Scleral lenses have revolutionized the world of vision correction, offering comfort and clarity to individuals with a variety of eye conditions. However, one common issue that wearers often encounter is midday fogging. In this article, we will delve into the reasons behind midday fogging with scleral lenses and explore effective solutions to ensure your visual comfort throughout the day.

Scleral lenses are a godsend for us with advanced keratoconus, I was curious about this fogging late in the day, and watched the NKCF webinar where Dr. Maria Walker of the University of Houston talked about this phenomenon and gave suggestions to improve this problem.

Understanding Scleral Lenses

What Are Scleral Lenses?

Scleral lenses are large, gas-permeable contact lenses that rest on the sclera, the white part of the eye. They are specially designed to provide clear vision for individuals with irregular corneas or specific eye conditions, such as keratoconus.

The Phenomenon of Midday Fogging

Why Do Scleral Lenses Fog Up?

Midday fogging with scleral lenses can be a frustrating experience. Several factors contribute to this issue, including:

1. The lens is the problem: Check the lens itself, that the surface is not scratched or covered with dirt or with protein deposits, oil or soap residue or make up products.

2. Second, check that your eye is not inflamed or infected or your cornea is hurt, usually photophobia is a good indicator of this.

3. Third, check your eyelids for deposits or strange secretions around the eye. Do you wake up with strange gunk or sand deposits in your eyelashes?

4. If the above is ok, the problem may be in the fluid reservoir, the space between the lens and your cornea, which can fill with debris formed of epithelial cells and neutrophils which are immune cells that point to some inflammation. There are also wax (cholesterol), lipids and triglycerides on the reservoir.

Dealing with Persistent Fogging

If midday fogging remains an issue despite following the above tips, explore these advanced solutions:

1. Scleral Lens Coatings

Some specialized coatings like “HydraPeg” coating can minimize fogging by reducing moisture evaporation. Discuss this option with your eye care professional.

2. Application adjustments

Review your application technique: Fill your lens to the top with a solution and use a DMV holder parallel to the floor to avoid bubbles, and don’t press the lens to the eye. Also open your eyelids wide while inserting the lens.

3. Try other solutions

Change solutions to a higher viscosity, preservative free artificial tears or buffered solution instead of just saline solution, and try different brands.

4. Eyelid hygene check

Eyelid problems (inflammation, blepharitis, meibomian glands dysfunction or dry eye) can worsen midday fogging. Clean your eyelids and eyelashes carefully to not produce more problems and don’t touch or rub your eyes.

Conclusion

Midday fogging with scleral lenses can be bothersome, but with the right strategies, you can mitigate this issue and enjoy uninterrupted clear vision. Try to touch your eyes as little as possible, also allergies can play a role in this condition. Remember to prioritize eye health and consult your eye care professional for personalized advice.