't feel your questions or concerns are being addressed, you may need to firmly advocate for your needs. And if you seem to have reached a dead end, it may be time to seek expertise from an optometrist with more specialized skills and experience relevant to your specific needs.

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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.