How to Insert & Remove a Scleral Lens

How to insert a scleral lens 

STEP 1: PREPARATION

1. Thoroughly wash and dry your hands
2. Clean your work surface
3. Lay out all necessary equipment
4. Place a flat mirror on the table, if required
5. Clean the suction cup with a sterile alcohol wipe before use

STEP 2: LENS PREPARATION

1. Remove the lens from its case
2. Choose your holding method:
   • Option A: Large scleral lens suction cup
     • Attach suction cup to front of lens
     • If using non-vented suction cup, ensure it has a hole at the bottom (you can cut the bottom of the cup to expose a hole)
   • Option B: Manual method
     • Hold lens with 2-3 clean fingers
3. Fill the lens completely with unpreserved single-use saline
   • Fill to the absolute top
   • Ensure there are no air gaps
   • CRITICAL: Only use unpreserved single-use saline

STEP 3: POSITIONING

1. Lean forward
2. Tuck your chin to your chest
3. Position your face so it is parallel to the ground
4. Keep both eyes wide open
5. Use flat mirror on table for guidance if needed.

STEP 4: INSERTION

1. Eyelid position:
   • Pull your upper lid back with your thumb or finger
   • Hold the lids firmly by the eyelashes
   • Pull lower lid down and out of the way
2. Lens insertion
   • If using a suction cup:
     • Slowly bring the lens to your eye.
     • Continue moving the filled lens steadily towards the eye until it makes gentle contact
       • For vented suction cups with a hole, the lens will release automatically
       • For non-vented suction cups, squeeze the suction cup to release the lens
   • The DMV Scleral Stand has been designed to help you with insertion
3. Release eyelids slowly:
   1. Lower lid first
   1. Then upper lid
   1. Blink gently

STEP 5: VERIFICATION

1. Check for any air bubbles in the mirror
   • If bubbles are present you will have to take off the lens and re insert it:
     • Remove lens
     • Clean lens
     • Repeat insertion process
2. Assess comfort:
   • If the lens is uncomfortable:
     • Remove lens
     • Clean lens
     • Re-insert

How to remove a scleral lens 

Scleral lenses are best removed with a Rigid suction cup lens remover (small size) 

STEP 1: PREPARATION

1. Wash and dry your hands thoroughly
2. Moisten the small DMV plunger tip with unpreserved saline
3. Position yourself in front of a mirror

STEP 2: REMOVAL PROCESS

1. Open your eyes wide (as wide as during insertion)
2. Plunger placement:
   • Position the plunger on bottom third corner of the lens
   • IMPORTANT: Place the plunger on the edge, NOT the centre of lens
3. Break suction:
   • Option A: Use small DMV plunger
   • Option B: Put gentle finger pressure below lens to introduce an air bubble
4. Lift lens:
   • Remove the lens slowly
   • The lens should come away easily and not require too much force

AFTER REMOVAL CARE

1. Normal post-removal symptoms:
   • Temporary eye dryness
   • Mild redness (should resolve within minutes)
2. Clean all equipment:
   • Wipe suction cups and scleral stand with a sterile alcohol swab
   • Clean lens immediately
   • Store lens properly in fresh solution

EQUIPMENT CARE

1. Suction Cup Maintenance:
   • Clean with alcohol swab after each use
   • Inspect for damage regularly
   • Replace every 6 months or if dirty
2. DMV Scleral Stand (if used):
   • Clean after each use with an alcohol swab
   • Store in clean, dry place
3. Lens Case:
   • Clean daily
   • Air dry completely
   • Replace every three months or with every bottle of solution