Some Questions and Answers on Scleral Contact Lenses from Dr. Folman

What are scleral contact lenses?

Scleral lenses are a type of rigid gas permeable contact lens specially designed for eyes that are otherwise difficult to fit in traditional soft contact lenses. The lens material is harder than traditional soft contacts, which allows for a more customized fit, and the most superior optics of any lens available. The wide diameter of the lens allows it to sit on the white part of the eye, rather than drape over the more sensitive cornea. The lens is filled with a non-preserved saline solution before inserting it onto the eye. In this way, the lens vaults over the cornea, protecting it and keeping it hydrated all day long.

What conditions can be treated with scleral lenses, and who is a good candidate?

While anyone can be fit with a scleral lens, it has become the lens of choice for patients with irregularly shaped corneas, such as patients with keratoconus, corneal graft recipients, corneal dystrophy patients, patient with incomplete eyelid closure, and patients with severe dry eye. If a doctor has ever told you that you cannot be fit in contact lenses, you may be a good candidate for scleral lenses!

How do scleral lenses work?

Vision is a complex neurological process that begins with light entering the eye and being bent (or refracted) to a focal point on the retina. When the front of the eye does not have a smooth spherical shape, light entering the eye scatters, creating optical aberrations, and defocus on the retina. We see this in many ocular conditions that produce an irregularly shaped cornea.

The scattered light is interpreted by the brain as a blurry image, glare, halos, or distortion. Scleral lenses vault over the cornea, creating an artificially smooth front surface of the eye. The space between the contact lens and the cornea is filled with non-preserved saline, creating an optical system that masks any irregularities to the front surface of the eye. Light is then free to enter the eye and come to a crisp focal point on the retina. As an additional benefit, the saline keeps the eye hydrated throughout the day for added comfort.

What types of scleral lenses are there?

There are multiple manufacturers that produce scleral lenses. The difference between them are the fitting philosophies and the available curvatures and parameters. Our doctors will select the best lens for your eyes based on your corneal topography and the underlying condition being treated.

Are scleral lenses typically covered by medical or vision insurance?

In the vast majority of cases, scleral lenses are used to treat an underlying ocular condition. A prior authorization may need to be submitted to your medical insurance company to be fit in this specialty lens. This is handled by our billing department. Most insurance companies approve and pay for the fitting process and cost of the lenses. In some cases, the patient may be responsible for part of the balance. This is worked out prior to the fitting so that you do not receive any surprise bills.

How long do the lenses last?

Because the lenses are made of a rigid gas permeable material, they have a much longer life than traditional soft contact lenses. Depending on how well you care for the lenses, and your tear film’s ability to rewet the lens surface, scleral lenses usually last 1-2 years.

Will scleral lenses eliminate my need for glasses?

For nearly all patients, scleral lenses eliminate the need for distance glasses. However, if patients are over 40 years old, they may still require reading glasses to be worn over their contact lenses to see clearly at all distances.

To learn more about Scleral Lenses and other hard to fit contacts, click here.

Whether you live in a climate with cold winter weather or you are planning a ski trip up north, winter can be a challenge if you suffer from dry eyes. Dry, cool air, cold winds and even drier indoor heating can cause eye irritation, burning, itchiness and redness, and sometimes even excessively watery eyes as more tears are produced to compensate for the dryness. Many people have a chronic feeling that they have something in their eye and some even experience blurred vision. These symptoms can be debilitating!

Dry eyes is one of the most common complaints eye doctors get from patients during the winter season, especially in the cooler climates. That’s why we’d like to share some tips on how to relieve dry eye discomfort, and how to know when your condition is serious enough to come in for an evaluation.

“Dry, cool air, cold winds and even drier indoor heating can cause eye irritation, burning, itchiness and redness”

Tips to Relieve Winter Dry Eyes:

1. Keep eyes moist using artificial tears or eye drops. You can apply these a few times each day when the eyes are feeling dry or irritated. If over-the-counter drops don’t help or if you have chronic dry eyes, speak to your eye doctor about finding the best drops for you. Since not all artificial tears are the same, knowing the cause of your dry eye will help your eye doctor determine which brand is best suited for your eyes.
2. Use a humidifier to counteract the drying effects of indoor heaters or generally dry air.
3. Point car vents or indoor heaters away from your face when the heat is on. Try to keep your distance from direct sources of heating, especially if they blow out the heat.
4. Drink a lot! Hydrating your body will also hydrate your eyes.
5. Protect your eyes outdoors with sunglasses or goggles – the bigger the better! Larger, even wrap-around glasses as well as a hat with a wide brim will keep the wind and other elements out of your eyes. If you wear goggles for winter sports, make sure they fit well and cover a large surface area.
6. Soothe dry eyes using a warm compress and never rub them! Rubbing your eyes will increase irritation and may lead to infection if the hands are not clean.
7. Give your eyes a digital break. People blink less during screen time which is why extensive computer use can lead to dry eyes. Follow the 20/20/20 rule by taking a break every 20 minutes to look 20 feet away for 20 seconds and make sure you blink!
8. For contact lens wearers: If you wear contact lenses, dry eyes can be particularly debilitating as the contact lenses can cause even further dryness and irritation. Contact lens rewetting drops can help your eyes feel better and may also allow you to see more clearly. Not all eyedrops are appropriate for use with contact lenses, so ask your optometrist which eyedrop is compatible with your contacts and cleaning solution. If rewetting drops don’t help, consider opting for glasses when your dry eyes are bad, and speak to your optometrist about which brands of contact lenses are better for dry eyes. Many people find dry eye improvement when they switch to daily single use contact lenses.”

Chronic Dry Eyes or Dry Eye Syndrome

Dry eye syndrome is a chronic condition in which the eyes do not produce enough tear film, or do not produce the quality of tear film needed to properly keep the eyes moist. While winter weather can make this condition worse, it is often present all year round. If you find that the tips above do not alleviate your discomfort or symptoms, it may be time to see a optometrist to see if your condition requires more effective medical treatment. ”

Call Dr. Martin D. Arkin, P.C. on (203) 866-3280 in Norwalk, CT to schedule an eye exam with our optometrist.

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Regular exercise is an essential component of overall health and wellness. It is proven that exercise reduces sickness and disease; it increases strength, immunity, and mental health; and it also helps regulate bodily functions and maintain a healthy weight. Research shows that exercise can lower our risk of chronic conditions such as high blood pressure, heart disease, diabetes, diabetic retinopathy and diabetic macular edema, as well as other eye diseases such as glaucoma, cataracts and wet age-related macular degeneration (AMD).

Whereas, a sedentary lifestyle increases the risk of these diseases and of vision loss, studies show that even moderate exercise at least three times a week can improve the prognosis of the above-mentioned chronic illnesses and reduce the risks of developing vision threatening eye diseases.

Inactivity is an even higher risk factor if you have other co-factors for developing eye diseases, including: a family history, previous eye injury or surgery, diabetes, high blood pressure or very high myopia. A combination of healthy lifestyle habits which include regular exercise and a nutritious diet and tending to your mental and emotional well-being can reduce these risks significantly.”

“Regular exercise is an essential component of overall health and wellness.”

Tips for Incorporating Physical Activity Into Your Day

Make it a priority. Schedule your exercise time into your day as if it is a non-negotiable appointment. Find the time of day that works best – for some that is early morning and for others late at night. Work your way up to a half hour at least three times a week.
Be realistic. You don’t need to become a fitness expert to experience the benefits of exercise. Walking, yoga, swimming, even dancing around the house are all options for staying fit. Find a type of exercise that you love so you will enjoy working this habit into your life.
Just move. Find ways to move your body throughout your day. Park your car a little further away from the mall entrance, take the stairs instead of the elevator or walk or bike to work. Remember, every little bit of movement helps.
Find something you enjoy. Often finding the right exercise is a good stress reliever, and reducing stress will also reduce risk of many chronic diseases.
It’s never too late. Exercise for the elderly can be a challenge especially during the cold winter months, when many seniors can’t get out of the house due to the weather. Even walking up and down the stairs in the house or following an exercise video can be helpful to keep from being sedentary.”

Protection & Prevention of Eye Conditions

If you are exercising outdoors or playing contact sports, make sure to protect your eyes with sunglasses or sports safety glasses to ensure your eye health and safety.

Regular exercise can significantly decrease your risks of certain eye conditions but you still have to ensure that you visit your eye doctor for regular exams. Schedule a comprehensive eye exam every year to ensure your vision and your eyes are healthy and to catch any possible problems as early as possible.”

Eye health and disease prevention are just two of the many health and wellness benefits you gift yourself when you make exercise a regular part of your lifestyle. Speak to your doctor if you have any health issues that need to be considered. At any age or level of physical fitness, you can find some form of exercise that works for you.

Call Dr. Martin D. Arkin, P.C. on (203) 866-3280 in Norwalk, CT to schedule an eye exam with our optometrist.

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Alternatively book an appointment online here CLICK FOR AN APPOINTMENT

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You Don’t Have to Live With Dry Eyes

Have you noticed that your eyes feel chronically dry, itchy, scratchy or even sometimes watery? Many people that have these symptoms just go on with their lives until the symptoms become unbearable. What they don’t realize is that these are signs that they might be suffering from dry eye syndrome, a condition in which the eyes are not able to produce enough tears to effectively lubricate the eyes. This is a problem that won’t just go away on its own.

What causes Dry Eye?

Dry Eye Syndrome, also known as Tear Film Dysfunction is characterized by a reduction in the amount or quality of tears that are produced. Tears are essential for optimal eye health, vision and comfort. Ideally, tear film covers the eyes at all times to prevent the eyes from drying out and to ensure clear vision. If the glands that produce tears start to produce fewer tears or tears that don’t have the proper balance of water, oils, proteins and electrolytes, the tear film with become unstable, allowing dry spots to form on the surface of the eye, and cause disruptions in outer barrier of the eye’s epithelial surface. This disruption in the outer barrier allows microbes to invade the eye, leading to irritation and infection. The condition can be caused by many factors, including tear gland dysfunction, eyelid problems, medications or environmental factors.

Symptoms of Dry Eye

As mentioned above, many of the symptoms of dry eye involve varying sensations of dryness including, burning, stinging, itching, grittiness, soreness or a feeling that there is something in the eye. The eyes may also be red and sensitive to light, wind or smoke. Vision may be blurred or doubled and the eyes may fatigue easily. Another common symptom is that vision seems blurry but clears when you blink (especially common when reading or using a computer). This is because the tear film does not form a smooth coat over the eye surface or it evaporates too quickly causing a blur.

You may also notice pain, some discharge from the eye (especially upon waking in the morning) and experience discomfort when wearing contact lenses. One of the most confusing symptoms of dry eye is actually excessive tearing, which occurs because the eyes are trying to compensate for the lack of moisture – however the tears produced are low quality and don’t properly hydrate the surface of the eye.

Reducing Symptoms

The first thing to look at when you have dry eyes is whether you are taking any medications, engaging in certain behaviors or being exposed to environmental factors that may be causing the condition. Medications that may cause dry eye as a side effect include:

• Antihistamines and Decongestants
• Diuretics
• Sleeping pills
• Birth Control pills
• Antidepressants
• Acne medications
• Angiotensin-converting enzyme (ACE) inhibitors
• Opiate-based painkillers such as morphine

Important! Never stop medication without the approval of your doctor! If you are taking a medication that may be causing dry eye, don’t stop taking the medication without speaking to your healthcare provider first. Treating dry eye symptoms may be a simpler solution than stopping or switching medications.

You may be able to alter your environment to reduce symptoms of dry eye as well. Environmental factors that can exacerbate dry eye include:

• Wearing contact lenses
• Extended use of computers or other electronic devices
• Exposure to dry, windy climates or blowing air (such as an air conditioner or heater).
• Exposure to smoke
• High altitudes

Treatment for Dry Eye

If you are experiencing dry eye symptoms, make an appointment with your optometrist. The diagnosis and treatment will be based on a complete examination of your eyes, your medical history and your personal circumstances around the condition. The doctor may decide to perform a tear film test that can determine the quantity and quality of the tears and whether your tear glands and tear film are functioning properly.

The type of treatment will depend on the underlying cause of the problem. Treatment may include behavioral or environmental changes such as using a humidifier, wearing sunglasses in windy weather, reducing computer time or changing to a different type of contact lens, as well as medical treatments that may include:

• Artificial tears, eye drops or ointments to lubricate eyes
• Steroid or antibiotic drops or pills may be used for certain conditions such as blepharitis
• Reducing the drainage of tears by blocking tear ducts with silicone plugs
• Medications which reduce inflammation and trigger tear production can be prescribed
• In some situations a surgical procedure might be recommended
• Scleral lenses that hold moisture on the surface of the eyeball

The most important thing you should know about dry eyes is that you do not have to suffer. Treatments are available to increase moisture on your eye and reduce the uncomfortable and sometime debilitating symptoms. If you are suffering, schedule an appointment with your eye doctor and get the relief you deserve.

Eyeglasses Are Back!

Picking out new eyeglasses can be a daunting task, whether you’re getting your very first pair or you’ve worn them nearly all your life. The sheer volume of eyeglass choices can be torture to work your way through if you don’t have any idea what you’re looking for.

Not only are there many different shapes and colors in eyeglass frames, but advances in technology have also brought us a variety of new materials, for both the frames and the lenses, which makes eyeglasses more durable, lightweight and user-friendly. Eyeglass frames are now created from high-tech materials such as titanium and "memory metal" for the ultimate in strength and style, while the lenses are now thinner and lighter than ever before, even in high prescriptions.

Lens options, such as anti-reflective coating, light-changing tints, progressive lenses and new high-tech, light weight materials such as Trivex(TM) and polycarbonate, let you choose a pair of eyeglasses that enhances your vision, no matter what you like to do.

Link to a LASIK article or other news items here . . .

Dr. Seewell recently was a featured speaker at Vision Expo East which was attended by more than 15,000 eyecare professionals from around the world.

Dr. Seewell spoke about integrating new technology into an optometric practice and used examples of technology found in our own practice.