Scleral lens wear time

Survey period: January 3-9, 2023

Participants: 305

Comments: 88

QUESTION 1: On average, how many hours do you wear your scleral lenses each day?

QUESTION 2: Do any of the following limit how long you can wear your lenses?

a. Discomfort

b. Fogging

c. Mucous

d. Doctor's instructions

e. Other factors

Comments and questions from participants

Comments from Rebecca in red

• I have a life so I have to wear them as ling as possible since U can nit wear glasses at all and only one eye is corrected.
• Glad I switched from hard lenses vision and comfort greatly improved
• I see much better with my lenses in. I love them. They just cost too much.
• I would like the dry eye foundation to work on expanding the list of acceptable diagnoses that are considered medically necessary. I know that “dry eyes” is too broad and would be too difficult to judge and expensive. But I think at a minimum, Stevens Johnson’s Syndrome and Sjogrens should be on these lists alongside keratoconus. We need lobbying from dry eye and scleral specialists to make this happen and I know some doctors have worked toward these types of goals. SJS and Sjogrens are rare enough and specific enough as far as legitimate diagnoses, with a clear tie to severely dry eyes that affect daily life, that they need to be considered as medically necessary for scleral lenses. [I could not agree more. It is disheartening to see what a battle this can be sometimes, for the very people who need it most. I don't know what timing would look like but I am happy to look at pulling together a working group. Reach out to the foundation at [email protected] if you'd like to keep up to date or chat about this!]
• I wear lenses about 16 hours each day, But usually have to take out to clean due to fog/protein deposits around early evening.
• Any suggestions about products safe for sclerals with Hydra Peg that are good for bad protein deposits would be much appreciated. I used to use Optimum by Lobob before getting sclerals and it was great. Unfortunately it’s no longer available and probably not compatible with the Hydra Peg. [Alcohol based cleaners are not compatible with Hydrapeg - that includes the now discontinued Lobob ESC and also the closest equivalents on the market which I believe are Sereine ESDC (sold here) and Miraflow (sold at miraflow.com). This whole issue of deposits is quite challenging - the improved comfort and 'wetting' of hydrapeg can be very important for many users, but then what are the drawbacks of the inability to do a thorough rub cleaning and all the best cleaners being off limits? It's a dilemma. As regards Hydra Peg friendly cleaning, Unique pH and Tangible Clean are both good, but the truth is, repeated rub cleaning even with a simple MPS like those can compromise the coating.]
• how long do they usually last my first pair one of them cracked after four months the second pair cracked after eight months [Adding this to future survey list! In the meantime, that is definitely not normal. Ask optometrist to talk to the lab about this.]
• These are my first Scleral lenses after using RGP for many years. I love Scleral lenses.
• Sometime my eyes feel dry . Can I still use rewettimg drops? [Sure. Any rewetting drop labeled for contacts is fine. However, a lot of them can make sclerals feel too sticky, so thin preservative free lubricant drops are a popular alternative. Check out the survey about eye drop frequency, there were a lot of questions about this there.]
• Deposits between the scleral lens and my cornea
• My doctor limits the use of the lenses to 12hrs, however I routinely exceed that limit because of work demands
• Does it hurt your eye if you wear the Lens for longer than 12 hours? [Limits to wear time depend on your specific medical conditions. Many people wear them longer; some people are restricted for medical reasons.]
• 14 hours
• I sometimes take a nap during the day so I take them out for that and then sometimes I just dont put them back in.
• what can I use in place of Tangible Boost? [Unfortunately there is no alternative. We're just waiting for it to come back :) ]
• I should take them out after 4 hours and put more fluid in but it takes a while and sometimes very difficult.
• I tend to use a lot of the refresh
• I answered that I sometimes limit my wear time because of clouding or mucus build up, but when that happens I just take them out, rinse and reinsert for my full wear time.
• No I’ve been a successful wearer since 2006! [Me too :) ]
• I actually have stopped wearing mine because the prescription is so uncomfortable. I feel I can never see well. Or I should say I either choose to see distance but not read (even my phone). With working it felt like too much of a strain (even with readers). Is that common? [I don't think so. The combination of glasses and sclerals needs to be optimized for your vision needs. Have you explored some options with your optometrist? For myself - I have full distance correction in my sclerals and I have bifocals with are no script in the top and a reading script in the bottom. That works well for everything except work/computer use, where I have a different strength of readers that I use just for the computer. Just an example :) ]
• How many others use their lenses for 12 and 12? [Not quite sure what you mean by this? If you mean rotating between two sets for 24 hours, that's very rare and should only ever be done with medical advice and frequent monitoring.]
• After 10 hours they become dry, and resetting only relieves it for a short time. They also become blurry after this time.
• Not really
• I have to wear them all waking hours in order to ser
• Sclerals have changed my quality of life and I am very glad I am able to wear them throughout the day. Almost no issues; sometimes they get foggy and bother me, but I don't think it is a major thing. I have 20/200 vision without them, had corneal transplant, cataract and I have the internal ring in the right eye. Keratoconus since I was 15 and I am 52 now. As I said, I feel blessed that I can use sclerals.
• My lenses are always comfortable!
• I hate them [Hmmm have you discussed alternatives with your eye care provider?]
• I usually wear them 12 hr. After that my eyes are tired and feel dry. No mucus. Maybe a little foggy. I have Sjorgens
• Is there a problem with wearing the lenses too long? [For some people, it's self-limiting as vision and/or comfort may deteriorate after a certain point. For some people it could endanger their cornea health due to their specific medical condition. If you're ever unsure, reach out to your lens provider to see if they have an 'upper limit' for you.]
• if the lenses ever fog it is usually because I wore them during a shower or on the beach, etc. I just take them out and refill them and then continue wearing them. I can't see without them - not even with glasses, so I am glad I can put them in upon waking and take them out right before bed.
• Does anyone have any suggestions for removal that make it easier, less painful? [Removing sclerals should never, ever be painful. This is something you'll want to get back with your lens provider about. My suggest would be to get an end-of-day appointment, wear the lenses all day, and then be seen by the optometrist before the lenses are removed (give the technician or receptionist a heads up so they don't try to do any pre-testing) so they can see whether the lenses might be too tight or something and also so they can observe your removal method.] Does "cleaning" them during the day allow for longer wear and what does cleaning actually mean? [For some it does. Sometimes people simply remove them, rinse them off with saline and re-fill and re-insert them. For others it may mean doing a 'rub clean' before re-inserting. Check out our  midday-fogging guide for more information.
• I also take lenses out about midday to rewet and insert
• Love my scleral’s. Now see better than I have for years and am able to drive at night again
• If I am having a lazy couch day and think I may nap on and off then I may occasionally skip wearing my lens that day.
• Please help get BSS solution script code changed so that others can use BSS Solution by Alcon as a daily solution. Ive been using 15 ML bottles for the last 25 yrs. I retired and now my new insurance will NOT cover it. I used to use approx 120 per month of the 15ML bottles. According to Alcon or doctors the insurance code is just for hospitals/doctors making it extremely expensive. If Alcon would change their coding system then maybe everyone could benefit from it. [Don't known if I can help, but I have added this to a list of things to talk to someone about at GSLS later this month. I think you also emailed and I shared some thoughts there.]
• FYI, none of the reasons in the question about why you take your lenses out apply to me. I wear them until bed time. Very rarely do I take out because of discomfort or fogging. Other questions are never.
• Water dry out [?]
• Fogging is my biggest problem, even after taking lenses out and replacing them. Sometimes they fog almost as soon as I put them in. If my eyes are especially dry, the lenses seem to fog more quickly (less contact wearing time). [Check out the midday-fogging guide on our tutorial]
• With Keratoconus and irregular astigmatism (since early 1980’s), the curvature of my cornea has worsened to the point where I cannot tolerate my lens for more than two hours once in a while. I last wore it on November 24th (today is January 4th). [Yikes. Have you/your provider looked into some different types of advanced lens design technologies, or concluded you've already maxed out the potential of sclerals? Irregular cornea and unusual curvature are things that sclerals ordinarily excel at.]
• Would like to wear them longer but the fogging is the biggest issue. [See notes about midday fogging]
• They feel really comfortable, my only problem is inserting them on the stand some days right away and some a half hour [Might want to check out our insertion guide, in case any tips or videos could be helpful in identifying issues]
• Have been lucky! Good Dr. Good fit, so much better than piggy-back lens I was wearing. Stay clear right up to bed time.
• My eyes feel dry after 10 hours so I remove and reinsert.
• I recently had an issue with a cloudy cornea in my left eye - which is now cleared - but I have been instructed to limit how long I wear my scleral lens in my left eye. 4 to 6 hrs max.
• A year ago, I stopped working at a job that required me to sit in front of a computer for 8-10 hours per day. I was having major issues everyday with irritated, dry eyes. I had headaches and pain every day. I had to take my contacts off as soon as I got home. My husband and I have a business now and I’m only in front of the computer 1-2 hours per day. If I use the computer for more than 2 hours, my eyes start to hurt and feel irritated and dry.
• Is there a cheaper product other than refresh celluvisc to increase comfort and wear time? Pls do a snipet about this in a newsletter email maybe. [Will do! Going to make a blog post about it so others can comment with their experiences. In the meantime, my suggestion is to use a drop sold in a multi-dose-preservative-free bottle and with sodium hyaluronate, to be both effective and cost-effective - that's assuming you only need to add a drop or too, not fill the whole lens, which is going to be expensive no matter what I'm afraid. Also have you already tried Nutrifill - for many people, Nutrifill on its own can take the place of, for example, unbuffered saline plus celluvisc.]
• I had RK/AK … lots of scars and lots of astigmatism. Scleral lenses have greatly improved my vision. Comfortable to wear, less variation of vision throughout the day. Major improvement.
• Clean with Tangible Clean, fill with 3 drops of Refresh Celluvisc or PuriLens, rinse with PuriLens.
• I don’t recall my doc giving me a limit. What does the science say, for my eye health? Is there a time limit, other than out for 6 hours for clear care to neutralize? [It's very much patient-specific - depends on disease and condition of the cornea. But I'll keep an eye out for any posters/papers about this at GSLS next week.] 
• I have a very dry eye, even with the lenses and I work long days seasonally using drops every few hours
• Due to my increasing levels of discomfort, fogging, and general frustration in the past few months with long term daily lens wear, I’ve recently implemented a new morning routine I came across in the KC FB group in an attempt to help extend my daily wear time. 1. Cleanse - upon waking, I immediately place one drop of a dry eye specific lubricant in each eye 2. Heat - I follow that with a 30 - 45 second period of wearing a heated eye mask (warmed in the microwave for no longer than 35 seconds) 3. Protect - place one drop of an Rx-level allergy drop (Pataday or Alaway) in each eye 4. Hydrate - after waiting 15min following step 3, I place one to two drops of a viscous lubricant eye gel (Refresh Celluvisc or Refresh Advanced) in my lenses prior to topping them off with a PF saline (LacriPure or Purilens) 5. Insert [I love this. Only thing I would add is, I find eyelid cleansing with a tea tree wipe for dry eye very helpful. Also, watch out for the BAK in allergy drops if you're using them daily - preservative free is preferable where possible.]
• I could not live without it......
• Sometimes need to remove lenses because my eyes are tired. More so late at night. Not really related to lenses. Discomfort or fogging usually just require removal, cleaning and reinsertion.
• One lens becomes uncomfortable somewhere around 8 hours. The other lens is pain free for over 14 hours.
• It's very irritating the dry spots that will get on one lens at about the 8 hr mark. If I remove, clean and reinsert the dry spot happens again within 2 hrs.
• I use Lumify to help with eye redness. Is there anything else that can be used/done to reduce eye redness? [Lumify is preserved with BAK. See article. Please consider limiting your use, if you are currently using it daily. What can help? Depends what's causing the redness. Allergy? may need to be treated. Dryness? may need additional dry eye treatment (apart from the scleral themselves). Time for a cornea specialist?
• Rarely, I bump the lens and need to refill
• Often develop mucous build up that requires me to remove and clean the lenes and then reinsert. Sometimes repeated build up of mucous in a day causes foggy vision and discomfort resulting in the need to remove lenes for the day.
• I just got new glasses which allow me to read small print up close while also wearing my scleral contacts, so I intend to wear them more frequently than I have been.
• Very nearsighted for most of my life. I converted from glasses to gas perm contacts about 40 years ago with no issues at all; absolutely loved them! I've had 2 separate detached retina events with my left eye within the past 4 years (4 retina surgeries in total). I also had cataract surgery Spring 2022 on my left eye with an optical lens inserted to improve my uncorrected vision a great deal. My right eye remains very nearsighted; really has been an adjustment for my brain to handle when not using corrective lenses! My optometrist recommended I begin using scleral lenses for two reasons: (1) best solution to correct my vision where each eye has a very different optic prescription; and (2) to keep the lens off my left cornea that had the surgeries. I've been wearing scleral lenses for 4+ months now. They are comfortable most of the time and I want to leave them in all day like I did with gas perm lenses...but I am not confident to be able to do that...yet. The surface shape of my left eye is irregular due to the surgeries and for that reason, the lens seems to be more difficult to break the suction when removing it the longer time I leave it in. I have only removed the lenses using the DMV Ultra Remover. It's a true test of patience and confidence to not panic when the lens doesn't break the suction right away and requires several attempts. [See our guide in case there's any practical tips. I'm thinking about the rotate/twist option possibly, also make sure you're getting it wet?] I'm still trying to learn the best technique(s); the right lens is easily removed on my first attempt 99% of the time. I haven't taken the "next step" yet to learn how to remove the suction on the lens with my lower eye lid or any other approved method - not sure I want to...[I hear you, actually I absolutely hate doing that myself] I try to remove the lenses to rewet and reinsert them after about 5 or 6 hours and that seems to help. I'm glad to have my vision; it's not to be taken for granted! But I'm glad to be a gas perm "veteran" so I have that experience to compare to this new one and helps me transition easier to this "next level"; wearing scleral lenses is a "whole new ballgame" for me! [If you haven't already seen it I have a note to someone else above about scheduling an end-of-day appointment with the optometrist to try to troubleshoot any removal issues.] [p.s. I wrote those notes before speaking with you today :)]
• I am including "dryness" under the category "discomfort" and checked sometimes.
• I'm just trying scleral (Prose) lenses and am having overall difficulty inserting them and wearing them. After 30 min they are very uncomfortable. Tight feeling. I will be seeing the doctor at UCSF next week. [Wishing you the best. It is a process!]
• After I have worn the lens for approx 6 hours, especially if I am doing close work like computer or on phone, I will get uncomfortable mucous deposit on the lens.
• While I have discomfort, fogging, and mucus often, I usually just deal with it rather than taking my lens out before bedtime. Also my doctor's instructions would have been a never, but that wasn't an option.
• The hand soap may be causing some of my fogging issues [Hope so, because it's such an easy fix :) ]
• Mine are and have always been VERY comfortable. I rarely know I am wearing them. The only issue is occasional fogging or mucus build up. Gets worse during allergy season (For me, spring and summer). Taking them out, rinsing with saline cleans them and I re-insert. No need for complete cleaning...I wear them ALL day EVERY DAY. (Cannot see without them and my doctors have discouraged trying to get a fit for glasses. These work so well and with my uneven curvature of the lense, my vision is not good with glasses...
• my lenses become more irritating over time. It is possible for me to extend my wear time by taking them out mid day, rinsing and re-filling with fresh saline. However I suspect that I do not have the perfect size, fit, brand, saline, etc. Something is off. [As I mentioned to others, try scheduling an end-of-day appointment, and wear your lenses all day so your optometrist will see your eyes at their worst not best]
• Not lay this time
• Scleral lenses are just amazing - best vision and comfort I have ever had post corneal transplants for kerataconus 15 yrs ago.
• I have found that my eye deterioration during the day is directly related to scleral lens wear time. So if I have a function to attend in the evening--i may take a 2 hour break of wear time in the late afternoon. But it doesn't really matter because by early evening my eyes have lots of mucous production and are inflamed to the point where sclerals limit my sight (mucous under lens) as opposed to helping it.
• I was never told about limiting wear time to specific hours, and perhaps have to add drops 1-2x a day depending on activity level and environmental conditions. These lenses are such a great improvement from previous rigid, and smaller, lenses. I have keretoconus and these have allowed me to have 20/20 vision for first time in many years, so I wear them as much as possible.
• When I first started wearing the lens - about 12 years ago - nothing bothered me & I could go forever. Now the gradual decline in clarity over the day is very frustrating.
• I leave them in so long because they're so comfortable I forget I have them in.
• The reservoir of saline under the lens gets depleted eventually requiring eye drops
• I just started to wear scleral lenses after 50 years of RGP lens use, I find scleral lenses much more comfortable; I have dry eyes and keratoconus which made RPG use untenable. I went from 5-8 hours max (RGP) to 8-12 hours min (scleral) in very little lead time.
• Optase and OCuSoFt cleaner daily works wonders. I use once to twice daily. Wish I would have always used this. [Great tips! I think that the role of lid cleansing is particularly overlooked for scleral lens users.]
• Good questions: 1) what is your main problem with scleral lens insertion and comfort? (2) how many reinsertions to gets it right? [Added these to the list! Thanks for the suggestions!]
• Since using sereine lens cleaner I do not get mid day fogging [Hurray! It's good stuff.]
• Are there any new drops or products to help with dryness while the lenses are in? [There are no products developed specifically for use with scleral lenses, though there's always new dry eye drops making the rounds. I'm wondering whether the dryness you're talking about is the rest of the eye, or corneal discomfort that would feel better if the solution in the lens was a little different.]
• I have been having serious problems, so now I am experimenting as I try ti figure out what is best for wearing scleral contacts. 
• I feel like I need to give my eyes a day off every week. Even though they require so many drops on those day, I need t least a day without them.
• Are you supposed to limit scleral lens wearing to two waking hours without them? [I have not heard something like that. Everyone's own doctor is the best source of information how long it's safe to wear them.]
• Cold weather and low humidity affect how long I can wear my sceleral lenses [Me too. If you haven't already, consider protective eyewear outdoors - like 7eye airshields or WileyX climate control - to improve humidity. When humidity in my office drops too low - I monitor it was a little $10 hygrometer - I switch on a desktop humidifier, because otherwise my lenses get uncomfortable.]
• I love scleral lens - they have been a blessing to say the least! :) :) 
• One day I forgot to take off the lenses and shower, there were replaced new ones just few days before, are these lost longer? [Not quite sure I understand - are you asking whether having showed in the lenses could make them not last as long? If so, nope, not an issue. But definitely try to avoid that, due to acanthamoeba risk from water under sclerals.]
• I worry about my cornea not getting enough oxygen. I do see red veins around my iris after taking out the lenses. [Great thing to discuss with your optometrist and, if you have one, cornea specialist ophthalmologist.]

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