Scleral Contact Lenses for Sjogren’s Syndrome

What Is Sjogren’s Syndrome?

Sjogren’s syndrome is an autoimmune disease that causes extreme dryness that affects much of the body, including the eyes. In addition to dryness of the mucous membranes, Sjorgren’s syndrome can cause pain, exhaustion, nerve damage and blood cancer.

About 4 million Americans have the disease, 90% of them women. An additional 3 million may be living with the disease without knowing it, according to the Sjogren’s Syndrome Foundation. In fact, an estimated 1 in 10 patients with dry eye symptoms have Sjogren’s syndrome.

Why Sjogren’s Syndrome Causes Dry Eyes

Individuals with the syndrome have inflammation of the lacrimal glands, which causes them to produce a lower quantity of tears. Lower tear volume means that irritants that would ordinarily be washed away by tears remain on the ocular surface, leading to inflammation, irritation and, if left untreated, corneal scarring.

Many individuals with Sjogren’s syndrome also have other autoimmune diseases, such as lupus, celiac disease or rheumatoid arthritis.

Eye Symptoms Related to Sjogren’s Syndrome

In those with Sjogren’s syndrome, having dry eyes is a given.

Other common symptoms include:

• Burning eyes
• Sensitivity to light
• Blurry vision
• Eye strain and fatigue
• Blepharitis – an inflammation of the eyelids
• Discomfort while wearing regular contact lenses

How Is Sjogren’s Syndrome Diagnosed?

Because the symptoms are varied and develop gradually, it can take several years for those with Sjogren’s syndrome to be diagnosed with the disease.

However, eye doctors are often the first to suspect the condition since dry eyes are a key symptom of the disease.

After taking your medical history and providing a thorough eye exam, your eye doctor may perform the Schirmer’s test to see whether your tear glands are working properly.

During the test, the eye doctor will place special paper inside your lower eyelids while you keep your eyes closed for a few minutes. Once the paper is removed, the doctor will measure the amount of liquid on the paper.

Another test, which uses dye to make your tears more visible, measures how quickly your tears evaporate.

How Scleral Lenses Alleviate Dry Eyes

Individuals with dry eye syndrome, whether caused by Sjorgren’s syndrome or another condition, often complain that traditional contact lenses irritate their eyes. That’s because traditional contacts dry out easily and compensate by drawing moisture away from the eye.

Scleral lenses, which are gas-permeable, do the exact opposite. They form a protective dome over the cornea that conserves saline solution. The solution acts as a liquid buffer between the lens and the cornea’s surface. That, in turn, alleviates the irritation, itchiness and redness that are the hallmarks of dry eye.

Due to their larger diameter and custom fit, scleral lenses don’t move around as much as conventional lenses. This boosts visual acuity and reduces irritation.

If your eyes feel parched and gritty, contact Dr. Nathalie Cassis for a comprehensive eye exam to determine whether you have dry eye syndrome and to discuss whether your symptoms could be due to Sjorgren’s syndrome.

Call the Scleral Lens and Keratoconus Center at Envision Ghent Optometry today to schedule your consultation.

Our practice serves patients from Norfolk, Virginia Beach, Chesapeake, and Suffolk, Virginia and surrounding communities.

References:

• https://www.healio.com/ophthalmology/news/…/factors-separate-sjgrens-syndrome-from-simple-dry-eye
• http://www.ocularsurface.com/graphics/PDFs/FLUORESCEIN_CLEARANCE_TEST_T3001.pdf
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/sjogrens-syndrome/sjogrens-syndrome-diagnosis
• https://www.contactlenses.org/scleral.htm

Learn More About Scleral Lenses

Specialty Contact Lenses For Presbyopia

As we get older our vision starts to change. Between the ages of 40 and 50, almost all people develop presbyopia (age-related farsightedness), which makes nearby objects appear blurry.

Reading glasses used to be the only option for contact lens wearers with presbyopia who wanted to perform tasks that require good near vision such as reading a book or menu.

Nowadays, several specialty contact lenses offer patients with presbyopia clear near and distance vision for ultimate visual comfort and convenience.

Contact Lenses for the Farsighted

Monovision

This is a vision correction technique in which the contact lens in one eye corrects for distance vision and the other eye for near vision. Basically, each lens has a different prescription.

Scleral Lenses

Scleral contacts are large-diameter gas-permeable contact lenses that vault over the entire corneal surface and rest on the white part of the eye (sclera) instead of the cornea.

Scleral contacts can also be designed as multifocal contacts for presbyopic patients to correct both farsightedness and nearsightedness. When compared to regular multifocal lenses, scleral lenses are firmly positioned on the eye, offering substantially better stability and comfort.

Multifocal

Patients who wear multifocal contact lenses are able to see at all distances without sacrificing depth perception. Those who participate in outdoor activities, use the computer regularly or don’t like using reading glasses to view their smartphone, tablet, or newspaper might consider multifocal contact lenses.

There are two basic types of multifocal contact lenses: simultaneous vision design and segmented vision design.

1. Simultaneous vision design – Concentric rings of distant and near powers encircle a primary viewing zone in the lens’s center. The central viewing zone is typically used to view distant things, although there are also center-near designs. Under other circumstances, the dominant eye is fitted with a center-distance design, whereas the non-dominant eye is fitted with a center-near design. These multifocal contacts are similar to concentric multifocal lenses, but instead of discrete rings of distance and near power encircling the lens’s center, the multifocal lens power gradually changes from distance to near (or near to distant) from the lens’s center to the periphery. Aspheric multifocal contact lenses are similar to progressive eyeglass lenses in this way.

2. Segmented vision designs – Bifocal and trifocal eyeglass lenses have a similar design to segmented multifocal contact lenses. The upper and center zones of the lens feature a zone for distant vision, while the lower half of the lens has a zone for near vision. A noticeable line in the lenses separates the distant and near zones.

These contact lenses are made of rigid gas permeable (GP) contact lens material. These lenses have a smaller diameter than soft contact lenses and rest above the edge of the lower eyelid on a layer of tears. A segmented multifocal contact lens stays in place as your look shifts downward for reading or seeing close objects, allowing you to see through the lower, near-correction part of the lens.

Rigid gas-permeable (RGP)

RGP contact lenses are composed of rigid silicone polymers that allow oxygen to pass through the cornea. Unlike soft contact lenses, they hold their shape and can often provide clearer vision than soft lenses.

Orthokeratology

Orthokeratology, also called ‘ortho-k’ lenses, are lenses that are worn overnight to reshape the cornea. Ortho-k can be used to correct both eyes for distance vision and be used as monovision and multifocal vision.

If you have presbyopia and are looking into your contact lens options, contact Scleral Lens and Keratoconus Center at Envision Ghent Optometry to learn more about which specialty contact lenses are right for you.

Our practice serves patients from Norfolk, Virginia Beach, Chesapeake, and Suffolk, Virginia and surrounding communities.

Learn More About Scleral Lenses

Scleral Lenses for Giant Papillary Conjunctivitis (GPC)

Giant Papillary Conjunctivitis (GPC) is an inflammatory reaction that occurs on the eyelids when proteins are secreted in your tears. These proteins then form a filmy coating on contact lenses that not only makes wearing them uncomfortable but also irritates the eyelids, causing an inflammatory reaction.

In the initial phase of the condition, the inside of your eyelid may become red, itchy, swollen and irritated, but as time goes on, bumps (also called papillae) will develop, occasionally growing to the size of a pimple. GPC can thus make wearing contact lenses irritating and uncomfortable.

Fortunately, GPC isn’t permanent. Wearing scleral lenses not only reduces GPC’s effects but, unlike other lenses, can prevent a recurrence. If you suspect that you have GPC or are simply interested in seeing whether scleral lenses are right for you, speak with Dr. Nathalie Cassis today.

What Causes GPC?

• Wearing certain types of contact lenses heightens the risk of developing GPC
• Protein deposits or other substances on the contact lenses
• A contact lens, artificial eye, or exposed stitches that rub against the lower eyelid
• An allergic reaction to either contact lenses or their cleaning products
• Asthma, hay fever, or other allergies coupled with the use of contact lenses

Can People With GPC Wear Contact Lenses?

Yes. However, those with GPC have more difficulty finding a contact lens that doesn’t further exacerbate the irritation.

Gas permeable (GP) lenses, such as scleral lenses, are highly recommended since proteins don’t accumulate on GP lenses the way they do on soft lenses. This ensures that gas permeable lenses remain cleaner and are therefore less likely to cause an inflammatory reaction.

Another alternative is daily disposable lenses, as they are discarded after a single day of wear. This prevents protein deposits from accumulating on the lenses.

Monthly soft lenses tend to retain protein deposits over time, no matter how well they’re cleaned on a daily basis.

Scleral Lenses for GPC

Due to their large size, scleral lenses are more stable on the eye than conventional GP lenses, and are therefore less likely to dislodge from the eye. Moreover, all scleral lenses are customized and made with highly breathable gas permeable material so that plenty of oxygen reaches the front of the eyeball. The reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a moist environment. It’s no surprise that scleral lenses consistently rank at the top of the charts when it comes to providing sharp visual acuity, comfort and healthy eyes.

Why Do Scleral Lenses Help Prevent GPC?

The customization of scleral lenses is one of the key factors in preventing GPC. Because the lens is properly fitted to the specific eye, and the vault over the cornea is filled with artificial tears, it prevents debris from entering while soothing GPC symptoms simultaneously. Furthermore, those who have highly sensitive eyes and are prone to experiencing allergic reactions can benefit from wearing scleral lenses, as they protect both the tear film layer and are easier to clean than other GP lenses.

Speak with Dr. Nathalie Cassis to learn how to care for your lenses and avoid developing GPC. If you’re susceptible to getting GPC, make sure to schedule follow-up visits with Dr. Nathalie Cassis.

Can GPC Develop in Scleral Lens Wearers?

Although the chances are much lower than in conventional contact lenses, giant papillary conjunctivitis may at times develop with scleral lenses due to potential lens surface debris buildup. For those with allergies, it is ideal to use a peroxide cleaning solution as it provides in-depth disinfection.

Make sure to regularly visit Dr. Nathalie Cassis to have your cornea monitored in order to prevent GPC from worsening or recurring.

Our practice serves patients from Norfolk, Virginia Beach, Chesapeake, and Suffolk, Virginia and surrounding communities.

Learn More About Scleral Lenses

Scleral Lenses for Athletes

Clear and comfortable vision is vital in sports—it can make a huge difference to optimizing your game-time performance. Fortunately, scleral lenses offer a way for athletes who need corrective eyewear to achieve their goals, even in contact sports like basketball, football and hockey.

Scleral lenses are custom-fit contact lenses for people with corneal irregularities, hard-to-fit eyes and severe dry eye syndrome, among other conditions. They provide comfort and offer sharp vision on and off the playing field.

Scleral lenses are extremely stable on the eye, as they vault over the cornea and rest on the sclera. Moreover, the reservoir of saline solution between the back surface of the lens and the front of the cornea ensures that the eye remains moist all day long. Furthermore, the lenses’ highly breathable gas permeable material ensures that plenty of oxygen reaches the front of the eye.

What Kind Of Athletes Wear Scleral Lenses?

Scleral lenses benefit athletes who find wearing traditional contact lenses challenging or impossible, and/or who have any of the following eye conditions:

• Astigmatism
• Dry eye syndrome
• Presbyopia
• Keratoconus
• Post-refractive surgery (i.e. LASIK, PRK)
• Giant papillary conjunctivitis (GPC)

Scleral Lenses for Athletes with Keratoconus

Keratoconus is an eye condition in which the cornea thins and weakens over time. This causes a cone-like bulge to develop and an irregular-shaped cornea. Keratoconus can result in increased sensitivity to light, distorted vision, slightly blurred vision and even significant vision loss. Professional athletes diagnosed with keratoconus often worry that the condition could end their career.

Scleral lenses are a long-term solution that helps athletes with keratoconus to continue to perform at their peak with amazing vision. Just ask professional athletes Brandon Williams from the Baltimore Ravens, Steph Curry from the Golden State Warriors, or Diamond DeShields from the Chicago Sky. These star athletes all wear scleral contact lenses and can now show off their true sporting prowess due to their sharp vision.

Do Scleral Lenses Work For All Sports?

When fitted correctly, the edges of these customized lenses fit comfortably under the eyelids, which prevents them from easily falling out. Moreover, because of their stability and extreme comfort, they offer an added advantage for athletes who engage in contact or extreme sports or those with rapid movements, such as in:

• Basketball
• Baseball
• Football
• Gymnastics
• Hiking
• Hockey
• Rock Climbing
• Soccer
• Skiing
• Tennis

However, scleral lenses are not advised for wrestling, karate, or boxing, other martial arts or any sports where facial injuries are common.

How Can Scleral Lenses Improve An Athlete’s Vision?

Athletes are often exposed to challenging environmental conditions, such as dust, chalk, sand and wind, all of which can lead to discomfort with soft contact lenses. As scleral lenses provide a seal over the eye’s surface, their eyes are much more protected from the elements. Because athletes have demanding visual needs, stable, clear, crisp vision is essential for optimal athletic performance.

To learn more, contact Scleral Lens and Keratoconus Center at Envision Ghent Optometry today.

Our practice serves patients from Norfolk, Virginia Beach, Chesapeake, and Suffolk, Virginia and surrounding communities.

Learn More About Scleral Lenses

Treating Ocular Surface Disease with Scleral Lenses

Ocular surface disease (OSD) is not a single disease. It is a group of eye disorders that affect the surface of the eye. It can significantly affect your eyesight and quality of life. Many cases of ocular surface disease are misdiagnosed a simply ‘dry eyes’, so this condition can go undiagnosed and therefore untreated.

Fortunately, scleral lenses, which are custom-fit and lubricate the eye’s surface, can provide the relief and comfort people with OSD seek.

What are the Causes and Symptoms of Ocular Surface Disease?

Your tear film is controlled by various tissues and glands around the surface of your eyes. If there is a problem with those glands or tissues, it can cause your tear film to become unstable, resulting in dry eye syndrome or other types of ocular surface disorders.

A stable tear film keeps eyes moist, protects them against infection and cleans the surface of your cornea.

When your tear film is unstable, symptoms can include:

• Redness
• Watery eyes
• Blurry vision
• Gritty or scratchy feeling in the eye
• Itching
• Pain

Ocular surface disease symptoms are usually worse in the evening. They can also be exacerbated by windy conditions or a dry climate.

Types of Ocular Surface Disease

Some of the most common types of ocular surface disease include:

• Dry eye syndrome
• Blepharitis
• Meibomian gland dysfunction
• Allergies
• Keratitis
• Conjunctivitis
• Immunological conditions (e.g. Sjogren’s syndrome)
• Chemical or thermal burns

Treatment With Scleral Lenses

Depending on the type of condition, treatment can range from artificial tears (dry eye) to antihistamines (allergies), but many people continue to experience dry, itchy, irritated eyes. Eventually, many patients with ocular surface disease seek out more durable methods of treatment.

In recent years, scleral lenses have become a preferred treatment option for patients with ocular surface problems.

While they are generally used to treat refractive errors and corneal irregularities, scleral lenses can also provide immense relief to patients with ocular surface disease.

Scleral lenses do three things simultaneously: they protect the eye, they provide vision correction, and they serve a therapeutic purpose by lubricating the eye. Scleral lenses decrease discomfort, pain, itchiness and eye redness while providing sharp, clear vision.

These customized lenses form a dome over the cornea and rest on the sclera (the white part of the eye). The zone between the lens and the cornea provides a continuous moist environment that protects the cornea and provides relief for those with ocular surface disease.

At Scleral Lens and Keratoconus Center at Envision Ghent Optometry, we regularly diagnose, treat and manage the different types of ocular surface disease to help patients experience clear, healthy vision again. Our Dr. Nathalie Cassis has the experience and proven treatment options you need to find relief from OSD.

If you have OSD and are interested in scleral lenses, Scleral Lens and Keratoconus Center at Envision Ghent Optometry can help. Dr. Nathalie Cassis is specialized in fitting scleral lenses for dry eyes and other corneal conditions.

Our practice serves patients from Norfolk, Virginia Beach, Chesapeake, and Suffolk, Virginia and surrounding communities.

Learn More About Scleral Lenses