Sclera Lenses How To Put In: The Complete Insertion Guide
Sclera lenses are specialized, large-diameter contact lenses that cover the entire visible white portion of the eye, requiring precise handling, specialized saline solution, and proper eyelid control for safe and successful insertion. Mastering the technique takes patience, strict adherence to hygiene protocols, and an understanding of how to align the lens properly without trapping air bubbles beneath the surface.
Essential Preparation and Equipment Setup
Applying full-sclera or mini-sclera lenses differs significantly from handling standard soft contact lenses. Because sclera lenses span 15mm to 22mm in diameter and rest entirely upon the conjunctiva covering the sclera rather than the cornea, they require a fluid reservoir beneath the lens to maintain corneal hydration and prevent suction trauma. Attempting to insert these lenses dry or with inadequate preparation risks damaging the ocular surface or trapping debris.
- Essential Equipment and Materials:
- Preservative-free sterile saline solution in single-use vials or buffered multidose bottles specifically approved for sclera lens rinsing and filling.
- A dedicated sclera lens insertion plunger (suction holder) or a clean tripod finger-grip technique.
- A lint-free microfiber towel and a well-lit mirror placed flat on a table or counter to allow a downward gaze.
- Daily cleaner, enzymatic cleaner, and hydrogen peroxide- or multi-purpose storage solutions recommended by your optometrist.
- Prerequisite Knowledge and Safety Standards:
- Hands must be washed thoroughly with non-moisturizing, antibacterial soap and dried with a lint-free towel before touching the lenses or your eyes.
- Verify that the lens is free from tears, chips, or protein deposits under bright magnification before handling.
- Never use tap water, homemade saline solutions, or saliva with sclera lenses due to the severe risk of microbial keratitis and acanthamoeba infection.
- Time and Budget Benchmarks:
- Estimated initial application time: 15 to 30 minutes per eye for beginners, reducing to under 2 minutes with regular practice.
- Average lifespan of custom-fit sclera lenses: 1 to 3 years with proper maintenance and annual eye care provider evaluations.
Step-by-Step Sclera Lens Insertion Workflow
Step 1: Sanitation and Lens Inspection
Begin by clearing a clean, flat surface in front of a mirror. Wash your hands meticulously for at least 20 seconds, paying close attention to the fingertips and nail beds, and dry them with a lint-free towel. Remove the sclera lens from its storage case, rinse it thoroughly with preservative-free sterile saline to remove any residual disinfecting solution, and inspect the edges for microscopic tears or inverted curves.
Pro-Tip: Place the cleaned lens concave-side up in the palm of your hand or balance it securely on the soft rubber cup of an insertion plunger.
Step 2: Creating the Saline Reservoir
Hold the clean sclera lens firmly on your fingertips using a tripod grip (thumb, index, and middle finger) or mount it securely on the suction plunger held vertically between your index finger and thumb. Fill the bowl of the lens entirely to the brim with preservative-free sterile saline solution.
Warning: Ensure there are no dry spots on the edges of the lens and that the saline forms a convex dome slightly higher than the rim of the lens. Any air trapped in this pool will create a bubble under the lens upon insertion, causing irritation and blurred vision.
Step 3: Head Positioning and Eyelid Control
Lean completely over so your face is parallel to the floor, looking straight down into the mirror or floor below. This posture uses gravity to your advantage, keeping the saline pool from spilling out of the lens before it touches your eye. Use the middle finger of your non-dominant hand to pull your upper eyelid upward, anchoring the lid margin firmly against the orbital bone to prevent blinking. Use the middle finger of your dominant hand to pull your lower eyelid downward.
Pro-Tip: Control the eyelashes, not just the skin. Securing the lashes against the brow bone and cheekbone is the single most effective way to prevent involuntary blinking during insertion.
Step 4: Alignment and Application
Bring the lens slowly upward toward your eye while maintaining a direct, downward gaze into the center of the lens. Watch the bottom edge of the lens approach the lower white of your eye first, or aim the center of the lens directly at the cornea depending on your practitioner's guidance. Gently press the lens against the ocular surface until you feel the cool saline make complete contact with the eye.
Warning: Do not slam or drop the lens onto the eye with excessive force. Apply steady, measured pressure until the sclera lens rests comfortably on the white of the eye and the edges conform smoothly to the conjunctiva.
Step 5: Releasing and Settling
Once the rim of the lens makes full 360-degree contact with the sclera, release your lower eyelid first, then gently release your upper eyelid. Slowly blink a few times to allow the lens to center itself and distribute the fluid reservoir evenly. If you used an insertion plunger, gently squeeze the base of the plunger to break the suction seal and remove it from the front surface of the lens.
How to Apply & Remove Scleral Lenses Safely | Patient Guide
Sclera Lens Technical Parameters and Handling Methods
| Parameter | Standard Soft Lenses | Sclera Lenses |
|---|---|---|
| Diameter | 13.5mm – 14.5mm | 15.0mm – 24.0mm |
| Landing Zone | Rests directly on the cornea | Rests on the sclera (conjunctiva) |
| Fluid Reservoir | None | Liquid layer bridging the cornea |
| Insertion Tool | Fingers only | Fingers or specialized plunger |
| Primary Indication | Refractive error correction | Irregular cornea, severe dry eye |
Troubleshooting Common Insertion Failures
- Air Bubbles Trapped Under the Lens:
- Root Cause: The lens was tilted during insertion, or the saline fill level was too low, allowing air to enter the fluid reservoir upon contact.
- Actionable Fix: Remove the lens immediately using a designated removal plunger, rinse it, refill it completely to a domed surface with sterile saline, and reinsert while maintaining a strict downward gaze.
- Saline Spills Before Reaching the Eye:
- Root Cause: Tilting the head too late, moving too slowly, or shaking the hand during the upward approach.
- Actionable Fix: Position your face completely parallel to the floor before bringing the lens up, and use your free fingers to stabilize your hand against your cheekbone.
- Involuntary Blinking and Lid Spasms:
- Root Cause: The eyelid margins are slipping over your fingers, triggering the corneal reflex due to anticipation.
- Actionable Fix: Dry your fingers and eyelids thoroughly to ensure a secure grip on the eyelashes, and practice opening both eyes wide while focusing on a fixed stationary point below.
- Severe Stinging Immediately After Insertion:
- Root Cause: Use of preserved saline or multidose solutions containing harsh chemicals that irritate the sensitive corneal tissue trapped beneath the lens.
- Actionable Fix: Immediately remove the lens, flush the eye thoroughly with sterile saline, and verify that your filling solution is explicitly labeled as preservative-free.
Frequently Asked Questions
Does putting in sclera lenses hurt?
Inserting sclera lenses should not cause pain, though the sensation of a large lens touching the eye can feel unfamiliar at first. Any sharp pain, burning, or persistent discomfort usually indicates an air bubble, trapped debris, or an incorrect fit that requires immediate removal and re-evaluation.
Can I use regular tap water to rinse or fill sclera lenses?
You must never use tap water, bottled water, or homemade saline solutions with sclera lenses. Non-sterile water contains microorganisms that can cause severe, sight-threatening corneal infections, such as acanthamoeba keratitis. Always use sterile, preservative-free solutions recommended by your eye care professional.
How do I remove sclera lenses safely?
Sclera lens removal requires breaking the suction seal created by the fluid vault. Look upward, apply a small removal plunger to the lower third of the lens surface, or gently lift the edge of the lens with your finger to allow air underneath before lifting it away from the eye.
Why is there blurred vision immediately after insertion?
Initial blurriness is frequently caused by a trapped air bubble, a droplet of saline on the front surface of the lens, or mild settling of the fluid reservoir. Blinking gently usually clears external moisture, but if vision remains hazy due to trapped air, you must remove, refill, and reinsert the lens.
Schedule Your Sclera Lens Fitting Consultation Today
Consult with a qualified optometrist or ophthalmologist specializing in specialty contact lenses to receive a custom fitting and personalized instruction tailored to your unique ocular anatomy. Perfect your insertion technique under professional supervision to ensure optimal visual clarity, ocular health, and all-day comfort.
