Overview
Scleral lenses can dramatically improve vision and comfort for people with keratoconus, dry eye, and other corneal conditions—but putting them on and taking them off takes practice. Whether you’re new to lenses or looking for a refresher, here are some of the top tips covered in this guide:
- Start with professional training—don’t try to figure it out from YouTube alone.
- Practice in a clean, well-lit environment with a mirror and blocked sink drain.
- Use preservative-free saline specifically approved for scleral lenses.
- Overfill the lens with saline to prevent air bubbles.
- Keep hands and eyelids dry for better grip and lid control.
- Check lens dots for correct orientation and placement.
- Use proper removal technique—never suction the center of the lens.
- Clean and inspect lenses daily, and never reuse solution.
- Contact your provider if you experience pain, bubbles, or difficulty.
Scleral lenses are becoming increasingly being utilized for patients suffering from irregular corneal conditions, such as keratoconus, and ocular surface disease, such as severe dry eye. Research has shown that the most common reason for scleral lens failure is voluntary discontinuation due to difficulty with lens application and removal. The most important thing to remember with scleral lenses is that application and removal is a learnt skill. It requires practice and patience. For those having difficulty this article will answer some common questions. Before you visit Reddit r/scleral lenses or Facebook scleral lens support groups, ask your doctor.
Setting the Foundation for Successful Applying and Removing Your Scleral Lenses
Proper application and removal training at the dispense of your scleral lens will set the foundation for success with your scleral lenses. All scleral lens experts will have a team member that is qualified to teach you the proper techniques for application and removal, as well as lens care. Here at CLEI our scleral lens application and removal training sessions have a 2 hour time allotment to allow a patient to learn in a calm, unrushed environment. Our technicians are simply the best; patient, caring, encouraging and most importantly exceptionally well trained to aid you in becoming a successful scleral lens wearer. Should you need additional training or want a refresher we are always happy to provide one.
Professional Guidance and Semantics
We know it’s just semantics but scleral lens application and scleral lens insertion are not the same. We want you to learn how to apply a scleral lens on the surface of your eye, we don’t want you to insert your lens anywhere but its storage case! That said it cannot be over emphasized that successful application and removal must be taught to you at an application and removal training session by a qualified professional. If you are experiencing challenges it is important to communicate with your doctor to pursue further training. If you were given scleral lenses without training or if your current provider does not offer further training when you need it, it may be appropriate to seek care from an eye care professional with more experience with scleral lenses. Trying to learn scleral lens application and removal techniques at home on your own without the foundation of in office training can lead to injury. Online resources should only serve as reminders of what you learned at your training session.
Learning How to Adapt and Overcome Scleral Lens Application and Removal Obstacles
Each individual is unique, and learning to apply and remove as scleral lens requires finding the technique that works for them. Skill and experience with contact lenses vary greatly from person to person. Some patients will pick up application and removal quickly, mastering it within a week or two, others may take a month or two. Either way don’t get frustrated or discouraged. Ensure you have ample time to practice at home. Do not allow yourself to be in a time sensitive situation where stress and anxiety can increase because you have to get somewhere.
Also other factors can influence the learning curve. Things like hand tremors, low vision, strong blink reflex, anxiety, and tight eyelids can make the process more challenging but with the right tools and training you can be successful.
Preparing For Scleral Lens Application
Hygiene is the most important part of application and removal. Wash your hands before touching your eyes or your lenses. Prior to handling scleral lenses, thorough handwashing with non-moisturizing soap is essential to prevent the transfer of oils that can compromise lens clarity and comfort. Hands should be dried completely with a lint-free towel to avoid towel fibers on or in your lenses.
Additionally a magnification mirror can be very helpful to aid in applying and removing the lens as well as ensuring there are no bubbles trapped behind the lenses. Alcohol prep pads can be used to clean the application and removal devices, these tools are often called lens plungers but they shouldn’t be plunging anything. These devices should be disposed of on a quarterly basis, like a toothbrush.
Environment Considerations
The environment you choose will affect application and removal. First ensure the environment you are in is clean. Avoid wet, dusty or windy environments. Bright lighting is exceptionally helpful, in general the brighter the environment the easier it will be to see what you are doing. If you are going to use a bathroom counter to apply your lenses make sure you have the sink drain blocked so if you drop the lens you don’t lose it down the drain. Consider placing a towel over hard surfaces so if you drop the lens it doesn’t bounce. If you lose or break a lens contact your provider for guidance and a replacement lens. A general tip is if you are unable to function without lenses you should purchase a spare pair of lenses to ensure your life is not interrupted by lens loss or breakage. If you drop a lens, lose a lens down the drain and recover it, or think you may have damaged your lens, contact your provider for guidance prior to lens wear. If you decide to wear the lens without contacting your eye care provider, do not wear it without thoroughly cleaning the lens and inspecting it for damage and. If there is any discomfort, remove it immediately.
Stand or Sit?
Each individual is different; some stand, some sit, some have health limitations and must do one or the other. Generally you should stick to what you were taught and successful with at your application and removal training. If you have no restrictions, do whichever is more comfortable to you. Once you master one technique you should try to learn the other for versatility.
Make and Give Time for Successful Scleral Lens Application
Putting a scleral lens on the eye is a learnt skill. When you are first learning it can be a frustrating experience. The most important thing is to be relaxed and not rush, accept that it is a learning process and let the improved vision or reduced pain be the motivation for success. Here are all the tricks and tips for successful lens applications.
Dry Hands, Dry Lids
Wet hands will cause your fingers to slide and prevent you from spreading and holding your eyelids apart. Additionally the oils from your eyelids or applied facial moisturizers can make lids slippery so for some, cleaning your eyelids will be an important step. In general the cleaner and dryer your fingers and eyelids are the better control you will have of your eyelids.
Inspect the Scleral Lens
Though scleral lenses are strong they can be damaged by forceful cleaning, improper handling, using cases that are too small for the lens, from dropping the lens, and by dragging the lens. After removing the lenses from the cleaning case, inspect the lens for scratches, chips, or cracks. If the lens is damaged it should not be worn. Call your provider to order a replacement lens. If the lens has debris or deposits on it, give the lens a gentle rub to clean the surface and then rinse the lens with saline.
Scleral Lens Dot Position
Most scleral lenses will have a black dot or dots at the edge of the lens to indicate a right or left lens and help with correctly positioning the lens on the eye. Make sure that you are set up correctly from the start. The typical arrangement is 1 dot to indicate a right lens and 2 dots to indicate a left lens. Generally these dots should be applied in a specific orientation, generally either the 6 o’clock or 12 o’clock position depending on the design your doctor has selected for you.
Preservative Free Sterile Saline and Scleral Lens
Use only the preservative free saline solutions prescribed by your doctor. Most salines found at CVS, Walgreens, or other stores are not designed to be placed under a scleral lens. Currently there are only a few FDA approved preservative free sterile saline options for scleral lenses: Menicon LacriPure, Contamac Nutrafill, Bausch + Lomb ScleralFil, Tangible Fill, PuriLens Plus Saline, and VibrantVue Scleral Saline. Be wary of salines and eye drops purchased on Amazon as they may be knock offs and not have FDA approval for use with scleral lenses.
Overfill Your Scleral Lens
Prior to applying your scleral lenses rub, rinse, and fill them with your prescribed saline. Overfill the scleral lens with the saline to avoid air bubbles, this is a critical step. Air bubbles under a lens will cause blurred vision and discomfort on application, and over time this will turn into pain, redness and tearing if the lens is not removed. One of the main causes of bubbles is not completely filling the lens with saline. Overfilling your scleral will ensure that no air is trapped under the lens.
Managing Air Bubbles
Bumping the lens into your lids or fingers on the way on to your eye can lead to spilling some saline which may lead to a bubble. Also releasing your lids too early can cause bubble issues as well. Hold your lids wide apart and hold the lens onto the eye prior to releasing the lens and closing your lids. If there is any chance that you may have an air bubble, remove, refill, and reapply the lens. If you consistently encounter issues with air bubbles, inform your eye care provider, this may simply be that you need further training or the lens shape needs to be modified.
Inspect the Scleral Lens on Your Eye
After applying your scleral lens take the time to inspect the lens on your eye. Ensure the lens is in the correct lens positioning to start (dot in the correct position and lens is centered) and verifying the absence of air bubbles. If you experience persistent difficulty achieving these steps, consult your eye care professional for further assistance. It is normal for lenses to rotate after being on the eye so do not worry if you placed your lens on at the 12 o’clock position and it has rotated to another position. If you apply your lens with the dots in the correct starting orientation the lens will rotate on its own to find its natural resting spot. Placing the lenses on your eye as directed is important as lenses that are not in the correct position can cause discomfort or blurry vision.
Scleral Lens Removal
There are several ways to remove a scleral lens but they all start with proper hand hygiene. The classic method of removal is to place a mirror on a flat surface,tilt your head downward, and look at yourself in the mirror. Gently pull down your lower eyelid and attach your small removal device (small plunger) toward the edge of the scleral lens and tip the lens off of the eye. Be sure not to blink during removal as it can scrape the lens across your eye. If the removal device is attached too close to the center of your scleral lens it will turn the lens into a big suction cup and will be very difficult to remove. If necessary and instructed to do so by your doctor, you can place your fingertip on your lower lid and apply some pressure to the eye just below of the edge of the lens to release scleral lens suction. Repeat the process for the other eye. If you experience pain, excessive suction, or difficulty removing the lens, contact your eye care professional promptly.
Daily Scleral Lens Care
After removing the lenses, thoroughly rinse and rub your lenses with your prescribed solutions as directed. Disinfect according to your eye care provider’s instructions, which typically involves overnight soaking in a disinfecting solution. Store the lenses in a clean case filled with fresh disinfecting solution. Reusing solutions can lead to contaminated lenses and open you up for infection. Your lens cases should be changed every 3 months or every time you get a new bottle of scleral lens cleaning solution, whichever occurs sooner. If you notice any changes in lens appearance, such as discoloration or cloudiness, consult your eye care professional before using them.
Additional Considerations
Always adhere to your eye care provider’s specific instructions for scleral lens care. Remove lenses before sleeping, avoid using tap water, and maintain regular follow-up appointments. If you experience any discomfort, irritation, or visual changes while wearing your lenses, promptly contact your eye care professional. By adhering to these guidelines and maintaining open communication with your eye care provider, you can ensure a successful and comfortable scleral lens wearing experience.
