Eye drops over sclerals (9/2023)

Survey conducted: September 2023

Participants: 307

Question 1: On a typical day, how often do you use over-the-counter eye drops over your sclerals?

Never: 18%
Sometimes, but not daily: 30%
Daily: 52%

Here's how the details break down:

Question 2: WHY do you use drops over your sclerals? Check all that apply.

Comfort rules, but vision is a big motivator too!

Most of the "Other" answers were about dryness.

Question 3: Which eye drops or solutions work best for you over your sclerals?

This was a bit tricky as I had to rely on people to type in some complete names to avoid ambiguity (providing a complete list of options would have been far too long of a list). But it was also very interesting to see the results!

Highlights

Top favorite: Refresh Plus
Second place: Preservative free saline (various brands mentioned)
Third place: Refresh Celluvisc.
Fourth place: Blink Contacts

After that, it was simply all over the place - from Bion Tears to Theratears and everything in between, including every possible version of Systane and Refresh.

Wetting drop or lubricant drop?

Only 15% use a product that is labeled as a contact lens wetting drop while 85% use either a lubricant eye drop (i.e. for dry eye) or a preservative free saline.

Specific lens wetting drops mentioned were Blink Contacts, Refresh Contacts, Blink & Clean and Boston rewetting drops. Scroll down for a complete list of the lubricant drops.

Thick or thin?

I was actually quite surprised at how many people are using thick drops on their sclerals, and even oil-containing drops.

Please, no prescription drops over sclerals!

Some people mentioned using prescription eye drops over sclerals - one even mentioned Cosopt (a glaucoma medication) This is very concerning. Prescription eye drops that need to get inside the eye (like Glaucoma medications) must have direct contact with the cornea. Using a prescription drop without removing your scleral lenses will reduce or completely prevent the drop from coming in contact with your corneas.

Lubricant drops - complete list of drops mentioned by participants

Bion Tears
Biotrue Hydration Boost
Boiron Optique 1 - CAUTION, FDA just sent a Warning Letter to this company!
Eyeganics
Genteal Tears
Hydrasense Advanced (Canada, not US)
Ivizia
Oasis Tears
Oasis Tears Plus
Refresh Celluvisc
Refresh Mega
Refresh Optive
Refresh Optive Advanced
Refresh Plus
Refresh Relieva
Refresh Tears (this is Refresh Plus with a preservative)
Retaine (I assume Retaine MGD?)
Soothe PF
Soothe XP PF
Systane Original
Systane Complete
Systane Hydration
Systane Ultra
Thera Tears
Salines: Addipak/Modudose/0.9% sodium chloride; Nutrifill, Scleralfil

Participant comments

Common themes from the comments:

Many drops are too thick to use over lenses.
Some people use PF salines.
Some people are unclear about whether it's okay to use prescription medicines while wearing sclerals (it's not).
Many people want some guidance on what is okay to use.

User comments + Rebecca's responses

most drops are too thick
I wish we could buy them in bulk. [70packs of Refresh Plus - or generic Refresh Plus - are the largest I know of.]
Best drop over sclerals is unpreserved saline. Others just dry up and leave more residue. Use the same stuff you used to insert the lens.
The reason why i wear scleral lenses is due to NOT being able to open eyes without scleral lenses.
I use eye drops when the lens is out not over the lens.
I don't put eye drops in while wearing my lenses. I do put 3 drops of Refresh PF inside each lens along w/my saline upon insertion. I usually shower midday and remove the lenses, soak in Tangible clean and remove any deposits that way, and then put the lenses back in. I wear them on average 16 hrs a day. Very occasionally if something is on a lens and I don't have time to remove it, I will rinse with saline with the lens on the eye.
Most often I use two drops in the lens with sterile saline, but will occasionally use these drops over the lens as well just for lubrication during the day as well. They are thick enough it can cause slightly reduced vision for a few minutes, but then it is fine.
using them for 10 months.
Refresh Contacts do not result in impaired vision.
My ophthalmologist insists on preservative free only [Good]
Getting a better fitting (thanks Dr G) and simplifying cleaning was key to minimizing drop use.
Addipak
I was told to use no other drop than this one. I don't like it because it blurs my vision for a long time. Sometimes I use Nutrifill. I'd love to know what else is safe. [This was with reference to Optase Dry Eye Intense. I find that much too thick myself for use over sclerals. In terms of what's safe, few drops are labeled for use over lenses but there certainly seems to be a general consensus amongs scleral lens providers that preservative-free lubricant eye drops in general are safe for this use. You might want to try Refresh Plus as it's one of the least likely to cause blurring. While salines will tend to quickly clear up vision, they do not have lubricating properties, and over-using them can backfire.]
need to use drops so lens doesn't stick to eyelid when eyelid is dry. No tear production
I have to use preservative free drops because any other option makes my eyes burn after 5 or so hours.
I use the drops to relieve dryness and irritation. It helps, but the relief doesn't last long enough.
I use a couple of drops of Celluvisc inside my lenses, but find it too thick to use over the lens. Bion Tears (single use vial) or Addipak are lighter and seem to work better for temporary relief.
I have 2 prescription drops I put in iver lens in right eye 1-2xs a day [Please review this with your lens provider? Prescription drops should only be applied when lenses are not in the eyes. The eye drop cannot reach the cornea when the lens is in the way.]
I am curios to see what works for others. I have tried different drops and not liked the way they felt over the sclerals.
Sometimes they help, sometimes I need to take my lenses out, rinse them with saline and put them back in.
I get a lot of sticky residue in my eye lashes when I have to use them more often. Is there anyway around cleaning lashes with contacts on? Somedays my contacts are comfortable and clear and I just hate that I have to take them off to clean. Also makes wearing make up very hard :( [Readers, any suggestions?]
I’d love to use them, but I don’t because I’m just not sure what to use.
Curious if anyone uses allergy eye drops over or under sclerals. [1) They should not be used over sclerals because they will not reach the cornea. 2) They should not be used under sclerals because they are preserved. Note - the only preservative-free OTC allergy drop on the market, Alaway PF, was recently discontinued. - Personally, I used to sometimes use Alaway PF a little while before putting in my lenses.]
The inner corner of my eyes get dry. The scleral lenses are comfortable all day.
I need them more if working at the computer or reading because I don't blink enough
I was told nothing gets to my cornea when I have a scleral lens covering it. [Quite right. The purposes of drops over the lens is for vision or for comfort on the interface between the lens and the lid.]
Does using eye drops help remove deposit build-up as you wear the sclera lease though out the day? I find my lense fogs up terribly bad as soon as 2-3 hrs after I put it in, w heavy deposit build up in the middle zone of the lense where my eyelid shuts and opens [They seem to for some people. This is a big topic - sometimes issues are under the lens, sometimes on top.]
If I need comfort, I use Blink Contacts. If my lense feels dirty, I use Blink & Clean
I sometimes use the same sterile saline I fill my lenses with as an eyedrop. Certain eyedrops do create a blur with sclerals for a couple of minutes, as they may without lenses in. I find it's worth "blinking it in" for the increased comfort and clarity.
Instead of drops I generally take my lenses out, rinse, refill and reinsert them.
Mine fog up frequently so hoping to find good recs thru this survery
I use Refresh for Contacts becasue it is one recommended by my doctor. Never tried a different one. Should I be concerned that it is not preservative free? [Very little if any is reaching your cornea, so if you're not using it all that frequently and aren't sensitive to the preservative, it may not be an issue. If you want the convenience of a bottle, and a drop that isn't terribly thick, you might try Ivizia.]
Which eye drops are approved for over sceleral lenses? [None are specifically approved for this purpose. In fact, no OTC drops are approved, period, they're just allowed to be marketed if they follow certain rules (honor system basis). But I digress :) The closest thing to what you're asking are the ones that say Contacts in the name - Blink Contacts, Refresh Contacts, etc. However, it has become very common for people to use preservative free lubricant drops of all kinds over their sclerals. Always best to ask your lens provider before trying anything new over the lenses!]
Looking for a good eye drop for dry eyes [That's generally a different kind of need than drops over sclerals - what works on the lens/lid interface might not be quite what we want for the cornea/lid interface.]
Difficult to squeeze applicator bottle, doesn't seem to help the dry feeling. [Is this in reference to the Systane Ultra PF that you mentioned - the new one in the preservative-free multi-dose bottle? If you reach out by email or phone I might be able to make a suggestion.]
Also use moisturizer chamber glasses because I have an extremely dry eye due to facial palsy [smart!]
I do realize that using such a viscous drop like Refresh Liquigel or ointment such as Refresh PM is normally ill-advised with sclerals, but for my right eye- it’s what I need to get through the day. I’m willing to sacrifice some clarity and put up with some cloudiness/smearing in order to achieve enough comfort to be able to wear the lens.
Na
I'm unclear if everything I use is actually compatible with PROSE lenses [Check with lens provider - drops often aren't labeled specifically for use with gas permeable lens materials regardless of whether they are compatible]
Would like to find an alternative, still preservative-free - to Refresh Plus - that is more environmentally friendly! I do realize this is a challenge. [Yes the former Retaine HPMC was the closest equivalent in a bottle, bummer that it was discontinued. Have you tried Ivizia? Also, there's the Biotrue Hydration recycling program for vials.]
If I feel like I need drops, like to wash out an eyelash, I just use schleralfil drops.
The thicker viscosity drops leave my eyes the more comfortable ( Optase MGD or Celluvisc) but takes time for blurriness to dissipate which can be an inconvenience.
I really don't know which drop is safe to use over sclerals. [Comments above + discuss with provider]
I have found some eye drops leave a film or cause my sclerals to be cloudy. [Yes I think personally that CMC 0.5% tends to be most lens friendly. I was surprised to see such a range of drops people are using on their lenses.]
theres no one size fits all solution. I carry multiple with me.
Which drops do others recommend for dryness while wearing my sclerals? I do not get cloudiness or fogging, but I do feel dry at times during the day and would love to put in a drop that won't make my contacts blurry.
Please let us know what works. When I tried eye drops it just causes more blurry then clearing.
N/a
Every few hours my vision gets a little blury or cloudy. A couple eye drops clears it up.
At my Dr’s recommendation, I also put a couple of drops of Oasis Tears in each scleral lens with the pf saline, which helps get less discharge on my lenses throughout the day.
With the Celluvisc mixed with my Sclerafil, I have never needed eye drops over my sclerals
Ths is not the best solution, still searching
I use my plunger like a windshield wiper to remove deposits and fog. With a drop of saline on the plunger, I delicately loosen the suction of the lens to allow fresh moisture u see the scleral. [Interesting. I would be too worried about bubbles to try that myself. I sometimes use a Q-tip with saline as a squeegee.]
I also use bio true preservative free
Most often I remove them, rinse with saline, and refill with fresh saline.
I have found especially in dry winter months when humidity gets below 50 percent I use Systane Ultra 5 to six times a day sometimes more. Summer months and higher humidity an temperature only use 2 or 3 times a day.
How often should I use eye drops with sclera lenses? [Not required unless your doctor says so - this is usually driven by symptoms i.e. getting less comfortable or vision fogging up.]
Systane Hydration and Systane Complete PF are both opaque. They encourage tears in my eyes but due to dryness the tears are thick and problematic. These I use only when scleral lenses are out.
I wish someone could create a chart so that when there is a back order on an item a substitution is obvious. [Oooh what a great idea. I mean, we do this with things that are on longstnading or chronic backorders, but we've never done it as a general "if you can't get this, try that" type reference. I'll see what I can do!]
See previous answer :⁠-⁠)
Some days the sclerals are enough, you don't need more eye drops. Tear production in my eyes has improved a lot since wearing them.
I use Systane Ultra most often but Oasis Tears PF and Optase Dry Eye Intense Drops have worked just as well.
Could I apply lumify redness relief drops over my scleral lenses?...especially since they have the tangible clean specific coating [I don't think it would get the job done with the sclerals in the way; also the manufacturer's instructions require removal of lenses before application. I don't know about the compatibility question and I doubt that the Tangible company would comment about this because of the Lumify instructions.]
Sometimes it helps and sometimes I end taking lenses out and refilling and reinserting
It’s frustrating that some people with dry eyes don’t need drops over their lenses and others like me do. I have hydrapeg coating, so I’m not sure why I need to continually add drops although it’s been better lately using the Ivizia. [For some of us, it's all about the dryness in the lens/lid interface... sadly even coating just isn't enough for us all... Sometimes it also comes down to improving the ocular surface in terms of any other diagnoses - allergy? lid margin disease? need more aggressive treatments for dryness? etc]
What can help with deposit/blurriness on lenses. [Have you discussed with provider - depends on causes. Improved cleaning regimen? remove-rinse-refill? drops? more treatments?]
N/A
Sometimes use Refresh Celluvisc Lubricant Eye Gel - but always blurry for awhile afterward
Bad spell check. That was Lumify, not Lumpy
if you put a couple drops of the sooth xp in the lens with your solution, it seems to help a little
What is recommended when scleral lens are inserted? [As you can see here, people use all sorts of things... there is no general recommendation, but hopefully the survey results will give you some ideas to discuss with your provider]
I didn’t know you could use drops over sclerals. What is the purpose? If they help with fogging, I’d like to start using them. Which drop is best to use with sclerals? [I'm running out of steam, will try to come back and write more.]
what is teh best eye drops for my lens
I have never tried it as I thought the drops would not be effective with a large lens.
The inner corners of my eyes get dry. The sclerals are still comfortable.
I have terrible allergies and would use Pataday allergy 2-4 times daily before I wore sclerals contacts. Since I’ve been wearing the contacts my eyes are not as itchy. I can’t tell you the last time I put in eye drops. I was also told by the nurses at my eye doctor that I should not put Pataday in while I have my contacts in. If my eyes are itchy or dry I will put in my Purilens solution.
best drop for scleral with slippery coating?
Sometimes drops work, but usually I just have to take them out and clean them again. I usually have to do this 3-4 times a day, sometimes more. I don't make enough tears to keep the outside clean, and there is epithelial sloughing.
I use Muro128 on a q-tip to clean off deposits and then Addipak to provide a rinse. Works like a charm for us how have deposit issues. Way better than hydrapeg which I tried prior.
Again, for comfort relief keep the drops in the fridge
Other drops have irritated my eyes, the saline I use for my contacts help with comfort but not so much for cleaning the deposits
I like the Refresh Plus more than any other drops I have used. I like them because they have fewer additives.

Last suggestions from Rebecca

if you're using a ton of drops over your sclerals, please consider trying moisture chamber glasses (if you haven't already).
some folks struggling with their lenses may need more detailed ocular surface diseases & more aggressive treatment plan
Dry Eye Foundation hosts a monthly scleral lens support group - check the calendar

Eye drops over sclerals (9/2023)Updated 7 months ago