Wearing scleral contact lenses should not cause any pain or discomfort if the lenses are properly positioned, fit correctly, and are worn appropriately. If there is discomfort when wearing these lenses, it can result in decreased vision or contact lens intolerance. Identifying the cause of the discomfort with the scleral contact lens can allow the eye doctor to improve the comfort and provide clear, comfortable vision.
Differences Between Scleral Contacts and Soft Contacts
There are a few key differences between scleral contacts and traditional soft contacts. The scleral contacts are larger, hard contacts which are designed to vault over the cornea and allow tears to flow beneath the lens.
Soft contacts are a much more flexible, flimsy material which conform to the front of the eye. This restricts the amount of tears that can flow between the contact and the cornea.
A scleral contact is designed to be worn for much longer than soft contacts – often scleral contacts are replaced only once a year. This increases the importance of proper cleaning and hygiene.
Scleral contacts need to be cleaned thoroughly with lens cleaner and rinsed with solution or saline. Then to insert the contact lens, the lens is filled with saline to help create the needed suction on the eye.
Soft contacts need to be cleaned as well but can be cleaned with a multi-purpose solution and then stored overnight. These are usually replaced every month or every two weeks.
What Does Dr. Woo Think About Scleral Lens Discomfort?
"If you wear scleral lenses, you may have had a few lenses in the past that caused you discomfort. This is very common, due to the fact that the shape of the lens has a lot of different parameters that can be adjusted by your eye doctor.
In this particular patient, she was having discomfort with her right eye around 7:00. When I took a look at the lens, you can see there is a small amount of conjunctival chalasis right at 7:00. Also, you can see the hashmarks, which represent the flat meridian of the scleral lens edge. What I suspect is happening is the edge in that area is too flat, which is causing her to have some discomfort.
The more information you can tell your doctor about your situation, the better. If you can pinpoint WHERE the discomfort is, that is super helpful for us."
Types of Discomfort with Scleral Contacts
Scleral contacts can cause a few different types of discomfort. If there is a localized, chronic pain that is always at a single location, it may be from the fit of the contact lens.
Alternatively, if the discomfort is more generalized and across the entire eye, it may be the solution or build up of material on the contact lens.
Pain on insertion or removal can also occur and usually are linked to a poor fitting contact lens.
If there is an intense pain, it is possible that the scleral contact lens has caused a corneal abrasion. This is rare and it is usually due to improper wear or bad technique when inserting or removing the lens.
Localized Discomfort with Scleral Contacts
When wearing a scleral contact, the lens is designed to always sit the same way on the eye.
Since the contact is not designed to freely rotate, each area of the lens will always have the same position.
Identifying which “clock hour” of the lens is causing a particular problem can allow the eye doctor to make specific changes to the fit of the lens and improve the comfort.
Generalized Pain with Scleral Contacts
If the discomfort from the scleral contacts is not confined to a certain area, it is usually a result of something that is on the lens or in the solution.
Infrequently, an allergic reaction to a component of the solution or cleaner can cause a painful reaction across the eye.
Similarly, if the lens has a build up of bacteria or debris, it can cause irritation across the entire eye.
Corneal Abrasion from Scleral Contacts
It is extremely rare that sclera contacts will cause a corneal abrasion if the contacts are worn the correct amount of time and put in and taken out properly.
If the lenses are overworn or improperly removed, it can result in a scratch on the front of the eye that is extremely painful.
The abrasion will usually heal in a few days and the pain will subside at that point.