Scleral Lens Hygiene and Care

Main Article Content

Daddi Fadel
Mindy Toabe

Keywords

Scleral lens, hygiene, aftercare, disinfection, storing process

Abstract

Scleral lenses (ScCLs) are developed using the same material as rigid gas permeable corneal lenses yet the care of scleral lenses differs from corneal lenses. These large diameter rigid gas permeable lenses necessitate hygiene, care and compliance protocol that is more complex compared with corneal lenses. Cleaning, disinfection, storing, rinsing and applying ScCL will be discussed. Practitioners will gain confidence in ScCL care which will provide patients with a better understanding of the steps involved in ScCL disinfection leading to increased patient compliance and increased success rates. In turn, patient education will lower the risk for infection and other complications associated with ScCL.

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References

1. Ruben CM, Benjamin WJ. Scleral contact lenses: pre-liminary report on oxygen permeable materials. Contact Lens J 1985;13:5–10.
2. Bleshoy H, Pullum KW. Corneal response to gas per-meable impression scleral lenses. J Br Contact Lens Assoc 1988;11:31–4.
3. Pullum KW, Hobley A. Parker JH. The Josef Dallos Award Lecture, part two. Hypoxic corneal changes following sealed gas permeable impression scleral lens wear. J Br Contact Lens Assoc 1990;13:83–7.
4. Pullum KW, Hobley AJ, Davison C. 100+ Dk: does thickness make much difference? J Br Contact Lens Assoc 1991;6:158–61.
5. Mountford J, Carkeet N, Carney L. Corneal thickness changes during scleral lens wear: effect of gas perme-ability. International Contact Lens Clinic 1994;21 (1-2):19-22. doi: 10.1016/0892-8967(94)90036-1
6. Kaye S, Tuft S, Neal T, Tole D, Leeming J, Figueiredo F, Armstrong M, McDonnell P, Tullo A, Parry C. Bacte-rial susceptibility to topical antimicrobials and clinical outcome in bacterial keratitis. Invest Ophthalmol Vis Sci 2010;51(1):362–68. doi: 10.1167/iovs.09-3933. Epub 2009 Aug 13.
7. Poggio EC, Glynn RJ, Schein OD, Seddon JM, Shannon MJ, Scardino VA, Kenyon KR. The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses. N Engl J Med 1989;321(12):779–83. doi: 10.1056/ NEJM198909213211202.
8. Ward MA. Can media sensationalism help reinforce compliance? Contact Lens Spectrum Apr 2016;31:21.
9. Schornack M. Scleral lenses in current ophthalmic practice evaluation : SCOPE study updates. Presentation
at the Global Specialty Lens Symposium. Las Vegas, 2017 January, 26-29.
10. Zimmerman AB, Marks A. Microbial keratitis secondary to unintended poor compliance with scleral gas-permeable contact lenses. Eye Contact Lens 2014;40:e1–e4. doi: 10.1097/ ICL.0b013e318273420f.
11. Severinsky B, Behrman S, Frucht-Pery J, Solomon A. Scleral contact lenses for visual rehabilitation after penetrating keratoplasty: long term outcomes, ContLens Anterior Eye 2014;37:196–202. doi: 10.1016/j. clae.2013.11.001.
12. Bruce, AS., Nguyen, LM. Acute red eye (non-ulcerative keratitis) associated with mini-scleral contact lens wear for keratoconus. Clin Exp Optom 2013;96(2):245–8. doi:10.1111/cxo.12033.
13. Sticca M, Carvalho C, Silva I, Souza L, Belfort R, Car-valho R, Freitas D. Acanthamoeba keratitis in patients wearing scleral contact lenses. Con Lens Ant Eye. Pub-lished online Dec 05, 2017. https://doi.org/10.1016/j. clae.2017.12.004.
14. Morgan PB, Efron N, Toshida H., Nichols JJ. An in-ternational analysis of contact lens compliance. Cont Lens Anterior Eye 2011;34(5):223–28. doi: 10.1016/j. clae.2011.08.001. Epub 2011 Aug 24.
15. Potter R. The Road to GP Comfort: GP lens comfort has never been easier to deliver, but you must make the right choices along the way. Contact Lens Spectrum Issue: October 2008.
16. Tangible Hydra-PEG Patient Handling Guide.
17. Ensley, R. Miller, H. Good chemistry: Are you up to
date on pairing GP lenses and solutions? Here’s a look at what makes a perfect match. Rev Cornea Contact Lens 2/15/2016.
18. Bausch & Lomb Boston Advance Comfort Formula Conditioning Solution package insert.
19. Bausch & Lomb Boston Simplus Multi-Action Solution package insert.
20. Barnett M, Johns L. Ophthalmology: current and future developments. contemporary scleral lens. Theory and application. Bentham eBooks; 2017.
21. Ward M. What’s new in lens care avoiding complications. Presentation at the Global Specialty Lens Symposium. Las Vegas, 2017 January, 26-29.
22. Dumbleton KA, Woods J, Woods CA, Fonn D. Compliance with current contact lens regimens. Optom Vis Sci 2007;84. E-abstract 070087.
23. Wilson LA, Sawant AD, Simmons RB, Ahern DG. Microbial contamination of contact lens storage cases and solutions. Am J Ophthalmol 1990;110(2):193–8.
24. Lupelli L. Il perossido d’idrogeno nella manutenzione delle lenti a contatto. Lac 2015;17:17–21.
25. Toabe M. Scleral lens troubleshooting FAQs. Available at: http://gpli.info/pdf/GPLISLSTSGuide11017.pdf.
26. U.S. Centers for Disease Control and Prevention. Acanthamoeba Keratitis among Rigid Gas Permeable Contact Lens Wearers – Talking Points April 20, 2016.
27. Legarreta JE, Nau AC, Dhaliwal, AC. Acanthamoeba keratitis associated with tap water use during contact lens cleaning: manufacturer guidelines need to change. Eye Contact Lens 2013 Mar;39(2):158–61.
28. Fadel D. Modern scleral lenses: Mini versus large. Cont Lens Anterior Eye 2017;40:200–207. doi: 10.1016/j. clae.2017.04.003
29. Barnett M, Fadel D. Scleral lenses: Benefits of toric landing zones. Contact Lens Spectrum 2017;32:No-vember; 36–41.
30. Fadel D, Barnett M. Scleral lenses: prepare for landing. Cont Lens Spect 2017;32:42–55.
31. Lupelli L. Il contenitore: il brutto anatroccolo della contattologia. LAC 2010;12:3–6.
32. Wu, Y, Willcox M, Stapleton F. The effect of contact lens hygiene behavior on lens case contamination. Optom Vis Sci 2015;92(2):167–74. doi: 10.1097/ OPX.0000000000000477.
33. Wiley L, Bridge DR, Wiley LA, Odom JV, Elliott T, Olson JC. Bacterial biofilm diversity in contact lens-related disease: emerging role of Achromobacter, Stenotrophomonas, and Delftia. Invest Ophthalmol Vis Sci 2012;53(7):3896–905. doi: 10.1167/iovs.11-8762.
34. Bates AK, Morris RJ, Stapleton F, Minassian DC, Dart JK. ‘Sterile’ corneal infiltrates in contact lens wearers. Eye 1989;3(Pt. 6):803–10. doi: 10.1038/eye.1989.124
35. Willcox MD. Solutions for care of silicone hydrogel lenses. Eye Contact Lens 2013;39(1):24–8. doi: 10.1097/ ICL.0b013e318275e0d9.
36. Amos CF, George MD. Clinical and laboratory testing of a silver impregnated lens case. Cont Lens Anterior Eye 2006;29(5):247–55. doi: 10.1016/ j.clae.2006.09.007. Epub 2006 Nov 2.
37. Vermeltfoort PBJ, Hooymans JMM, Busscher HJ et al. Bacterial transmission from lens storage cases to contact lenses- Effects of lens care solutions and silver impregnated cases. J Biomed Mater res B Appl Biomater 87 (1) (2008) 237-43. doi: 10.1002/jbm.b.31102.

38. Szczotka-Flynn LB, Imamura Y, Chandra J, Yu C, Mukherjee PK, Pearlman E, Ghannoum MA. Increased resistance of contact lens related bacterial biofilms to antimicrobial activity of soft contact lens care solutions. Cornea 28 (8) (2009) 918-26. doi: 10.1097/ICO.0b013e3181a81835.

39. Wu YT, Zhu H, Willcox M, Stapleton F. The effectiveness of various cleaning regimens and current guidelines in contact lens case biofilm removal. Invest Ophthalmol Vis Sci 52 (8) (2011) 5287-92. doi: 10.1167/iovs.10-6785.

40. Wu YT, Teng YJ, Nicholas M, Harmis N, Zhu H, Willcox MD, Stapleton F. Impact of lens case hygiene guidelines on contact lens case contamination. Optom Vis Sci 88 (10) (2011) 1180-7. doi: 10.1097/OPX.0b013e3182282f28.
41. Cho P, Boost M. Rivers and mountains may change, hu-man nature does not! (traditional Chinese saying). Cont Lens Anterior Eye 2009;32(4):155–6. doi: 10.1016/j. clae.2009.06.001. Epub 2009 Jun 27.
42. Wu Y, Carnt N, Willcox M, Stapleton F. Contact lens and lens storage case cleaning instructions: whose advice should we follow? Eye Contact Lens 2010;36(2):68–72. doi: 10.1097/ICL.0b013e3181cf8aff.
43. Wu YT, Zhu H, Willcox M, Stapleton F. Impact of air-drying lens cases in various locations and posi-tions. Optom Vis Sci 2010;87(7):465–8. doi: 10.1097/ OPX.0b013e3181e172a1.
44. Stapleton F, Keay L, Edwards K, Naduvilath T, Dart JK, Brian G, Holden BA. The incidence of contact lens-related microbial keratitis in Australia. Oph-thalmology 2008;115(10):1655–62. doi: 10.1016/j. ophtha.2008.04.002. Epub 2008 Jun 5.
45. Sweeney D, Holden B, Evans K et al. Best practice contact lens care; a review of the Asia Pacific Contact Lens Care Summit. Clin Exp Optom 2009;92(2):78–89. doi: 10.1111/j.1444-0938.2009.00353.x.
46. FDA. Ensuring safe use of contact lens solution. 2017. Available at: www.fda.gov/forconsumersupdates/ umc166549.htm.
47. Stapleton F, Edwards K, Keay L, Naduvilath T, Dart JK, Brian G, Holden B. Risk factors for moderate and severe microbial keratitis in daily wear contact lens users. Ophthalmology 2012;119(8):1516–21. doi: 10.1016/j. ophtha.2012.01.052. Epub 2012 Apr 21.
48. Seal DV, Dalton A, Doris D. Disinfection of contact lenses without tap water rinsing: is it effective? Eye (London).