Contact Lens Case Reports
A New Lens Cleaning Technique
BY PATRICK J. CAROLINE, FAAO, & MARK P. ANDRÉ, FAAO
Surface deposits and nonwetting are common problems associated with modern scleral lenses. The underlying condition (often surface disease-related) combined with the high (100+)-Dk lens materials, can be a recipe for this complication. Traditionally, patients managed this problem by removing, cleaning, and reapplying their lenses. This exercise has always been a source of frustration for our patients, especially in the early stages of the scleral lens-wearing experience.
Recently, while visiting Dr. John Mountford in Brisbane, Australia, he introduced us to an alternative to traditional lens cleaning that he calls the “squeegee technique.” This technique allows patients to clean and rewet scleral lenses without lens removal.
Figure 1. Surface debris on the patient’s scleral lens.
Figure 2. The “squeegee technique” with a hollow DMV wetting/conditioning solution and application of the rubber device to the surface of the contact lens.
The Cleaning Technique
Our patient was a 32-year-old female who had keratoconus. She was intolerant to rigid lenses as well as to numerous attempts with piggyback lenses. She was successfully fitted with scleral lenses and reported good comfort and vision. Despite appropriate cleaning, storage, and handling techniques, the patient experienced occasional surface debris and nonwetting of her lenses (Figure 1). To manage these problems, we introduced her to the “squeegee technique.”
The technique begins by placing a drop of wetting/conditioning solution onto the tip of a vented DMV device (the hollow DMV device that allows patients to control the suction by squeezing the handle, Figure 2). The rubber device is placed directly onto the scleral lens surface and moved in a circular fashion around the surface of the lens for approximately 15 seconds. Following removal of the device, the lens surface is cleaned and any areas of nonwetting have been eliminated (Figure 3).
Figure 3. The clean and well-wetted surface following the on-eye cleaning technique.
Figure 4. Another patient before and after the “squeegee technique.”
For patients who are heavy depositors, we instruct them to use the technique four times a day to prevent the formation of surface deposits. Figure 4 illustrates another patient before and after the on-eye cleaning technique.
Keep Improving Lens Wear
Every day we are learning more about the emerging technologies surrounding scleral lenses. Whether it is patient selection, lens design, or patient instruction/management, it is important to stay abreast of new techniques so as to improve our patients’ success with this new modality. CLS
Patrick Caroline is an associate professor of optometry at Pacific University. Mark André is an associate professor of optometry at Pacific University. He is also a consultant for CooperVision.