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Vision problems caused by an irregularly shaped cornea — whether naturally occurring, due to an eye condition such as keratoconus, or resulting from eye surgery — typically cannot be fully corrected with glasses or soft contact lenses. In these cases, rigid scleral lenses usually will provide sharper vision. Rigid lenses provide a smooth surface in which the light can focus accurately. In contrast, a soft lens conforms to the shape of the distorted cornea.
Scleral lenses are large diameter rigid gas permeable lenses that range from 14 mm to over 20 mm in diameter. They are termed “scleral” lenses because these contact lenses completely cover the cornea (the clear dome of tissue that covers the colored part of the eye) and extend onto the sclera (the white part of the eye that forms the outer wall of the eye). Smaller rigid lenses are notoriously uncomfortable but a scleral design achieves maximum comfort by vaulting over the corneal nerves.
Scleral lenses, as well as the fitting fee, may be covered under your insurance plan as medically necessary contacts. You will be responsible for whatever the insurance does not cover. Due to guidelines set by insurance companies, as well as the lens manufacturer, we are given a total of 6 months to complete the fitting process. Due to the precise nature of the fitting, several lenses may be ordered and multiple follow-up appointments may be needed to complete the process. You must return each lens before receiving a new one. It is important to keep all follow up appointments with the doctor in order to complete the fitting within the initial 6 months.
*Always wash your hands (mild hand soap preferred-avoid lotions or perfumes in order to prevent deposits which can cause dry spots and discomfort)
*For insertion of the scleral lens you may use a DMV scleral lens cup or try the “tripod” method using your fingers. Both techniques can be demonstrated during the training to find which works best for you.
*Proper lid control is key when inserting scleral lenses. You must have lashes out of the way to ensure lens has room to adhere properly to the front surface of your eye. You must remove the lens if air bubbles are seen after insertion.
* The DMV Ultra (smaller plunger) will be used for removal, then you will place the plunger on the outer edge of the lens (never in the center) gently push against the lens to adhere it and lift up and out.
*Clear Care is a hydrogen peroxide based solution and will be used each evening to store and disinfect your lenses. They must soak for at least 6 hours in order to neutralize the chemical reaction, after they have neutralized you will rinse the lens with the Addipak .9% NaCl sterile saline solution before then filling the lens with the saline for insertion.
**A starter kit is available for purchase with everything you will need to get started, it includes:
1. Clear Clare starter kit
2. Addipak .9% NaCl (10 ampules) full size boxes available through Amazon.com
3. DMV plungers (larger for insertion and smaller for removal)
4. An extra contact lens case
There is a great YouTube video you can watch to get an idea of what to expect during your initial fitting and training appointment, feel free to check it out.
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