Learning to insert and remove scleral lenses can feel intimidating at first because these lenses are larger and handled differently than soft contacts. With a clear, step‑by‑step routine and attention to hygiene, most patients become confident within a few practice sessions.
How scleral lenses are different from soft contacts
Scleral lenses are rigid gas‑permeable lenses that vault over the cornea and rest on the white part of the eye (the sclera). They hold a reservoir of preservative‑free saline between the lens and cornea, which can improve comfort and vision for people with irregular corneas, dry eye, or keratoconus.
Because they are large and create a fluid-filled space, insertion and removal use different techniques than soft contact lenses. Scleral lenses require proper fitting by an eye care professional and regular follow‑up to monitor fit, ocular health, and any lens‑related complications.
Before you begin: supplies, setup, and safety
Preparation reduces frustration and lowers infection risk. Assemble everything before you touch the lenses.
- Wash and thoroughly dry your hands with soap — avoid scented or oily lotions.
- Preservative‑free saline for filling the lens reservoir (as prescribed by your fitter).
- A clean, lint‑free mirror and a towel on a flat surface — practice over a sink or soft towel to protect the lens if dropped.
- Your recommended lens cleaner, daily cleaner/rub solution, and lens case per the fitting instructions.
- Insertion tools if recommended: soft plunger/suction cup or a large lens applicator. Some patients use a direct finger technique when comfortable.
- If you have dry eye or lid disease, discuss dry‑eye therapies like low level light therapy (LLLT) with your provider; improving ocular surface health can make scleral wear easier.
Important safety notes: never use tap water to fill or store scleral lenses. Always use the saline and cleaning solutions your practitioner recommends. If you experience sharp pain, sudden vision change, discharge, or significant redness, remove the lens and contact your eye care provider promptly.
Step‑by‑step insertion
1. Inspect and hydrate
Place the lens on a clean surface and inspect for chips, cracks, or debris. Rinse only with the prescribed preservative‑free saline; do not use tap water. Fill the bowl of the lens completely with saline so there are no bubbles — trapped air can cause discomfort and poor vision.
2. Positioning
Using two hands, bring the lens close to your eye while looking straight ahead into the mirror. If you use a plunger, attach it to the lens per the manufacturer’s instructions. If you prefer a two‑finger or one‑finger technique, support the eyelids with your other hand so you can maintain steady control.
3. Apply the lens
Gently look up as you bring the lens to your eye. Place the lens on the sclera (white of the eye) and then slowly settle it down so it vaults over the cornea and contacts the sclera evenly. Once centered, blink slowly to allow the lens to seat. There will be a visible fluid reservoir behind the lens; a small bubble may sometimes occur — if it’s large or causing blurred vision, remove and reapply.
4. Verify comfort and vision
After insertion, check comfort and vision. Minor awareness of the lens is normal at first, but persistent pain, tearing, or severe blur requires removal and evaluation. Expect a short adjustment period; many patients report increased comfort as they adapt.
Step‑by‑step removal
1. Prepare and relax
Wash and dry your hands. Sit in front of a mirror and tilt your head slightly back. Some people find removal easier after applying a few drops of preservative‑free saline or re‑wetting drops recommended by their fitter.
2. Use your removal method
There are two common removal methods — suction/plunger and push‑pull:
- Suction/plunger: Place the plunger on the center of the lens and gently pull straight away until the lens releases.
- Push‑pull (manipulation): Use one hand to pull down the lower lid and the other hand to push the lens gently toward the sclera while pinching the edge to slide it onto the conjunctiva, then lift away. This technique requires more practice and is done under professional instruction.
If you encounter resistance, stop and re‑wet the lens or blink to help break surface tension. Never forcibly remove a lens.
Daily care, follow‑up, and safety tips
Proper cleaning and follow‑up are essential to minimize infection risk and maintain lens performance.
- Follow the cleaning and disinfection protocol provided by your fitter — rigid gas‑permeable and scleral lenses typically require specific cleaners and soaking solutions.
- Replace the lens case as recommended and store lenses in fresh solution each night. Do not reuse saline from a prior day.
- Avoid swimming, hot tubs, and showering while wearing scleral lenses to reduce exposure to waterborne microbes.
- Attend scheduled follow‑up appointments so your clinician can check lens fit, corneal health, and tear film status. Scleral lens fit can change over time and with ocular surface conditions.
- If you have dry eye, therapies such as Low Level Light Therapy (LLLT) may be discussed to improve gland function and comfort with lenses; ask your provider if this is appropriate for you.
Remember: scleral lenses can significantly improve vision and comfort for many patients, but they do not stop disease progression in conditions like keratoconus. If cross‑linking or other interventions are appropriate for corneal stabilization, your provider will discuss referral options.
When to contact your eye care provider
Contact your eye care professional right away if you experience:
- Sudden decrease in vision, severe eye pain, or light sensitivity
- Persistent redness, discharge, or swelling
- A lens that won’t come out or feels stuck
- Unusual tearing or a foreign body sensation that does not resolve
Early evaluation reduces the risk of complications. Your fitter can troubleshoot insertion and removal technique, adjust the lens fit, or recommend alternative care pathways if needed.
Learning proper insertion and removal takes practice and patience. If you’re new to scleral lenses, schedule a supervised training session with your fitter so they can observe your technique and make personalized adjustments. Evolutionary Eye Care’s team of specialists in Houston is experienced with scleral lens training and ocular surface therapies — we have convenient locations in Sugar Land, Webster, and Downtown Houston. Contact us to schedule an appointment and a step‑by‑step fitting session tailored to your needs.