Putting in scleral lenses takes practice, but the technique is straightforward once you learn the steps. Most new wearers need a week or two of daily practice before insertion feels routine. The key differences from regular contacts: you fill the lens bowl with saline before inserting, you look straight down into a flat mirror, and your body positioning matters more than you’d expect.
What You Need Before You Start
Wash your hands with a non-moisturizing soap. Soaps with lotions, oils, or moisturizing ingredients leave a film on your fingers that transfers to the lens surface, causing foggy vision and discomfort. Dry your hands on a lint-free cloth or towel, not a fluffy cotton towel that sheds fibers.
Gather your supplies: a preservative-free saline solution, a flat mirror you can lay on a table or counter, and your insertion tool if you use one. For saline, your eye doctor will recommend a specific brand, but common options include ScleralFil, Purilens Plus, LacriPure, Nutrifill, and Tangible Fill. Most come in single-use vials. The important thing is that the saline is preservative-free, since preserved solutions can irritate the eye when trapped under the lens for hours.
Place the flat mirror on a table and sit or stand so you can lean over it, looking straight down. Before touching your lenses, inspect your eyes in the mirror for unusual redness or discharge. Then hold each lens up to the light and check for chips, debris, or cloudy spots.
Insertion With the Tripod Method
The tripod (or three-finger) method uses your thumb, index finger, and middle finger to cradle the lens. Always start with the same eye each time so you never mix up which lens goes where.
Balance the lens on your three fingertips with the bowl facing up. Fill the bowl completely with preservative-free saline, creating a slight dome of fluid over the rim. Overfilling is better than underfilling. When the bowl isn’t full enough, air gets trapped underneath the lens during insertion, creating a bubble that blurs your vision and may need to be corrected by removing and reinserting the lens.
Now lean forward so your face is parallel to the floor and look straight down into the flat mirror. This position feels exaggerated at first. Some people describe it as feeling like they’re nearly standing on their head. But keeping your face truly parallel to the floor is what prevents the saline from spilling out of the bowl before the lens reaches your eye. If you’re losing fluid on the way up, you’re not leaning forward enough.
With your non-dominant hand, hold both your upper and lower eyelids wide open. This is the part that takes the most practice. You need to keep both lids pulled back far enough that the lens can pass between them without catching on your lashes. Don’t let go of your lids until the lens is fully on your eye.
Bring the lens straight up toward the center of your eye while looking at your reflection (or a small fixation dot drawn on the mirror). When you feel the cool saline touch your eye, gently press the lens against your eye and release your fingers. The lens will settle into place. Blink a few times to help it center itself, then repeat with the other eye.
Insertion With a Plunger or Stand
A DMV plunger (also called a suction cup) is a small rubber-tipped tool that holds the lens steady so you don’t have to balance it on your fingertips. Lightly squeeze the plunger’s grip and place the lens in the center of the suction cup. Release your grip so the suction holds the lens in place, then fill the bowl with saline just as you would with the tripod method.
The plunger occupies one hand, which leaves only your other hand to manage both eyelids. For some people this is easier because the plunger is more stable than three fingers. For others, it’s harder because they need both hands to control their lids. Try both approaches and see which feels more natural.
If holding the plunger, controlling your lids, and maintaining fixation all at once feels like too much, a scleral lens stand can help. These small tabletop devices hold the plunger upright so the filled lens sits at a fixed height. You lean over the stand, use both hands to hold your eyelids open, and lower your eye down onto the lens. Some stands include a small fixation light that gives your eye something to focus on, which reduces the reflex to look away as the lens approaches. Stands are especially useful for people with tremors or limited dexterity.
How to Remove Scleral Lenses
Removal uses a smaller DMV suction cup than the one used for insertion. Look straight ahead in a mirror. Place the suction cup near the edge of the lens (not the center over your cornea). Press gently to create suction, then tilt the plunger away from your eye. The edge of the lens will lift, breaking the seal, and the lens will come off. If you place the suction cup directly in the center of the lens and pull straight out, you create unnecessary pressure against your eye.
Dealing With Air Bubbles
Air bubbles are the most common problem new wearers face. A bubble trapped under the lens appears immediately after insertion, so you’ll know right away. Small bubbles (around 2mm or less) generally don’t affect your vision or eye health. Larger bubbles are a different story: they distort your vision, disrupt the lens fit, and can dry out the corneal surface underneath.
If you see a large bubble, the fix is simple but annoying. Remove the lens, refill the bowl with saline, and reinsert. To prevent bubbles in the first place, overfill the bowl so a meniscus of saline rises above the rim. If you consistently struggle with spillage or bubbles despite overfilling, ask your eye doctor about adding a thicker preservative-free lubricant drop to the bowl. The added viscosity helps the fluid stay in place during insertion.
Cleaning and Storage
After removal, clean your lenses before storing them overnight. The two main disinfection options are multipurpose solutions and hydrogen peroxide systems. Hydrogen peroxide systems are particularly effective at killing microorganisms, including resistant pathogens like Acanthamoeba. One-step hydrogen peroxide systems use a platinum disk or catalase tablet in the storage case that neutralizes the peroxide over about six hours, converting it to water and oxygen. You drop the lens in, close the case, and it’s ready by morning.
The critical rule with hydrogen peroxide systems: never put a lens in your eye before the neutralization cycle is complete. Un-neutralized hydrogen peroxide causes intense burning and pain. As long as you leave the lens in the case for the full recommended time (typically six hours), the solution is completely safe. Your eye care provider will recommend a specific cleaning system based on your lens material and needs.
Building Up Wear Time
Don’t expect to wear your lenses all day right away. Start with shorter sessions and gradually increase. Most people work up to 10 or more hours of daily wear, but this takes time. Your eyes need to adjust to having a vaulted lens sitting over the cornea, and your doctor will check at follow-up visits to make sure the fit looks right and your cornea is getting enough oxygen.
Bring your lenses to follow-up appointments and demonstrate your insertion technique. Handling difficulty is one of the top reasons people give up on scleral lenses, and small adjustments to your approach, like changing which fingers control your lids or switching from a plunger to a stand, can make a significant difference. Most people who push through the first couple of weeks find that insertion becomes nearly automatic.