Most contact lens wearers who develop Sjogren’s Syndrome find that they need to bid farewell to their contacts due to eye dryness. Many of these patients don’t realize that there is a contact option that not only allows them to correct their vision, but also provide some dry eye relief.
Scleral lenses are hard contact lenses that are customized to fit individual patient’s eyes. Rather than resting directly on the cornea, like most contacts, scleral lenses have a gap between the cornea and the lens which is filled with a saline solution. Primarily prescribed for patients with for irregularly shaped, thinning, or damaged corneas, many doctors don’t realize the value that scleral lenses can provide to patients with dry eye conditions. Because the contact forms a seal that continually lubricates the cornea with a saline solution, scleral lenses can provide relief from dry eye while correcting vision problems.
There are some potential difficulties to scleral lens use for Sjogren’s Syndrome patients. The first and most troublesome is cost. Because scleral lenses must fit each patient’s eye, they have to be sized by an optometrist familiar with scleral lenses and build based on precise measurements. After the lenses are ordered and shipped, additional measurements are taken while the patient wears them, and new lenses may need to be ordered to provide a better fit. It is not uncommon for scleral lens patients to require several orders to find the best fit. As a result, a pair of scleral lenses can cost over a thousand dollars, and generally must be ordered each year. For those with vision insurance covering ‘medically necessary’ lenses, they may be covered, though not all providers consider sicca diseases to qualify. VSP seems to be the best provider for covering scleral lenses for dry eye patients, but any patient interested in scleral lenses should absolutely consult their insurance company about coverage before ordering.
Other concerns are more procedural. First, scleral lenses are more difficult to insert and remove. The lens must be filled with saline solution and placed in the eye to form a tight seal, which can be challenging for patients used to traditional soft contact lenses. Removing the lens requires the use of a small plunger to break the seal, which also is awkward for new patients. For more information, you can view a demonstration video.
Wearing contacts can also limit the type of over-the-counter eye drops a patient can use, though hopefully they will not need to rely as much on OTC drops while wearing scleral lenses. In addition, the pure, sterile saline needed is generally not sold in pharmacies, though it can be purchased online. Finally, it can be more difficult to travel, as TSA security requires the use of saline containers under 3 ounces, and patients will need to also bring cleaning solution and tools to insert and remove the lenses.
Those conditions aside, scleral lenses are a great option for Sjogren’s Syndrome patients with less than perfect vision. If you are interested, ask your optometrist or ophthalmologist about the possibility of getting scleral lenses.