Training Resources

Scleral Contact Lens Care Guide

Introduction to Scleral Lenses

Scleral contact lenses are large-diameter rigid gas permeable (RGP) lenses that rest on the white part of your eye (the sclera) rather than the cornea. This design creates a tear-filled vault over the cornea, which can provide exceptional comfort and vision correction for a variety of complex eye conditions, including severe dry eye, keratoconus, and irregular astigmatism.

Essential Daily Care Routine

Proper daily care is crucial to maintaining the health of your eyes and the longevity of your scleral lenses.

Step 1: Hand Hygiene

• Always wash your hands thoroughly with mild soap and water before handling your lenses.
• Dry your hands completely with a lint-free towel.

Step 2: Lens Insertion

• Before Insertion: Wash your hands thoroughly.
• Filling the Lens: Before inserting, fill the bowl of the scleral lens completely with a preservative-free sterile saline solution. Do NOT use tap water or any other solution not specifically approved for this purpose.

• Solutions we recommend to fill scleral lenses are Addipak Sterile Saline Solution, Scleralfil, and Purilens. Please note that Addipak Sterile Saline Solution is used off-label for filling scleral lenses. All scleral lens solutions can be found on Amazon by searching for their respective names.
• Insertion Tool: Many find a large plunger or insertion tool helpful for scleral lens insertion.
• Scleral lens insertion tools can be purchased from Amazon by searching for “DMV Scleral lens inserter”.

• Technique:
  1. Balance the saline-filled lens on your insertion tool.
  2. Look directly down.
  3. Use your other hand to hold your eyelids wide open, ensuring your eyelashes are out of the way.
  4. Slowly bring the lens straight towards your eye, keeping your head parallel to the ground.
  5. Gently place the lens onto your eye. Avoid trapping air bubbles under the lens.
  6. Release your eyelids and blink gently to settle the lens.
  7. Use a mirror to check for any air bubbles trapped under the lens. If air bubbles are present, you will need to remove the lens and re-insert.

Step 3: Lens Removal

• Before Removal: Ensure you have a clean, well-lit surface to place your lenses.
• Removal Tool: Use a DMV Scleral Cup or similar approved suction cup tool for removal.
• Scleral lens removal tools can be purchased from Amazon by searching for “DMV Scleral lens remover”.

• Technique:
  1. Moisten the suction cup with a few drops of saline solution.
  2. Gently press the cup onto the lower edge of the lens.
  3. Once the cup is attached, gently pull the lens down and away from your eye, breaking the suction.
  4. Repeat for the other eye.

Step 4: Cleaning

• Immediate Cleaning: Apply a few drops of an approved daily cleaner (e.g., Boston Simplus, Unique pH, or Clear Care, if specifically recommended for cleaning before disinfection).
• Rubbing: Gently rub both surfaces of the lens with your fingertip for 20-30 seconds.
• Rinsing: Thoroughly rinse the lens with solution to remove all cleaning solution and debris. Unique pH, Clear Care, and Boston Simplus are all available for purchase from Amazon by searching for their respective names.

Step 5: Disinfection and Storage

• Place lenses in the baskets and rinse for 5 seconds with Clear Care solution
• Fill the Clear Care case to the fill line with Clear Care solution
• Assemble the case and tighten. Allow lenses to soak for a Minimum of 6 hours. Applying lenses prior to minimum 6 hour soak time may result in injury to the eye.

• Store the lid of the case upside down when not in use to avoid contamination.
• Never apply Clear Care solution in or around eyes without neutralizing in case, doing so may result in injury to the eye.
• After removing the lenses, empty the used disinfecting solution from the lens case.
• Never reuse old solution.
• Only use the lens case provided in combination with Clear Care solution. The Clear Care case has a special metal disc that neutralizes the hydrogen peroxide solution over the course of 6 hours. Using Clear Care solution with any other case not included with purchase of solution may result in injury to the eye.
• Replace Clear Care case every time you purchase a new solution. The solution will always include a new case.
• Clear Care solution can be purchased through Amazon by searching for “Clear Care Contact Solution”.

Important Do's and Don'ts

Do's:

• Do follow your eye care professional's specific recommendations for solutions and care routines.
• Do always use fresh solution each time you store your lenses.
• Do clean and air dry your lens case daily after pouring out the old solution.
• Do schedule regular follow-up appointments with your eye care professional to monitor your eye health and lens fit.
• Do carry a small bottle of preservative-free saline for rinsing or re-wetting throughout the day if needed.
• Do have an emergency backup pair of glasses or spare lenses.

Don’ts:

• Don't use tap water or saliva to rinse or store your lenses.
• Don't sleep in your scleral lenses unless specifically instructed by your eye care professional.
• Don't share your lenses with anyone.
• Don't "top off" old solution in your lens case; always discard the old solution and use fresh.
• Don't use expired solutions.
• Don't use solutions not specifically approved for RGP or scleral lenses.
• Don't ignore redness, irritation, pain, or blurred vision. Remove your lenses immediately and contact your eye care professional.
• Don’t swim or shower in scleral lenses

When to Contact Your Eye Care Professional

Contact your eye care professional immediately if you experience any of the following:

• Sudden or persistent pain
• Significant redness or irritation
• Decreased vision
• Excessive tearing or discharge
• Light sensitivity
• Any signs of eye infection

Following this guide diligently will help ensure optimal vision, comfort, and eye health while wearing your scleral contact lenses.

Orthokeratology Contact Lens Care Guide

This guide provides essential instructions for the proper care and handling of your orthokeratology (Ortho-K) contact lenses. Following these guidelines diligently is crucial for maintaining lens hygiene, preventing complications, and ensuring the continued effectiveness of your vision correction.
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Daily Care Routine

Morning Routine

• Lens Removal:
  • Wash your hands thoroughly with soap and water and dry them with a lint-free towel.
  • Ensure your fingers are completely dry to avoid the lens sticking to them.
  • Place a few drops of lubricating or rewetting drops into each eye to help loosen the lens.
  • Using a small suction cup (as instructed by your eye care professional), carefully remove each lens.
  • Immediately after removal, place each lens in its designated well in your lens case.

• Lens Disinfection and Storage (Clear Care Solution):
  • Place lenses in the baskets and rinse for 5 seconds with Clear Care solution
  • Fill the Clear Care case to the fill line with Clear Care solution
  • Assemble the case and tighten. Allow lenses to soak for a Minimum of 6 hours.
  • Applying lenses prior to minimum 6 hour soak time may result in injury to the eye.
  • Store the lid of the case upside down when not in use to avoid contamination.
  • Never apply Clear Care solution in or around eyes without neutralizing in case, doing so may result in injury to the eye.
  • Clear Care solution can be purchased through Amazon by searching for “Clear Care Contact Solution”

Evening Routine (Before Insertion)

• Lens Rinsing:
  • Wash your hands thoroughly with soap and water and dry them with a lint-free towel.
  • Remove the lenses from the storage case.
  • Rinse each lens with Unique pH solution to condition the lens and to remove any residual disinfecting solution.
  • Unique pH solution can be purchased from Amazon by searching for “Unique pH contact lens solution”

• Lens Insertion:
  • Ensure your fingers are completely dry.
  • Place a few drops of lubricating or rewetting drops into each eye, or directly onto the concave side of the lens, as instructed by your eye care professional. This helps with comfort and proper suction.
  • Carefully place the lens on your fingertip.
  • With your other hand, pull down your lower eyelid and gently pull up your upper eyelid to hold your eye open.
  • Look straight ahead and gently place the lens directly onto the center of your eye.
  • Slowly release your eyelids and blink a few times to settle the lens.
  • Repeat for the other eye.
  • Apply lenses right before bed as lenses are designed for optimum comfort with eyes closed.

• Case Care:
  • After removing the lenses, empty the used disinfecting solution from the lens case.
  • Never reuse old solution.
  • Only use the lens case provided in combination with Clear Care solution. The Clear
  • Care case has a special metal disc that neutralizes the hydrogen peroxide solution over the course of 6 hours. Using Clear Care solution with any other case not included with purchase of solution may result in injury to the eye.
  • Replace Clear Care case every time you purchase a new solution. The solution will always include a new case.

General Hygiene and Safety Tips

• Always wash your hands: Before handling your lenses, always wash your hands thoroughly with soap and water and dry them with a lint-free towel.
• Use fresh solutions: Always use fresh, sterile contact lens solutions. Never reuse old solution.
• Never use tap water: Do NOT use tap water, distilled water, or saliva to rinse or store your lenses. These can contain microorganisms that cause serious eye infections.
• Follow solution instructions: Adhere strictly to the instructions provided by your eye care professional and the contact lens solution manufacturer regarding soaking times and cleaning procedures.
• Replace your lens case: Replace your contact lens case regularly, typically every 1-3 months, to prevent bacterial buildup.
• Never sleep with lenses not meant for overnight wear: Ortho-K lenses are designed for overnight wear. However, if you are using any other type of contact lens, do not sleep in them unless specifically prescribed for extended wear.
• Do not share lenses: Never share your contact lenses with anyone.
• Keep solutions capped: Keep all lens solution bottles tightly capped when not in use.
• Avoid expired products: Do not use expired contact lens solutions.
• Regular eye exams: Schedule regular follow-up appointments with your eye care professional as recommended to ensure your eyes remain healthy and your lenses are fitting correctly.
• Redness, Irritation, Pain (R.I.P.): If you experience redness, irritation, pain, blurred vision, or excessive tearing, remove your lenses immediately and consult your eye care professional.

When to Contact Your Eye Care Professional

Contact your eye care professional immediately if you experience any of the following symptoms:

• Redness
• Pain or discomfort
• Blurred or hazy vision
• Excessive tearing or discharge
• Unusual light sensitivity
• Swelling

These could be signs of an eye infection or other serious complication that requires immediate attention. By diligently following this care guide, you can maximize the benefits of your orthokeratology treatment and maintain optimal eye health.

Soft Contact Lens Care Guide

Caring for your soft contact lenses properly is crucial for maintaining good eye health and comfortable vision. This guide outlines the essential steps for cleaning, disinfecting, and storing your lenses.

Daily Cleaning and Disinfection

Before Handling Lenses

• Wash Your Hands: Always wash your hands thoroughly with soap and water and dry them completely with a lint-free towel before touching your contact lenses. This prevents the transfer of dirt, oils, and microorganisms to your lenses and eyes.
• Prepare Your Workspace: Work over a clean, flat surface to avoid losing or damaging your lenses.

Cleaning Your Lenses

1. Remove One Lens: Start with the same eye every time (e.g., always the right eye first) to avoid mixing up your lenses.
2. Place in Palm: Place the removed lens in the palm of your clean, dry hand.
3. Apply Solution: Apply a few drops of fresh, multi-purpose contact lens solution onto the lens. Never use tap water, saliva, or any non-sterile solutions.
4. Rub Gently: Gently rub the lens with your index finger for about 10-20 seconds on both sides, using a back-and-forth or circular motion. Be careful not to tear the lens. This step helps remove protein, lipid, and debris buildup.
5. Rinse Thoroughly: Rinse the lens thoroughly with more fresh multi-purpose solution to flush away loosened debris

Disinfecting and Storing

1. Fill Lens Case: Fill each chamber of your clean contact lens case with fresh multi-purpose solution. Never "top off" old solution.
2. Place Lenses in Case: Place the cleaned and rinsed lens into its designated chamber in the lens case.
3. Repeat for Other Eye: Repeat the cleaning and rinsing process for the other lens and place it in its chamber.
4. Close and Soak: Close the lens case tightly and allow the lenses to soak for the recommended disinfection time, as indicated on your contact lens solution packaging (usually at least 4-6 hours or overnight).

Important Considerations

• Lens Case Hygiene:
  • Rinse your lens case with fresh solution after each use and leave it open to air dry completely.
  • Replace your lens case every 1-3 months to prevent bacterial buildup.
• Solution Expiration: Always check the expiration date on your contact lens solution and discard any expired solution.
• Never Reuse Solution: Always use fresh solution for cleaning, rinsing, and storing your lenses. Reusing solution significantly increases the risk of eye infections.
• Avoid Tap Water: Tap water contains microorganisms that can cause serious eye infections. Never use tap water for cleaning or rinsing your lenses or lens case.
• Do not reuse daily contact lenses
• Cosmetics and Sprays: Put on contact lenses before applying makeup. Avoid direct contact of hairspray, aerosols, and other sprays with your lenses.
• Sleep: Unless specifically instructed by your eye care professional, never sleep in your soft contact lenses. Extended wear lenses are an exception, but still require proper care.
• Swimming/Showering: Remove your lenses before swimming or showering to avoid exposure to waterborne microorganisms. If you must wear them, wear tight-fitting goggles.
• Redness, Irritation, Pain (R.I.P.): If you experience redness, irritation, pain, blurred vision, or excessive tearing, remove your lenses immediately and consult your eye care professional.
• Regular Eye Exams: Schedule regular eye exams with your ophthalmologist or optometrist as recommended (usually annually) to ensure your eyes are healthy and your contact lens prescription is up-to-date.

By following these guidelines, you can help ensure the longevity of your contact lenses and, more importantly, the health and safety of your eyes.

Product Recommendations

Soft Contact Lens Solutions:

Rewetting drops:

What to Expect After Cataract Surgery

This guide provides important information about what you can expect in the days and weeks following your cataract surgery. Understanding these expectations will help ensure a smooth recovery.

Immediately After Surgery

After your cataract surgery, your eye will be covered with a shield or patch to protect it. It is normal to experience some mild discomfort, itching, or a feeling of grittiness in the eye.

1-7 Days Post-Surgery

Your vision will begin to improve rapidly during the first few days. It's crucial to follow all post-operative instructions carefully to prevent complications.

• Eye Drops: You will be prescribed various eye drops (antibiotic, anti-inflammatory) to prevent infection and reduce inflammation. Administer these exactly as instructed by your surgeon.
  • Antibiotic: Besivance or Ofloxacin - 1 drop 3x/day for 1 week
  • Steroid: Lotemax or Prednisolone Acetate - 1 drop 3x/day for 1 week then 2x/day for 2 weeks
  • NSAID: Prolensa (1x/day for 1 month) or Diclofenac (1 drop 3x/day for 1 month)
• Protection: Continue to wear the eye shield at night and during naps for the first week to prevent accidental rubbing or pressure on the eye.
• Activities to Avoid for 1 week:
  • Bending over, heavy lifting, or strenuous activities.
  • Rubbing or pressing on the operated eye.
  • Swimming or using hot tubs.
  • Wearing eye makeup.

1 week-1 month Post-Surgery

Your vision will continue to stabilize and improve over the next several weeks.

• Vision Improvement: While initial improvement is quick, full visual recovery can take several weeks as your eye heals and adjusts.
• Follow-up Appointments: Attend all scheduled follow-up appointments with your co-managing optometrist. These are essential to monitor your healing process and address any concerns. The typical follow up schedule is 1-day, 1-week, 1-month, 3-months, and 6-months after your surgery. However, this follow up schedule may be adjusted depending on how you are recovering.
• Return to Work/Activities: Most people can return to light activities and work within a few days, but strenuous activities should be avoided for several weeks.

When to Contact Your Doctor

While complications are rare, it's important to be aware of symptoms that require immediate medical attention. Contact your doctor immediately if you experience:

• Sudden decrease in vision
• Severe eye pain
• New floaters or flashes of light
• Increased redness or discharge from the eye

For non-emergency questions or concerns, please contact our office at (805) 495-4625 or DLV Vision at (805) 987-5300, or leave a message. If you are experiencing a medical emergency, please go to the nearest emergency room.

Vision Expectations

Your vision after cataract surgery should be improved but your dependence upon glasses or contacts will vary depending on the type of intraocular lens you chose. Glasses or contact lenses cannot be prescribed while the eye is still healing. We will wait a minimum of 1 month after your surgery for your vision to settle before prescribing glasses or contact lenses.

• Standard IOL - Spherical IOL, does not correct for astigmatism or reading at near. May need glasses for distance. Will need glasses for reading.
• Premium IOL - Will correct for astigmatism and give some range of focus at near. Will not likely need distance glasses. May need reading glasses for very small print depending on the type of intraocular lens you chose.

There is also the option of having a touch up laser procedure to correct for residual vision correction. This will be reserved for 3 months after your surgery to allow time for your vision to stabilize

Posterior Capsule Opacification (PCO):

• Approximately 90% of patients that undergo cataract surgery will develop a thin layer of cells on the back of their lens implant termed posterior capsule opacification. This is the most common occurence associated with cataract surgery and can develop anywhere from a few months to a few years after surgery. PCO will cause symptoms such as blurred vision and glare similar to the original cataract. If it is found that you developed PCO, you will be referred back to your surgeon for a simple laser procedure called a YAG capsulotomy which will clear the PCO. The YAG capsulotomy is a one time procedure that will not need to be repeated.

We are committed to providing you with the best possible care throughout your recovery. If you have any questions or concerns not addressed in this guide, please do not hesitate to ask your medical team