How do I use night ointment without clouding my scleral lenses the next day?

Why ointment and scleral lenses clash

Night ointments are thick, greasy lubricants meant for the inside of the lower eyelid. Two common examples show what they’re made of: Retaine PM lists mineral oil and white petrolatum as its active ingredients, with no inactive ingredients,^[1] and GenTeal Tears Night-Time lists the same two, with lanolin as an inactive ingredient.^[2] Both labels direct you to apply a small amount to the inside of the eyelid.

That’s what makes them soothing overnight, and also why they cause trouble with scleral lenses. Oil left on your lids and lashes in the morning ends up on the lens: on the front, where it smears with each blink, or trapped in the fluid behind the lens. Wearers describe vision that looks greasy, smoky or hazy within minutes, or a lens that fogs hours later.

A morning routine wearers use

Routines vary, but most include some version of these steps:

1. Warm the lids. A warm compress or a warm, steamy shower loosens ointment and lid oils.
2. Clean the lids and lashes. A lid cleanser, lid wipe, micellar water or gentle cleanser, used as your eye doctor recommends. Rinse it off fully.
3. Rinse the eye. Flush with sterile preservative-free saline and blink a few times to clear what’s left on the eye’s surface.
4. Wash and dry your hands with a plain soap that leaves no lotion behind.
5. Give it a little time. Many wearers find a gap between cleaning and insertion helps the last traces clear.
6. Insert, then check. If vision looks greasy straight away, remove, rinse and refill rather than wearing it all day.

Gel or ointment?

Wearers who’ve tried both report:

• Gels are thinner, and many find them easier to clear in the morning. Some use a preservative-free night gel instead of ointment, or a gel followed by ointment only on their driest nights.
• Ointments last longer and suit people whose eyes are very dry or whose lids don’t close fully overnight. They’re harder to clear.
• Formulas differ. Ointments vary in their mix of petrolatum and mineral oil and in whether they contain lanolin.^[1][2] Some wearers say ones with more mineral oil and less petrolatum clear more easily, and some prefer lanolin-free ones. That’s experience, not a tested comparison.
• Less is more. A thin line along the lower lid, rather than a large amount, was enough for some, and left less to clean.

Some wearers stopped ointment and use preservative-free drops at night, or moisture goggles, instead. Ask your eye doctor before changing, because the ointment may be part of protecting your eye. See moisture chamber glasses.

Prescription ointments

Antibiotic, steroid and other prescription ointments are a different matter. They’re medicines, and the timing is your prescriber’s decision. Many wearers report pausing lens wear during a course of ointment, for example for a stye, or asking whether a drop version could be used instead. If you’ve been prescribed an ointment, ask:

• Can I wear my lenses during this treatment at all?
• If so, how long after the ointment can my lenses go in?
• Is there a drop form that would fit better with lens wear?

See steroid and antibiotic drops with scleral lenses.

What wearers say

Wearers with very dry eyes often say night ointment noticeably improved next-day comfort, and some say it reduced fogging once they had a good cleaning routine. Others found the residue more trouble than it was worth and switched to gels or drops. A few say their doctor advised against ointments entirely because they’re hard to clear from lenses. Mornings with smeary lenses usually traced back to too much ointment, too little time, or lids that weren’t fully clean.

For more on oily drops and fogging, see eye drops with scleral lenses and film and deposits on the lens.