Scleral Lens User Guide: 4 - Rinsing & Filling
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
Items you may need
- Buffered preservative-free saline in bottles (Purilens Plus)
- Buffered preservative-free saline vials (ScleralFil)
- Unbuffered preservative-free saline vials (LacriPure)
- Unbuffered preservative-free saline vials packaged for respiratory therapy (Modudose, Addipak)
- Celluvisc, Oasis Tears or another preservative-free lubricant drop
- Multi-purpose solution such as Unique pH or Boston Simplus
Rinsing your lenses
Many of us use preservative-free saline for multiple steps in our daily process:
- rinsing off our lenses after cleaning them before putting them in the case for overnight disinfection
- rinsing them off in the morning before filling and insertion
- rinsing and refilling them during the day
Not everyone has the same needs, however.
Others, especially those using the smaller sclerals, use a multi-purpose solution such as Unique pH or Boston Simplus for rinsing, and a result find that their need for preservative-free saline is limited to filling their lenses during the application process.
Some people use a lower cost preserved saline such as B&L Sensitive Eyes for rinsing their lenses (not for filling!) to help manage costs.
Selecting a preservative-free saline
There are several factors that play into the decision of which preservative-free saline(s) to use.
- Doctor's recommendation: Does your doctor have a specific brand recommendation for you, or are they okay with you using anything as long as it's preservative-free?
- Buffered or not: Buffered means pH balanced for the eye, but it also means the presence of additives. For some, pH is critical to their success in lenses. Others don't experience a difference. More rarely, someone may have a sensitivity to specific buffers.
- Size: How much saline do you use in a day (see below)? What size packaging is going to be the best match for your needs? Currently available packaging ranges from 5mL vials to 4oz bottles.
- Cost: What will be most economical, especially after figuring in shipping costs, since most people have to get their saline online? (Note: Here in the DryEyeShop, we offer Subscribe & Save discounts on all salines as well as an annual free shipping membership plan. We also take phone orders, not just online.)
- Availability: There have been recurring shortages of most brands of preservative-free salines over the last several years.
- Local vs online: Is there anything I can get locally? (For the most part, the answer is no, except that it is possible to get 3-packs of Purilens at some Bed, Bath and Beyond stores, and some pharmacies may sell Addipak on prescription.)
Please check out our preservative-free saline guide and review the choices with your doctor.
Filling your lenses
It is almost universally accepted that whatever you fill your lens with, it must be preservative-free. Not all doctors and not all patients follow this 100%, but there is a sound reason for the rule: Whatever you put in your lens is held against your cornea all day long, and preservatives are toxic to the cornea, meaning the more exposure, the greater the possibility of harm from chronic use. Since scleral lenses are used mostly by people with corneal diseases, we have every reason to avoid any preventable risks.
A common mistake
A common mistake amongst new users who didn't receive written instructions or did not pay attention to the instructions they were given is this:
- You start with the preservative free saline you were given.
- It runs out.
- You go to the drugstore. You can't find the same thing.
- You ask the pharmacist for something similar.
- They point you to a "sensitive eyes" type saline.
"Sensitive eyes" type salines contain preservatives! "Sensitive eyes" usually just means it does not contain thimerosal. Don't fall into this trap!
The fact is, preservative free salines are not sold in drugstores anymore - hence this common point of confusion. The catch-22 is that because they are not sold in drugstores, pharmacists are not familiar with them.
Mixing cocktails in your lens
Many scleral lens users add a preservative free artificial tear - Celluvisc is a particular favorite - the bowl of their lens. This seems to often be helpful for preventing fogging and in some cases preventing mucous collecting under the lens as well.
How much? People may use a drop, or a few drops, added to the saline, or they may fill the entire lens with it - which is quite expensive, but worth it if it makes a lens wearable that was not otherwise.
In some cases, doctors may direct a patient to use a prescription product in their lens.
Whatever "cocktail" is being mixed in your lens, please make sure it's preservative-free and that your doctor knows what you're using!
Issues and trial and error
We discuss this more in the troubleshooting section, but lens comfort as well as fogging are often directly tied to what you're filling your lenses with, so make sure to revisit this with your doctor regularly if you're having issues.
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.