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Where Do Scleral Lenses Fit Into Your Dry Eye Treatment Protocol?

Dry Eye Syndrome is a highly common eye condition. In fact, it remains one of the top reasons that drive patients to seek help from eye care specialists. Today, there is increasing awareness about this eye condition among both the general public and eye practitioners.

A recent survey revealed that out of the more than 30 million Americans who have symptoms of Dry Eye, only 16 million are diagnosed. Surprisingly, just 1 million out of these patients receive medical attention. These numbers are a concern, since there are millions of people suffering needlessly.

Woman Tired, Blue Eyes

Dry Eye Disease: Signs And Symptoms

Dry Eye Syndrome can affect a patient’s quality of life in negative ways. Common signs and symptoms include:

Common Signs And Symptoms
  • Blurred vision
  • Crusty eyelids
  • Dryness
  • Grittiness
  • Itchy eyes
  • Redness
  • Stinging
  • Tearing
Other Indications
  • Burning
  • Intense ocular pain
  • Photophobia (sensitivity to light)
  • Sensation of something in the eye

The patient may also experience distortion or visual fluctuation.

When Should Scleral Lenses Be Incorporated?

Fortunately, scleral lenses can help provide relief to patients suffering from Dry Eye. However, the common concern is deciding on the right time to incorporate scleral lenses into a dry eye treatment plan.

The Majority Of Scleral Lens

There have been a number of reports and tests whereby the rigid gas permeable contact lenses of scleral lens therapy have been used for ocular surface. The scleral lenses constantly bathe, shield, and repair the ocular surface through the post-lens tear reservoir. The majority of scleral lens practitioners utilize robust ocular surface disease scleral lens practices.

Scleral Lenses Should Not Be The Primary Therapy...

Still, scleral lenses should not be the primary therapy or treatment procedure for patients with mild to moderate dry eye syndrome, but without systemic comorbidities. Eye practitioners are often advised to try out other conventional treatment options first.  

Other Conventional Treatment Options

These can include:

  • Environment modifications
  • Eyelid hygiene
  • Nighttime goggles
  • Nighttime lubrication
  • Prescription dry eye medications
  • Preservative-free eyedrops
  • Punctal occlusion
Scleral Lenses Can Be Used In Treating Conditions

In the event that these treatment methods successfully yield effective results, scleral lenses may be introduced as a viable management option for these patients. In addition, scleral lenses can be used in treating conditions that are related to neuropathic ocular pain.

young woman wearing scleral lenses

Scleral Lenses in Seattle As A Tertiary Therapy

As stated by DEWS II, scleral lenses should only serve as tertiary therapy, after overnight treatment options and prescription medications such as moisture goggles or ointment have been recommended. However, scleral lenses should be incorporated before the long-term use of steroids, surgical punctal occlusion, and amniotic membrane grafts. This therapy should also be recommended before other surgical procedures, such as salivary gland transplantation or tarsorrhaphy.

Some of the other tertiary therapies that can be recommended alongside scleral lenses include:

  • Autologous/allogenic serum eye drops
  • Oral secretagogues
  • Soft bandage contact lenses

Like scleral lenses, these treatment procedures are highly effective. However, they should only be recommended if the primary and secondary therapies fail to improve the patient’s Dry Eye condition.

woman holding contact lens

Scleral Lenses Vs. Daily Contacts For Dry Eye

Often, an eye care specialists will recommend daily disposable contact lenses for patients with a Dry Eye condition. These daily contacts are single-use lenses. The patient disposes the contacts and replaces them with a fresh pair the next morning. These daily contacts come at a higher cost and create a large amount of waste, since they cannot be recycled.

However, scleral lenses are effective for Dry Eye disease. They can overcome the challenges experienced by other contact lenses. The fluid layer can help smooth out the defects caused by the condition, while providing a uniform refractive surface for the eyes. This can help improve Dry Eye.

beautiful woman wearing winter stylish contact lens

Scleral Lenses For Sjorgen’s And Severe Dry Eye

Severe Dry Eye usually occurs due to medical conditions like Sjögren’s syndrome or Meibomian gland dysfunction (MGD). Individuals with severe Dry Eye disease will have notable inflammation in their eyes. In some cases, patients may even experience scarring on their eye surface.

Scleral Lenses Offer An Alternative Treatment Method

For patients that are unsuccessful with traditional therapy options, scleral lenses offer an alternative treatment method. The scleral lens will move across the corneal surface of your eyes, then rest on the white part of the eye, referred to as the sclera. The liquid will fill the space between your eyes and the back of the scleral lens. This liquid bandage helps protect the cornea and continuously bathes the sensitive corneal tissue. With this, you can expect an instant relief from your Dry Eye condition.

Patients with severe Dry Eye disease are advised to visit their eye specialist regularly. This will ensure that they are closely monitored for ocular surface damage. Adequate treatment will be recommended fast to prevent further complications, pain, or any discomfort.

Dry Eye Treatment Plans To Help Patients Improve Vision

Today, there is increasing number of eye physicians who now incorporate Dry Eye management and treatment strategies into their practices.

Although there are lectures, seminars, and hands-on workshops on Dry Eye treatments and ocular surface disease, scleral lenses are seldom talked about as a viable therapy or treatment procedure. Optometrists and ophthalmologists are encouraged to research and consider the use of scleral lenses. With this, they will be able to fit scleral lenses into Dry Eye treatment plans to help these patients improve their vision.

Contact Our Seattle Eye Clinic Today!

For the latest information and tips on scleral lenses, subscribe to our newsletters today. You can also contact us if you notice any pain or discomfort with your eyes. Our certified Dry Eye specialist, Dr. Ross Cusic, of is available to answer any of your questions and concerns. An amazing experience awaits you at our office.

Serving Patients From:

Other Specialty Contact Lens Fittings In Seattle

Our practice specializes in custom contact lens fittings for a wide range of specialty contact lenses. This includes:

  • Gas permeable (GP) and rigid gas permeable (RGP) lenses
  • Multifocal contact lens fitting for presbyopia and myopia
  • Soft daily lenses for moderate dry eye, discomfort, and eye allergies
  • Scleral lenses for patients with keratoconus, corneal scarring, severe dry eyes, corneal transplants, and irregular astigmatism.

Our optometrist, Dr. Ross Cusic, has successfully helped many patients come from all over Washington including Seattle, Bellingham, Olympia, Vancouver

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