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Being Fitted for Scleral Lenses

Last updated: December 2022

My scleral lens fitting took a total of three office visits to my dry eye doctor. During my first visit, the technician took some initial measurements using a machine that scanned my eye. Then, based on those measurements, my doctor tried me in a sample pair of scleral lenses to check what diameter of lens I would need. (See why I decided to try scleral lenses).

He said that he generally fits people in sclerals that have a diameter between 15 to 18 millimeters, with 16 ½ millimeters being the most common. Based on my measurements, he tried me in a 16-millimeter lens in each eye, but said that my left eye was slightly smaller than my right, so we might need to go down a size in that eye.

Putting the lenses in

To put the lenses in, he filled each one up with saline solution and had me look down and hold my lower eyelid open. Then, he held my upper eyelid open and put each lens in my eye, making sure the lenses suctioned to my eyes and didn’t have any bubbles in them. He let the lenses settle in my eyes for about 15 minutes. The lenses felt strange, like there was something in my eyes. Also, they were not my prescription, so I couldn’t really see in them.

Then, I went with the technician again to get some more measurements and pictures taken of my eyes. When I came back, I told my doctor that my right eye was more comfortable than the left, and he said that we probably needed to drop the left eye down to a 15 ½ mm lens. He looked at my eyes through the slit lamp and had me read some letters to determine my prescription.

Then, he took the lenses out and said that they would order my first pair of custom lenses. He said that about 70 percent of the time, patients try two or three pairs before getting a perfect fit. I would come back in three weeks for my first pair.

My vision was off

When I came back, he tried me in the lenses and let them settle in my eyes again for about 15 minutes. I could immediately tell that the vision was off. I couldn’t see up close, but my far-away vision was very clear. After I had some more scans and pictures taken of my eye, I told the doctor that I couldn’t see up close, and he said that he had over-corrected me, and in doing so created presbyopia. He would need to change my prescription.

He showed me one of the pictures taken of my eye. He pointed out that the desirable depth of solution in the lens is generally a one-to-one ratio with the depth of the tear film. He said that the fit looked pretty good, but he was going to make a few slight changes to the fit as well.

Again, I would come back in two weeks for my second pair. On my way out, I went to a technician be trained on how to put the lenses in and take them out. My doctor said that I could wear the lenses he had just given me while waiting for my new ones if I wanted to. Learning how to put the lenses in was somewhat difficult; taking them out was easier.

Trying them at home

While waiting for my second pair of lenses, I did try my first pair out at home once. But I couldn’t take the vision being off. It made me a little dizzy and gave me a headache. I decided to just wait. When I came back to the office for a second pair, the process was the same. This time, though, I could see both close up and far away.

My doctor adjusted both the vision and fit again just slightly. He said that his office could mail me my third pair because he didn’t feel that he would need to see me in them, unless they weren’t comfortable to me. Then, I could come back. As of my writing this, I was awaiting my third and final pair. I was anxious to see how they fit and how my eyes acclimate to them over time. See what happened as I continued trying scleral lenses.

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