Dates: April 20 to May 16, 2026

Participants: 458

(For questions which were not applicable to all participants, the number of responses is indicated.)

What's changed?

We last ran this survey in 2023. How did this year's results compare? 

• Better: Lens removal - 92% can remove them consistently and suction breaks readily, compared to 86% previously
• Worse - The number of people who do not always fill their lenses with preservative-free solutions approved by their provider is up slightly to 5%
• Better: Disinfecting after every lens use is 96%, up from 90% last time, and the number of people who disinfect for the full cycle is now 91% (previously 87%)
• Better: Water safety in shower - 69% now say they remove their lenses before showering, up from 64%.
• Better: Water safety while swimming - 62% now say they remove lenses before swimming, up from 54%.
• Unchanged: Patients receiving written instructions is still stuck just under 60%. Help us change this - tell your provider about DEF's scleral lens patient handbook!
• Better: Wear time - 88% now say they stay within their provider's recommendation all or most of the time, up from 83% previously.

PART 1: Application and removal

I can consistently APPLY my scleral(s) successfully and without bubbles.

I can consistently REMOVE my scleral(s) and the suction breaks readily.

My eyes seem to look and feel okay immediately after removal.

I am prepared to remove my scleral(s) in an emergency.

PART 2: Filling solutions

I fill my scleral(s) only with preservative-free solutions approved by my optometrist.

I follow instructions for when to discard preservative-free solutions/drops after opening.

I maintain adequate back-up supplies for solutions that cannot be purchased locally.

PART 3: Disinfection

I disinfect my scleral(s) after use, using either a hydrogen peroxide system or a multi-purpose solution approved by my optometrist.

I follow the manufacturer’s instructions for a complete disinfection cycle.

(For example, Clear Care requires 6 hours; Unique pH requires 4 hours; Boston Simplus requires 4 hours; Tangible Clean requires 6 hours. Each manufacturer has steps to follow prior to soaking.)

PART 4: Storage

If I remove my sclerals temporarily during the day (e.g. for napping or swimming), I place them in a case with multi-purpose solution.

290 responses 

I follow my optometrist’s instructions regarding dry or wet longer term storage for spare or duplicate sclerals.

313 responses

I disinfect stored sclerals before returning them to use.

339 responses

PART 5: Water Safety

I wash and dry my hands before handling my sclerals.

I rinse my sclerals with saline or multi-purpose solutions (rather than water)

I remove sclerals before showering (or wait till after I've showered to put them in).

I remove sclerals before swimming.

230 responses

PART 6: General

My provider gave me written instructions to follow for the care and use of my sclerals.

I stay within my provider's recommendation for daily wear time.

257 responses (201 participants stated that they were not given wear time limits)

If I experience issues or have questions, I contact my lens provider.

PARTICIPANTS COMMENTS

>200 comments this time. I've sorted them by topics and added responses to most. - Rebecca

Solutions

• Wish clear care would bring back their travel size for triple action cleaning. Huge problem for me. Agree… we’re hoping for a new brand before long

• Very concerned about supply chain issues these days - I try to keep at least 6 month supply. Yes, sadly, still a significant issue

• Need all products in local stores like Walmart Yes I sure agree. I’ve recently learned that Purilens Minis are now in some Walgreens stores! That’s progress at least :) 

• Regarding discarding solutions, I will use a Refresh tear vial multiple times in one day and then discard it at the end of the day, rather than using one time only. I believe in the 24-hour rule myself, for recappable vials :) 

Cleaning & disinfection

• Nightly, I soak my lens in Boston Simplus. Once a week, I soak my lenses in Clear Clare using a Prose Case. My scleral lens manufacturing requires me to use clear care once every thirty days. Instead, I use it weekly to avoid wasting the product. Sounds good

• After wear, I clean them with surfactant and rinse with running tap water to remove all the soap, prior to storage in wetting solution. 

  • 1 - Tap water is a high risk practice. The risk of acanthamoeba has caused this to be phased out as an acceptable way to rinse any contact lenses, including hard or scleral lenses. 

  • 2 - What you mean by “storage” is actually a disinfection cycle, and needs to be done in an approved disinfection solution (meaning, either hydrogen peroxide or a multi-purpose solution). The way you will be able to tell is that the front of the bottle should say specifically that it is indicated for disinfection of gas permeable lenses. Most solutions require 4 or 6 hours. Lenses should never be stored, even temporarily, in a wetting solution - especially not a preservative-free solution of any kind.

Troubleshooting challenges

• I see better with them but they have and always will be difficult to put in and take out and are uncomfortable for the most part. Well fitting lenses should not normally be uncomfortable. Sorry that removal and insertion are hard! Might want to see some of my other notes on difficult removal below.
  

• I’ve had Scleral lenses for four years. I don’t like wearing them. I don’t like putting them in. I don’t like taking them out and I wore gas perm lenses for 30 years. I think these are awful and they need improvement. The only good thing they do is I can see really good out of them, but it isn’t worth the hours I spend trying to put them in and taking them out. A shame  they can’t make them better for people that have bad vision and really need something they can easily put in and take out. Because of this, I have two pairs soaking in solution. Then the past four years, I might’ve worn them 10 times. Also, because I have cornea transplants, I don’t like all the tugging. I have to do to put them in and take them out. Honestly, I don’t think they’re safe, but that’s my opinion. Wow, so sorry to hear this. Would you consider coming to DEF’s scleral lens zoom group to discuss these things? This sounds very far from ideal. If you are having to tug to get your lenses out, that most definitely is not safe! It might mean you need a different technique or it might mean your lenses are tightening up too much.

• I have been wearing scleral lenses for almost four years, usually at least 15 hours per day.  I have no issues either inserting or removing them.  However, they typically fog up within an hour of first insertion and must be removed, cleaned, and reinserted, sometimes two or three times.  I have consulted my doctor several times.  She is a scleral specialist (and wears sclerals herself) and we have tried many, many solutions, but without success.  The lenses are wonderful and I have no intention of giving them up, but the clouding issue is significant, especially since I must travel regularly, usually by train or plane. That’s a huge amount of daily impact, for sure. In some cases just because of the disease state it may be unavoidable. Fogging is one of the most talked-about issues among scleral providers. The answers sometimes aren’t all about the solutions.

• No problems after using them for over 15 years, some concerns as I get older if I will be able to put them in and take them out.  I have sagging eyelids and my fingers are not as agile as they once were but at this point I can still do it.  I will be 70 in August. I hear you! I’m trusting somewhat to improved technologies. I know they’ve been working on things like robotic insertion aids.

• I have a hard time getting the sclerals out. I put in a drop of preservative free saline solution in each eye and on the plunger. This helps some. Yes always best practice to wet the lenses and plunger before removal. Difficult removal can indicate need for a slightly different technique or it may suggest the lenses are tightening up too much. Recommend scheduling an end-of-day appointment and asking your provider to remove them with a plunger at that time, so that they can check for themselves how tight the lenses are.

• I like utilizing the Dry Eye Shop for information and education on Sclerals and Dry Eye.  Rebecca's videos and write ups are important to me.    My sclerals are great for me 90% of the time and the other 10% is hell when I have Dry Eye goop fogging my vision resulting in trying endless products as potential solutions.   I think this should be a topic of concentration from the Dry Eye Shop. Thanks so much for bringing this up. I have written it up a fair amount in the tutorial but I haven’t emailed or surveyed on this in quite some time. I’m adding it to the list now!

• My clinic lost its ophthalmologist handling Prose lenses. The payment approach for physicians for the organization put ophthamologists at a disadvantage, so they all left. It's taking a long time for them to find a replacement. It's very disappointing. So sorry to hear that

• Dr doesn’t have an answer why I see double whenever I remove my lenses. I’ve tried to find answers online but cannot. Some of us experience temporary ‘remodeling’ of the cornea, which affects our vision for awhile after removal. With RK patients is can be very pronounced and brings special challenges. However, poorly fitted lenses can do this too. Has your eye doctor ever seen your eyes after your lenses have been in most of the day? If not, you may want to schedule an end-of-day appointment and put your lenses in first thing in the morning, so the dr can see firsthand what your eyes look like on removal at the end of the day.

Positive experiences (congrats, all of you!)

• My Scleral Lens are a Godsend. Since getting them I see as well, if not better, than I ever have before.

• I have been successfully wearing scleral lenses for 8 years with no issues.

• Best for my issues without a doubt 

• I love my scleral lenses! 

• My sclerals have really helped my eyes!

• I’ve worn for over 12 years, no real issues after the first few weeks

• Been wearing them for 15 years, couldn’t live without them!

• I love them, and I can see much better. It would be great if I could find a place closer to home to do this stuff. I do love Dr. Kwok. Dr Kwok is amazing! This year I’m hoping for a local provider for myself too…

• I have worn sclerals for more than 10 years. They have been a lifesaver for me.

Water safety

TIP: Please see https://akeyefoundation.com/ to learn about the waterborne parasite acanthamoeba and why contact lenses, including sclerals, should never be exposed to water. It’s a matter of safety, not convenience.

All of these safety lapses are calculated, I'd say. I've worn sclerals for 10 years and none of these questions surprised me, but I'm not the perfect patient, and for example with showering with them -- I'm just physically aware enough of my body to know that I can shower with them in. What matters most is the daily cleaning and being able to take them off in an emergency. I never lapse on that. The rest is malleable. Actually, the showering issue has nothing to do with how you feel - it’s about a parasitic risk: acanthamoeba keratitis. Strongly recommend googling that.

• I wear good goggles in the shower if my lenses remain in.

• I use water to rinse after cleaning but then rinse with PF Saline prior to lens insertion. To difficult to get all cleaner off with just PF Saline rinse. I do take out midday to clean and follow the same process as beginning and end of day. Unfortunately this still leaves you at risk of acanthamoeba.

• My optometrist told me it is fine to rinse lenses with water.  She does. That’s frankly shocking. Standard of care is no water rinsing for any contact lens type, including sclerals, due to risk of acanthamoeba keratitis. I would encourage you to take this up with her again.

• Regarding showering with my lens in. I stand with my back to the shower with my eyes closed. After washing and rinsing my hair, I grab the towel on the shower curtain bar and wipe the water off my face and dry my hair and face before opening my eyes. It’s pretty hard to completely avoid any water exposure for your eyes in the shower

• For both showers and the rare times when I use a swimming pool ( to play with a grandchild with my head above water, not to swim laps) I use tight fitting swim goggles sometimes. Usually for showers I either have the shower before putting the sclerals in or take them out and let them soak in Boston Simplus and then reinsert them after the shower. When flying long distances I wear my backup eye glasses so I can nap on the plane. I am fortunate that I can see just well enough with the back up eye glasses. Good practices :) and yes so helpful if you can wear glasses instead

• If I swim in a pool or shower with lenses in, I wear swim goggles so no water enters the eye (yes, they work in the shower, too!). I do not wear my lenses in the ocean.

• Lifeguards can't remove contact lenses prior to entering the water for a save, so "removing prior to swimming" is not an option for me. Thanks for sharing - that’s a new circumstance for me. And thanks for what you do!

Hand washing… and drying

• I wash my hands before handling my lens most of the time, but I don't always dry my hands.  Just want to make sure you’re aware that the point of drying them is avoiding water contact with the lenses, which brings risk of acanthamoeba keratitis.

Dots

• I have scleral with bifocals. I struggle seeing the “l” and “r” to know how to position scleral, now the black dot is gone. Ask your provider about re-dotting? If they can do it once for you maybe you can maintain it with a sharpie? (yes, that’s a thing)

• Make the dots on the lenses last more than 6 months. Yeah it sure would be nice if they were permanent

Lens storage (temporary or longer)

• When removing my lenses during the day for a break, I put them into unique ph 90% of the time.  10% into multi purpose.  This is to clarify a question that perhaps should have option to take out and put into other than multipurpose solution. Unique pH is a multi-purpose solution. Anything that says it can be used for cleaning, rinsing and disinfection is a multi-purpose solution.

• My optometrist has not given me long term storage instructions for spare lenses. Might be worth a call to ask

• Where to place stored sclerals when taken by ambulance in an emergency? Interesting question! I suppose it depends on the circumstances and how much control you have over the situation? I would want my lenses removed in the ER and put in my own case if I had my bag with me - eek that reminds me I need to put a plunger thingy on my keyring! - I think my biggest fear would be someone handling them that does not understand they are custom and expensive. If I was at the mercy of whatever case they might have in the ER I’d be a little concerned that a cheap flip-top case might not be large enough to hold them safely.

• I have been wearing scleral lenses for 13 years and have figured out how to negotiate just about any situation, even travel. I have to admit that sometimes when I shower I will put my lenses back into neutralized ClearCare rather than a multi-purpose solution. Otherwise I follow best practices to the letter. You mean you keep the neutralized ClearCare? I dump mine out at the time I put my lenses in.

Instructions from providers

TIP: For those of who you don’t feel you received sufficient written instructions or where your optometrist is learning, please consider pointing them to Dry Eye Foundation’s Scleral Lens Patient Handbooks. (mbfsl.org/store)

• Had very little instruction from Optometrist about use and care of my Scleral. Learned most from your website Glad to help. Consider telling your optometrist about Dry Eye Foundation’s scleral lens patient handbooks

• If at times my Doctor's instructions are vague, I check out Rebecca"s videos for further clarification.:) 

• I used PROSE before scleral lens. Boston Foundation for Sight trained me extensively for using PROSE lens and they gave me lots of written instructions. Therefore, when I started using scleral lenses, my doctors assumed I knew what I was doing. The manufacturer of my last scleral lens provided written cleaning and disinfection instructions which I follow." I understand - same with me. BostonSight is the gold standard for training! And once you’re a veteran a new-to-you doctor is unlikely to provide written instructions. However, personally I would say best practice is to give the same instructions to everyone. You never know what someone might have missed in a previous life, even the best of us.

• It's nearly impossible to get quick help from the lens provider, but thankfully there is much information from DEF and on YouTube for assistance! Yes quick help might not be reasonable to expect but hopefully they are responsive on the important things

• My previous Dr was great with care instructions , communication etc . She retired and I can honestly say I know much more about sclerals and their care than my current Dr . It is extremely frustrating. When I am in for an appointment he asks ME why I do things a certain way and will take notes. Great that you had such a good doctor! Interesting about the new doctor. It’s a good sign that they are paying attention and wanting to learn. There are an awful lot of optometrists that are new to sclerals at this point with little experience in the nuances of care & handling. If you haven’t already, you may want to introduce them to DEF’s Scleral Lens Patient Handbook? It’s a good learning too for providers and technicians too :) 

• Yes, I got written instructions but they were not adequate. I shared feedback with my optometrist. Well done! Letting them know what’s missing is important

Napping etc

• My provider, after specific questioning, says that I can nap in my sclerals as long as I disinfect them overnight. Yes, this is definitely down to individual advice suited to the patient’s medical conditions

• The reason I don’t remove the lens if I take a quick nap, (I only have one for my right eye). I can not close that eye. So it does not close over the lens.  Oooh interesting, thanks for sharing!

• If I remove lenses for a brief time during the day, I put them in the case dry and then clean them (manual rub with cleaning solution, rinse and fill with Purliens) before reinserting. I haven't been putting them in disinfecting solution because I figured that 20 minutes or so wasn't going to do much, but perhaps I should reconsider? Yes placing them in multi-purpose solution is safer than dry, even though it’s not a disinfection cycle

Then vs now

• "I’ve worn sclerals for 19 years; therefore some of the things I was taught are not what they teach today.  For example, I clean them between 2 fingers—my thumb & ring finger (with Simplus) not in the palm.  Also, I don’t use a mirror to take them out or in.  I only use a mirror for bubbles.  And I don’t use a stand to put them in!  I previously wore hard contacts for 30+ years, so I knew how to put them in fairly good.  Thanks for sending emails & pictures occasionally!  We don’t have mountains or snow in Houston, Texas! Yes things sure have evolved over the years haven’t they! And, glad you like the pictures :) 

Issues with the survey, and suggestions

• More questions should have N/A options Please drop us a line to clarify which ones you had issues with. Thanks!

• I was surprised to not see a question about disinfecting tools for inserting and removing. That’s such a great point. Sorry. Making a note for the future!

• One question did not have a proper response.  I have stored spare sclerals per my doctor's instruction.  To the next question my answer should be I have not had the occasion to disinfect/use the stored sclerals but I was not given this choice for an answer and I could not leave it blank and continue. You mean you’ve stored them but never had occasion to return a stored lens to use? I understand - thanks for pointing this out, I can revisit it.

• You sent this to me, the fitter, shouldn't this be sent to actual patients? Sorry - apparently forgot to exclude fitters from the mailing list!

General feedback

• Thanks for all the work you do! 😀

• My provider was not that knowledgeable. I've relied on the Dry Eye shop and blog for much of my information [and I donate!]. Glad to help, and thanks so much for donating to DEF!!

• I have a top notch provider, however, the education, tips, insight I have gotten from this page has been enormously helpful. You are a superb resource! Thank you, so glad to have been helpful!

• If I have questions, I go to the dry eye shop website and keratoconus subreddit. 😀

• Thanks for asking!  Can always use more tips from Optometrists and from other patients. 😀

• Use websites, tangible clean and dry eye shop for references.😀

• Thanks for caring about sclera users and providing us with excellent advice and products.  😀

• Thank you for everything you do!  I would be lost without you!  It’s so nice to know that someone cares. 😀

• Some good reminders in here...Thanks!  Welcome 😀

• I am so glad that you all send out this survey. Beyond obtaining valuable information, the questions help to keep me on my toes for what is important in scleral lens use. Thanks so much, Deidra B. Doing this helps keep me on my toes too!

• I find a lot of help online. The dry eye shop has been great 😀

• You’re fantastic at sharing information and giving honest reviews, which is why I always buy from you. ;-) Aw thank you! 😀

• Per my cornea specialist, I also put 2-3 drops of my serum tears into each lens before inserting in eye. I hope that’s been helpful for you!

• Just wanted to mention that I was having fitment issues with my PROSE lenses from the Boston Foundation for Sight, but my new lenses (in my 2nd year of use) from EyePrintPro fit perfectly. So glad that you ended up with lenses that are working well for you. I have had success with both kinds over the years.

• I have been wearing scleral lenses for approximately 10 years and I can't say enough how much you guys have helped on that journey. aw that’s kind of you, thank you!!! 😀