Which is which? Scleral lens devices and alternative application and removal tools.
by Jaclyn Charbonneau, OD
Beginning your scleral lens journey may feel intimidating, especially when learning how to apply and remove scleral lenses on your own. Whether you struggle with dexterity, maintaining steady fixation, or opening your eyelids wide enough, a variety of devices are available to help make the process easier.
Scleral lenses are typically applied using a large suction cup and removed with a smaller one. For added convenience, single dual-sided tools also exist for both application and removal.
One of the biggest challenges during application is keeping the lens centered without spilling too much saline and holding both eyelids open. Scleral lens application devices help by securely holding the lens for you, freeing up both hands to focus on keeping the eyelids held open. This added stability can make the process much easier!
A low-cost do-it-yourself version of a scleral lens stand can be a helpful place to start. Simply create a small hole in the bottom of a styrofoam cup and insert a large suction cup tool into the opening with the cup positioned upside down on a flat surface. You may choose to use a vented tool or cut off the tip of a traditional (non-vented) applicator to create a viewing port through the center. For additional fixation assistance, position an electric tea light or phone flashlight beneath the cup to provide a visual target and help guide proper lens alignment during application.
Scleral lens applicator stands can also be purchased. The simplest ones, which function similarly to the DIY stand, hold the application tool and are available at different heights depending on what is most comfortable for you. Others are designed for portability, and some even have a light that shines through the application tool to help you with fixation. No matter which you choose, these devices are made to stabilize the lens and free up both hands to hold your eyelids while applying your scleral lenses.
Figure: Samples of various devices used to hold a scleral lens while applying it to the eye
Alternatively, if holding your eyelids open with one hand is not a challenge, but you have difficulty balancing the scleral lens on a large suction cup inserter, there are other insertion techniques you may find helpful.
One option is the tripod method, which uses your thumb, index finger, and middle finger to create a stable platform for the lens. While balancing the saline-filled lens on your three fingertips, use your other hand to hold your eyelids open. Then, bend forward and carefully guide the lens toward your eye.
Another effective option is a ring tool. A ring tool features a small cup attached to a ring that supports the scleral lens during insertion. Place the ring on your index finger, fill the lens with saline, and, while leaning forward, guide the lens toward your eye. Many wearers find the ring tool provides greater stability and control than a traditional large suction cup inserter.
Finding the right device for you depends on your individual needs. Whether you're just getting started or are a seasoned wearer looking to improve your technique, your optometrist and eye care team can help you determine which devices may work best for you as you build confidence with scleral lens wear.