Contact Lens Practice Pearls

Making Scleral Lenses Easy for You and Your Patients

By Jessica H. Mathew, OD, PhD, FAAO

Scleral GP contact lenses have recently improved in design and materials, which has allowed for an increase in popularity of this lens type for patients who have corneal irregularities. Unfortunately, this lens type is often used as a last resort when, in fact, it should be considered as the initial contact lens option in many cases.

The truth is, scleral GP lenses can be easier to fit than corneal GP lenses. So why aren’t more practitioners using this lens option? I think it comes down to the amount of time that must be spent with patients and the amount of instruction that comes along with the modality. Realizing ahead of time the steps and supplies necessary and having a scleral lens plan established in your office can make this transition easier for you and your patients.

Have Your Supplies in Order

Scleral contact lenses require several additional steps for patients that may initially appear burdensome, so it is especially important to make it as simple and convenient as possible (Table 1). Because there are no scleral lens “starter kit” supplies available, knowing ahead of time which care solutions you will be prescribing and having them on hand is imperative. Providing your own starter kit for patients to take with them will help build confidence in your patients’ scleral contact lens experience.

Many of these care solutions are hard to find and may not be available in local stores. The last thing you want is for patients to leave your office empty handed only to go to the store (or several stores) and realize that they can’t find what they need…and panic sets in! If you have provided all of the care solutions and supplies for them initially, this will not be a worry for you or your patients.

Put Instructions in Writing

Another way to avoid these types of experiences is to provide patients with written instructions. Include pictures of all the lens care solutions and supplies that you recommend so patients know exactly what they should get. You may also want to include websites where each of these items can be found, in case they are not available at local stores.

You should follow this up with written instructions on how to use each of the care solutions. Because it is a lot of information to take in at one visit—learning to apply/remove, clean, and store the lenses—it is a guarantee that your patients will get home with their three bottles of solution (Table 2) and forget which one they are supposed to use for what. The whole process is stressful, so be sensitive to this and do your best to make it as easy as possible.

Make It a Team Effort

Although scleral lenses may take additional chair time, most wearers are pleased with the vision and comfort and will be some of your most loyal and profitable patients. Train your staff and technicians so that they can also spend extra time with these patients, helping you free up more chair time. CLS

Dr. Mathew is a research assistant professor at the University of Houston College of Optometry. She manages patients who have severe corneal distortions who require specialty contact lenses, and she is also involved in basic science and clinical trial research. She has received research funding from Allergan, CooperVision, Clearlab, Essilor, Shire, Tearlab, Menicon, and Vistakon. You can reach her at jmathew@optometry.uh.edu.