Scleral lenses are specialized rigid gas-permeable contact lenses, significantly larger than conventional soft lenses (14.5 to 24 millimeters in diameter). They vault completely over the sensitive cornea, resting their edges on the less sensitive sclera (the white part of the eye). This design creates a fluid-filled reservoir over the cornea, providing stable optics and therapeutic hydration. However, this results in a strong suction effect that holds the lens securely in place. Unlike standard soft lenses removed with a simple pinch, scleral lenses require specialized tools and specific techniques to safely break this hydraulic seal without causing ocular irritation.
Necessary Equipment and Setup
Meticulous preparation is necessary before attempting lens removal to ensure safety and hygiene. Thoroughly wash your hands with a non-moisturizing, antibacterial soap, and dry them completely with a lint-free towel to prevent transferring debris or oils. You will need a large-diameter removal plunger (a soft suction cup designed specifically for scleral lenses), a clean lens case, and fresh disinfecting solution. Set up your workspace on a clean, well-lit surface, as laying down a soft, light-colored towel helps prevent the lens from bouncing or getting lost if dropped.
Standard Removal Technique
The most common and safest method for routine removal involves the use of the large plunger. Begin by moistening the tip of the removal plunger with a drop of preservative-free saline solution to create a better seal. Stabilize your eyelids by using your non-dominant hand to hold the upper lid firmly against the brow bone and the lower lid against the cheekbone. Look straight ahead into a mirror and gently position the plunger on the lens surface, ideally slightly off-center in the inferior quadrant (around the 6 o’clock position), as this avoids the area of greatest suction and facilitates easier removal.
Once the plunger adheres to the lens, the crucial step is breaking the suction seal. Gently tilt the plunger handle slightly upward and away from the center of the lens to create a vacuum break at the lens edge. This tilting motion allows air to enter underneath the lens, immediately releasing the hydraulic suction. With the seal broken, move the plunger in a smooth, arc-down-and-out motion to lift the lens completely off the eye. After removal, carefully slide the lens off the plunger by twisting it toward the edge, taking care not to pinch or damage the material.
Troubleshooting Difficult Removal
If the standard technique fails, a strong suction seal may make the lens difficult to remove. Avoid excessive pulling, as this can irritate the eye and increase suction. Instead, apply a few drops of sterile, preservative-free saline or artificial tears directly into the eye to re-lubricate the lens surface. Wait a minute or two, then attempt the standard plunger removal again, focusing on the tilting motion to break the vacuum.
If the large plunger method continues to fail, alternatives include using a smaller, specialized plunger designed to lift the lens edge, or employing a manual technique. For the manual method, look slightly upward and use a clean finger to apply gentle pressure to the eyelid just over the edge of the lens (typically at the temporal side) to encourage lifting. Another option is using the edge of your lower eyelid to gently push against the bottom edge of the lens until the seal breaks. Always ensure your fingernails are trimmed and smooth to prevent scratching the delicate ocular surface.
Post-Removal Lens and Eye Care
Immediate cleaning and disinfection must follow lens removal to maintain eye health and longevity. Place the lens in your palm and apply the recommended cleaning or multipurpose solution. Gently rub the lens surface with a clean fingertip to remove debris and protein deposits. Thoroughly rinse the lens with a sterile saline solution before placing it into the designated barrel of a clean lens case.
Fill the case with fresh disinfecting solution, such as a hydrogen peroxide system or a specialized multipurpose solution. Never reuse old solution, and ensure the lens soaks for the full recommended time. This allows for complete disinfection and neutralization, especially if using peroxide. If your eyes feel dry or slightly irritated after removal, instill a few drops of preservative-free rewetting drops for comfort and hydration.