Survey: Scleral lens insertion technique

Survey period: January 18-24, 2023

Participants: 337

Comments: 83

What do you normally use to put in your scleral lenses?

2018 vs 2023

In 2018, the split was about 70-30 between those who use a standard plunger insertion technique and those who use other tools/methods.

In 2023, the split has shifted to 60-40! Clearly, more and more people are learning about assistive devices and using them.

Comments from participants

Rebecca's responses in pink

• It is very cumbersome and most days not worth the effort.
• I use a plunger that I cut and mounted on top of a tealight candle. Works great for me.
• The See Green system has been extremely helpful for me. I don't believe I could hardly have managed without it!
• Sclerafill
• I use a device called the Chio by Cliara off Amazon for around $19. If I’m still having trouble I’ll go back to the plunger. I’m severely nearsighted so the Chio works well for me.
• This isn't a foolproof method, but it's the only way I can get the lenses inserted.
• The See Green light and stand are essential. Otherwise I would not be steady enough to insert them
• I am 70 years young sclera patient. I was diagnosed with keratosis at 16. For the last 7 years have very successfully used sclera lenses using the green dot inserter.
• I fill them with puri lens and insert them it’s actually much easier than you would think
• Plunger generally works well for me.
• I prefer the single two end plunger for insertion and removal vs keeping one fir insertion and different one for removal [FYI to readers - this is a reference to the DMV Versa]
• I have problem keeping my right eye open enough to insert lense [If you haven't tried a stand you might want to consider it - this keeps both hands free to hold the upper and lower lids firmly open]
• Remember to keep your face & the lens completely horizontal & bring the lens straight up when inserting.
• You'd think that after a year I would be able to insert it comfortably the first time, but it varies from day to day. Probably half the time I get it in comfortably and clearly the 1st time and other days it may take 3 or 4 attempts.
• while not new to contact use (wore RGP for 50 yrs) I was new to Scleral lenses (due to recent keratoconus diagnosis); the use of the lighted stand was a game changer
• When to close your eyelid? Pull plunger away first or close as you remove plunger. Which method keeps more saline in the lens ? [I don't close my lid till the lens is on and the plunger's away]
• I use the stand to fill the lens, but I lift off the lighted plunger for insertion. [Interesting!]
• Have found using a colored plunger for insertion helps give a better sense of depth & distance than a white. [I don't use white ones because I would never find them if they dropped :) I like bright orange]
• The light and plunger works best for me. I tried, with some success, to use only my fingers, like I did for years with hard contacts. My right eye worked with this method, but I just couldn’t get it in with my left. I would like to practice the fingers only which would eliminate the need to carry around extra equipment when I go out. I just have to prep for the frustration of multiple tries, shaky fingers, spilling, etc.
• I’ve been using the light to insert my lenses for years and really can insert now without the light but it just helps me ensure it’s as centered as possible
• Dont look at it coming
• Tipping the lens up in the back on the O ring made things so much easier for me!
• I tried everything to insert my contacts. Using the plunger never worked for me! I would get air bubbles and waste lots of sterile saline and time! I would take up to an hour to get them in. It was frustrating and I lost hope and rarely actually wore my scleral lenses. The stand helped me a little I cut the time down to about 15 minutes. I always thought i was going to poke my eye during insertion so I haven’t ever really felt that comfortable using the stand. Then I tried the application ring and it was a game changer! I was finally able to insert the contacts on the first try, 15 seconds!! I cried the first week every time I put them in! Not only could I do it quickly I could finally see again! My scleral lenses have definitely changed my life and the application ring has definitely changed my routine of insertion. My journey to fully wearing my scleral lenses daily took about 9 or 10 months and trying different products. If you are new to scleral, try the application ring first! [Thank you SO much for sharing this. I think that it's very important for all new users to understand that different tools work for different people, so it's important to have the opportunity to try various things.]
• The DMV Scleral Stand has been a game-changer for me. Insertion is no longer a time-consuming, hit-or-miss ordeal. The stand makes insertion quick and easy. Thank you for working with DMV to develop this low-cost insertion tool.
• I purchased a stand from the Dry Eye Shop but have yet to use it. Some days my hands can be a little unsteady after doing things like heavy yard work outside. So if needed will try the stand for this reason. Would probably try one sooner but at 6'4" its a long way down to the counter even with the stand setting on something. [Two thoughts (1) have you tried doing it sitting down? and (2) if you prefer standing, wonder if you might be a good candidate for the S5, which has a telescoping base. Look for it on Amazon. Make sure to put a towel around the base to catch the lens in case it drops.]
• A stand with DMV plunger has worked much better for me than using the DMV plunger alone or using a ring. I use a mirror which lies flat on the desk and has a lighted border. Recently I have been placing the stand so it is directly over the lit part of the mirror which helps. I highly recommend the stand-plus-DMV-plunger for those new to sclerals as an inexpensive way to increase insertion success.
• The lighted stand is the only thing I use to insert lens. I stopped trying other ways. It’s been a year now!
• I need a lighted stand I broke mine and can't find another one [Here's a link to the See Green kit]
• I've never thought twice about inserting my scleral lenses - I was taught to use three fingers to make a 'tripod', and it's always worked fine. However, I've often wanted a more reliable way to remove the lenses: I've tried both the solid and hollow DMV suction-cups (the solid, 45° ones work best for me), but they're a bit 'fussy' about adhering 'off-axis', and they do wear out. I'm open to suggestions... [DMV Ultra, attaching to the edge of the lens, is the most "tried and true" removal method.]
• How to prevent fogging [Here's a link to the tutorial section about that]
• I notice that some people prefer to put the sclerals in while standing up at a counter. I prefer sitting down at a table; I have more stability.
• The learning curve for insertion is daunting no matter what. Having a stand so that I can use both hands to hold my eye open was a game changer, and it's a low stress operation now. The downside is that I never mastered any other way to insert my lenses and I worry about getting in a situation someday where I don't have the stand. [If you haven't tried the DMV Scleral Stand you might want to as it's compact and very easy to tote around. I think a lot of people are getting it specifically for travel. Otherwise, the easy DIY is poking a hole in a Dixie or styrofoam cup for the plunger.]
• For me, the ring is absolutely the easiest insertion method.
• No mirror and only keep one eye open at a time.
• Cut the bottom off the plunger so you can see through it. Insert while standing over lighted mirror. [You can buy them ready-made, by the way: DMV Vented Scleral Cup]
• My lenses fog so terribly that I have learned to insert them with just my finger. I was hoping the plunger was causing the fogging, but that was not the case. However, I was impressed that I could get it in with just my finger! [Re fogging, check tutorial for any tips that might be new to you]
• I use the See Green light with a plunger which helps me position the lens much better than just moving down to a stand. If I squeeze the plunger when I set the lens on top it holds it from moving and then I release it after filling with Nutrifill. No pain. No awkward scraping of the lid.
• how long do scleral lens last? [It varies! Some of us have had lenses we were able to keep for years. Best to find out what the lens manufacturer advises.]
• The hole in bottom of plunger helps me center the lens; I see the light.
• I insert both a rigid and sillsoft lens the same way. I am very open to a new method! [Here's a link to our tutorial section on scleral lens insertion]
• A steady hand helps. Have also found that if when inserting need to be able to look straight into the hole in the plunger.
• i spent up to an hour trying to get my lenses in before i learned of the green stand & light. i see they’ve gone up in price but shop around! i will never be WITHOUT the stand & light!!! easy in & out!!
• Proper way to insert lens [I gather this is a question, right? Well there are actually many techniques and different ones work for different people. Here's a link to our tutorial. I would just want to add that it's important to have this process supervised when you're new to it, for safety's sake.]
• I cut the bottom off of the applicator which allows me to see through better aligning the lense and no vacuum seal aids insertion since my hands shake slightly [Again just want to mention  you can purchase it ready-made: Vented scleral cup]
• The best advise I found online was to cut the bottom of the plunger. That way you align your eye until you see light on the other end of the plunger. Ever since I did this, it literally takes me seconds to put my lenses in every time. [Ditto]
• It seems to me to be important to press lightly when inserting my scleral lenses. Is this true for everyone? [Yes light pressure to get it firmly in place is useful]
• I can insert the left lens by hand using only the plunger type device to hold the lens. It goes in instantly without problem.I use a stand with plunger for the right lens but it's still difficult. I often knock the lens askew in the effort to insert it or it drop out and often hurts when it comes out. [Lenses should never hurt during/after removal. That would indicate either a problem with removal technique, or even potential issue with how they fit at the end of the day. I would encourage you to make an end-of-day appointment with your provider so they can see what it's like at that time of day and watch your removal technique.]
• I do cut the end top of the plungers to help me center my eyes better
• It’s easy for me to insert the lens in my right eye but I have an impossible time with me left eye. Doesn’t make sense to me bc I’m right handed but using my left hand to hold the plunger to insert the right lens easily and then having so much trouble using my right hand to hold the plunger to insert the left lens. [Have you tried the opposite? If neither works you may want to consider trying a stand.]
• How often should you clean and discard plungers? [Manufacturer says "Wash frequently in warm soapy water and allow to air dry." I would say, ask your lens provider as they may have another opinion. Many people keep them till they wear out, others replace them on a schedule.]
• Love my rings!
• I began using little stand and plunger over 3 months ago. So much easier and faster than the lighted stand. I’ve used it on travel , camping , and at home. For scleral lens users it about equivalent to the invention of sliced bread.
• I like my old plunger (from 8 yrs ago) that you can squeeze and suck the lens to it before insertion, keeps it from moving or falling off. The newer plungers don’t do that. It makes it easier to insert, just insert and squeeze to release lens. [DMV Scleral Cup is the same now as it was ~16 years ago when I first began using scleral lenses - I'd give it a try. That is how I insert mine - suctioning the plunger to the lens and releasing it.]
• I use a vented inserter
• Overfill them and be gentle with plunger!
• The bottom of the plunger usual breaks off. I have found it’s easier to “see” what I’m doing through the opening. I now cut off bottom when I start using a new plunger.
• I am very thankful for the See Green lighted stand. I wasn’t able to insert my scleral lenses until I tried the lighted stand. I have been able to insert the lenses using the stand without the light, but it may take a few tries. I always use the light unless I have some type of technical problem.
• Scleralfil 1 drop celluvisc
• I do have a question , what is the proper amount of Solution to put in the bowl of the scleral lens for insertion [It should be filled to overflowing, that is, if you hold it up in front of you, the liquid should be higher than the edges of the lens.]
• I use a magnified light up mirror to make it easier to see while I’m inserting my scleral lens. I place it on the counter, turn the light on the lowest level, and then use my fingers to put in my lenses while leaning over the mirror.
• I find it very easy to insert the lenses with my finger.
• Easy to do
• I can only use fingers for my right eye and plunger for my left eye
• I use a vented scleral cup for insertion. My question, which applies to all tools for insertion and removal, is how often do they need to be replaced? [People vary in their preferences; manufacturer does not say; i'd check with your provider for their opinion. We know people who keep them for years or until they stop working, while others replace them every 1-3 months.]
• Make your own lighted stand.
• Sclerafill or plain sterile saline
• My stand and plunger work very well for me. I could not hold my hand steady enough to use just the plunger. I put the stand on white paper and shine a lamp on it. I can see the reflected light bright enough thru the tube to follow the light into my eye.
• The S5 mini inserter was a life saver for me in the beginning when I struggled for extended periods of time to get my sclerals in! And now, I just don't want to use any other product because there would again be a learning curve - which I am not willing to go through again.
• Nutrifill I use to fill up my scleral, why are Boston Sight lenses different than other brands, Dr Foster in Boston recommends Boston Sight’s for ocular pemphigoid, they are so hard to get, I am lucky we have a Center in Fl where I live but it still is a 4 hour drive, I am going to try it out for the first time, but had a different brand from my local opthalmologist.
• Plunger with a mirror on my sink
• I found that DMV scleral cup was hard to use. I could not squeeze the lens off the plunger and resulted in air bubbles. I now use DMV Luma-Serter Plus. by balancing the lens on the cup it reduces bubbles. [Cool, I don't think I've ever talked to someone who uses it!]
• I need to learn to use my finger to remove! [Ugh. I hate doing that. I mean I know how, I just don't want to ever have to do it.]
• Autologous Serum Tears
• For me, it works best if I don't look at the lens during insertion but look at a mirror that is flat on the table.
• Went from Addipak to Nutrifil which I use only now
• It's a journey, be patient and you will get it. I have been irritated , desperate and have struggled ..but it's easy now :)
• Admins : maybe we should record a video with various insertion techniques people use around the world..perhaps more detailed than usual ones..would be pretty helpful i think. [We included some YouTube videos in the tutorial but you're absolutely right about getting more real-world ones. Dry Eye Foundation is working on a new scleral lens site and will probably include more.]
• Occasionally use plain stand ( from dry eye shop) with plunger but prefer just plunger now but both work well. .
• My lit stand is actually a battery-powered tealight candle in a ziplock with the plunger stuck on top.
• As long term soft lens user, the ring inserter was closest to finger method and easiest for me to
• Use with scleral lens
• I have a lot of difficulty inserting my lens. [Please reach out to your lens provider for more training or more tool options. We also have a tutorial that might help!]