Scleral Lenses: The Greatest Secret to Dry Eye Management
With our 5th year anniversary on the horizon, I feel like I should be celebrating my first blog on our brand new website with champagne or something that goes "pop" after opening it... however, like everything in life, this new journey of ours will be a marathon, not a sprint. So maybe after our 10th year anniversary, I might take the time to smell the roses. In the meantime, I thought it's most fitting to be starting off our talks on optometry and eye health by discussing a long-term condition.
People who know me know it's rare I get excited about anything, but I am actually super pumped to introduce our latest weapon for fighting dry eye disease. That's right.. I said DISEASE. I don't say this for effect (ok maybe a little)... but I say it to remind all of my patients that dry eye is a chronic, annoying condition that not only reduces vision but negatively affects quality of life. I have seen dry eye (which is the worse simplistic name ever given to such a complex disease) affect so many of my patient's vision on a daily basis that it is a constant daily struggle to maintain a stable tear layer.
"But my doctor just told me to take some eye drops" is the common solution I hear every time. That is fair... artificial tears provide a fast, temporary relief (for some) to their dry eye symptoms. However artificial tears are merely a bandage to the underlying problem... which is tear layer instability. Just like the girl on the commercial says "if your having to insert eye drops several times a day and your eyes still feel dry.." then it's time for a different strategy to manage your eye condition. Now don't get me wrong... there are many different treatment avenues to treat dry eye, other than artificial tears. Today I am going to spend a little time talking about a new method on how we can better stabilize tears on eyeballs such that eye drops will hopefully be the last thing on your mind after a long day in front of the electronics.
Most people (including a lot of my patient's) would say contact lenses make their eyes more dry. Most of them are right. The mainstream of contact lenses we use today make patient's symptoms worse. A soft contact lens on a patient's eye will act as a barrier between your eyeball and the tears that are trying to lubricate it. However if we placed a rigid contact lens on the eyeball enclosing a tear layer on the surface of your eye, then theoretically your eyes would stay lubricated as you wear the lens throughout the day. A scleral contact lens is a type of rigid, oxygen permeable lens that vaults over the clear part of your eye, thus maintaining a cushion of tears on the eye surface. How effective is it? According to a 2010 BostonSight study that surveyed 80 Sjogren Syndrome (an autoimmune disease that causes dry eye) patient's, 85% of them achieved successful relief of their dry eye symptoms with scleral lenses.(1) The next best mode of therapy helped 11% of patient's in the study. FYI... over the counter eye drops, gels and ointments gave relief to only 5% of those surveyed. What's even better is this liquid layer on the lens surface should provide clear vision with relief of dry eye symptoms that lasts the entire work day. What? Contact lenses that are adequate to use in front of the computer screen? Never thought I would see the day (pun).
Scleral lenses are compatible with most distance prescriptions and even those with a certain type of astigmatism that couldn't be corrected well with soft contact lenses. They fit underneath the eyelids and rest on the white part of your eyeball which means you won't feel them as much as a regular hard contact lens. However like any contact lens, your eye care professional will need to find the proper fitting lens to ensure you enjoy the benefits of wearing these amazing lenses. So the next time you see your eye doctor, unlike the girl in the commercial, it's not just time to talk "eye love", maybe it's time to talk scleral lenses.
To a healthy visual field
Dr. Michael Yee, OD
1. 2010 BostonSight survey. http://www.bostonsight.org/PROSE/PROSE-Treatment/Conditions-PROSE-Treats/Sjogrens-Syndrome