Learning to insert and remove scleral lenses can be especially challenging if the learner has experienced significant vision loss and/or if they have never worn any type of contact lenses before. Here are 8 tips from Dr. Morrison to make learning to insert and remove scleral lenses as easy as possible.
EYES WIDE OPEN Make sure you are opening your eye wide enough so that you can see what all-around the iris, which is the colored part of your eye. If the eyelids are not open wide enough, the lens gets caught by the eyelashes or under the upper lid and scrapes the eye, which can cause irritation.
PRESS LASHES BACK Be sure to press your upper lashes up and your lower lashes down, as pictured to the right. Lashes can be a barrier when inserting lenses, and they can also knock the insertion fluid out of the lens, which can cause air bubbles - learn more about those below. If your lashes are not out of the way during removal, the lens could drag on the interior eyelid, which can cause irritation.
REMOVAL PLUNGER PLACEMENT When placing the plunger on the lens to remove it, it's important to orient the plunger appropriately. Aim for the lower 1/3 of the lens, as pictured above. Place the top of the plunger head on the colored part of your eye (iris) and the bottom on the white part (sclera) and gently remove. Follow this link to watch a video demonstration on how to remove a scleral lens.
4. BEFORE INSERTION, FILL IT UP! Be sure to use ample insertion fluid to avoid getting air bubbles - as full as you can fill it before it overflows, which can be 20-25 drops of fluid. The goal is to keep as much of the insertion fluid in the lens while inserting, so there is a solid barrier of fluid between the lens and the cornea with no air bubbles. Learn more about how to recognize and manage air bubbles here.
5. TRY AN ADAPTIVE INSERTION DEVICE If it is hard to see the lens while inserting due to vision loss, or if you need help keeping your eyes open wide enough, or if the plunger just doesn't seem to work, don't give up: try using an adaptive scleral insertion device to help you insert your lenses with more ease. See the devices Dr. Morrison recommends here.
6. SET YOURSELF UP FOR SUCCESS Lower any barrier to practicing insertion and removal by implementing these tips to arrange your space and schedule to accommodate your training each day:
Give yourself as much time as possible to get your lenses in and out while you are getting comfortable learning to insert and remove them. If you know you need an extra ten minutes or half hour to make sure you can get them in or take them out, build that time into your schedule, if at all possible.
We also recommend keeping insertion and removal supplies handy. If you know you will need tissues, a mirror, extra plungers, or extra filling solution - whatever it may be, keep your supplies as available as possible to avoid spending time searching each time you insert or remove your lenses.
For added convenience, have multiple sets of insertion/removal supplies, lens cases, backup glasses, etc. for work, school, home, etc. This way you'll always be able to remove or insert lenses wherever you are.
7. GIVE YOURSELF A BREAK If you find yourself getting frustrated by learning to insert and remove your lenses, take a break - literally. Take one or two minutes to take a walk, review your insertion/removal instructions, scroll social - anything that will give you a short break from touching your eye. Quickly review the instructions for insertion and removal or watch a few tutorials before trying again.
8. CONSISTENCY IS KEY It may not feel like you are getting better at inserting your lenses, but practicing every day will get you there. One of our patients was recently asked what they would tell a new scleral wearer who is learning to insert lenses and here is what they said: "Keep trying. It's frustrating for a little while, but one day, you just get it. There are days when you think you'll never pick it up but if you try each day, it WILL click." We could not agree more.
What worked best for you when learning to insert and remove your scleral lenses? Do you have questions? Drop us a line here.
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