Sclera Lenses How To Put In: The Complete Step-by-Step Insertion Guide
Sclera lenses are large-diameter specialized contact lenses that vault over the cornea and rest entirely on the white part of the eye, known as the sclera. Mastering the insertion technique requires precision hygiene, precise digital lid control, and the elimination of air bubbles beneath the bowl to ensure both comfort and corneal safety.
Pre-Operation and Hygiene Checklist
Preparing for sclera lens insertion requires a dedicated workspace, sterile equipment, and an unwavering commitment to ocular hygiene. Because these lenses are significantly larger than traditional soft or rigid gas permeable lenses—often measuring between 15mm and 24mm in diameter—handling them demands specific tools and a methodical approach. Rushing the preparation phase dramatically increases the risk of contamination, trapped air bubbles, or improper landing.
- Essential Gear and Materials:
- Preservative-free sterile saline solution in single-use vials or non-preserved multi-dose bottles approved for sclera lens filling.
- A dedicated silicone insertion plunger (sometimes called a DMV plunger) with a hollow center or a modified base.
- A well-lit mirror mounted flat on a table or vanity, allowing you to look straight down during the insertion process.
- Lint-free microfiber towels or paper towels for drying hands.
- Daily cleaner and protein remover formulated specifically for rigid gas permeable or sclera lens materials.
- Prerequisite Standards and Benchmarks:
- Thorough hand washing with a non-moisturizing, antibacterial soap for a minimum of 20 seconds, followed by complete air-drying or drying with a lint-free towel.
- Total avoidance of tap water exposure for any lens care components to mitigate the risk of severe microbial keratitis from pathogens like Acanthamoeba.
- Estimated setup and application duration: 10 to 15 minutes for beginners, reducing to 2 to 3 minutes with daily practice.
Step-by-Step Sclera Lens Insertion Workflow
Step 1: Cleaning and Inspecting the Lens
Begin by placing a clean, soft towel over your work surface to catch the lens if it slips from your fingers. Remove the lens from its storage case, rinse it thoroughly with preservative-free saline to remove any residual disinfecting solution, and inspect the edges for micro-nicks, debris, or protein deposits. Place the lens concave-side up either in the palm of your non-dominant hand or balanced securely on top of the hollow insertion plunger.
Warning: Never use tap water, saliva, or homemade saline solutions to rinse or fill sclera lenses. Doing so introduces microscopic parasites and bacteria directly to the ocular surface, risking permanent vision loss.
Step 2: Filling the Lens Bowl to the Brim
Hold the clean sclera lens firmly on your plunger or balance it steadily across three fingertips of your non-dominant hand. Fill the entire bowl of the lens to the absolute brim with preservative-free sterile saline solution. The fluid level must form a visible, convex dome rising slightly over the rim of the lens without spilling over.
Pro-Tip: If you struggle with trapped air bubbles upon insertion, add a single drop of a high-viscosity, preservative-free lubricating drop or artificial tear to the center of the saline pool inside the lens. This thickens the liquid matrix, making it easier to trap zero air bubbles against the cornea.
Step 3: Securing Eyelids and Positioning the Eye
Lean completely over your table-mounted mirror so that your face is parallel to the floor, looking straight down into the glass. This gravity-assisted posture is the single most important factor for successful insertion. Use the middle finger of your non-dominant hand to pull your upper eyelid upward, pinning the edge firmly against your brow bone to prevent blinking. Use the index or middle finger of your dominant hand to pull your lower eyelid downward, pressing against the bony orbital rim.
Step 4: Approaching and Landing the Lens
Keep both eyes wide open and stare fixedly at the center of the lens or the hole of the insertion plunger, fighting the natural reflex to pull away or blink. Slowly and steadily bring the lens upward toward your eye. Watch the lens approach the ocular surface until the fluid reservoir makes contact with the white of your eye and cornea. Once the liquid touches the eye, press the lens gently inward and release your grip on the eyelids—lower lid first, then upper lid—only after the lens has securely settled onto the sclera.
Step 5: Releasing the Plunger and Checking for Bubbles
If you utilized an insertion plunger, gently squeeze the base of the rubber tool or rock it slightly to break the suction, pulling the plunger away while leaving the lens in place. Slowly blink a few times and inspect your vision in the mirror. If you notice a dark, crescent-shaped pocket of air trapped underneath the lens bowl, you must remove the lens immediately using a removal plunger, refill it with fresh saline, and repeat the insertion process.
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Sclera Lens Technical Specifications and Material Comparisons
| Parameter / Feature | Traditional Soft Lenses | Corneal RGP Lenses | Sclera Lenses |
|---|---|---|---|
| Diameter Range | 13.5 mm – 14.5 mm | 8.5 mm – 9.5 mm | 15.0 mm – 24.0 mm |
| Resting Surface | Cornea | Cornea | Sclera (Vaults Cornea) |
| Material Composition | Hydrogel / Silicone Hydrogel | Fluoro-Silicone Acrylate | High-Dk Fluorosilicone Acrylate |
| Fluid Reservoir | None | Tear Film Exchange | Liquid-Filled Saline Vault |
| Primary Indication | Refractive Correction | Keratoconus / Astigmatism | Irregular Corneas / Severe Dry Eye |
Common Insertion Failures and Field Fixes
- Air Bubbles Trapped Under the Bowl:
- Root Cause: Approaching the eye at an angle, failing to fill the lens bowl to a convex dome, or looking away from the lens during the landing phase.
- Actionable Fix: Practice looking straight down at the floor, ensure the saline solution overflows the rim slightly, and use a high-viscosity artificial tear drop in the center of the liquid pool to displace potential air pockets.
- Saline Splashing and Spilling Before Contact:
- Root Cause: Jerky hand movements or tilting the head rather than bending directly over the mirror.
- Actionable Fix: Lock your elbow against the table for stability, drop your chin completely parallel to the floor, and lift the lens smoothly upward in a vertical plane.
- Inability to Keep Eyelids Open (Lash Interference):
- Root Cause: Gripping the soft fleshy part of the eyelid skin instead of anchoring the lid margin directly against the bone structure.
- Actionable Fix: Place your fingers right at the lash line and push inward toward the orbital bone, which automatically prevents the lids from sliding or snapping shut over the lens.
Frequently Asked Questions
Does putting in sclera lenses hurt?
No, inserting sclera lenses should not cause pain, though the sensation of a large object approaching the eye can trigger a mild psychological flinch reflex initially. Because the lens rests on the sclera—which has fewer sensory nerve endings than the sensitive cornea—properly inserted lenses feel comfortable almost immediately once settled.
Can I use regular tap water to rinse my sclera lenses?
Never use tap water under any circumstances to rinse, clean, or store sclera lenses or their insertion tools. Tap water contains dangerous microorganisms, such as Acanthamoeba, which can cause sight-threatening corneal infections and ulcers when trapped beneath a sealed sclera lens.
Why do I keep getting dark bubbles under my sclera lens?
Air bubbles occur when the liquid reservoir fails to make total uniform contact with the ocular surface upon landing, usually because the lens was tilted or under-filled. Ensure your face is parallel to the ground, look directly down into the mirror, and ensure the saline solution forms a high, rounded dome over the edge of the lens before application.
How long can I wear sclera lenses each day?
Most practitioners recommend a gradual wear-time buildup starting at 4 hours on the first day, increasing by 1 to 2 hours daily up to a maximum of 10 to 14 hours per day. Always follow your specific optometrist or ophthalmologist schedule based on your unique corneal health and fluid exchange rates.
What should I do if my eye turns red after insertion?
A red eye immediately following insertion typically indicates a trapped air bubble, a piece of debris under the lens, or excessive edge pressure on the blood vessels of the sclera. Remove the lens immediately with a removal plunger, inspect it for damage, rinse it thoroughly, and re-evaluate your fit if redness persists.
Schedule Your Sclera Lens Fitting Consultation Today
Achieving crisp, comfortable vision with specialized specialty optics requires precise professional mapping and personalized clinical instruction. Contact our expert clinical team today to schedule your comprehensive sclera lens evaluation and master your handling technique under direct expert supervision.
