Two patterns, two different causes
Watch closely for a day and notice which of these fits:
| What you notice | What it usually points to |
|---|---|
| Sharp right after a blink, then smeary or hazy until the next blink | The front surface of the lens isn’t staying wet, or has film on it |
| A shift, ripple or jump in your vision with every blink | The lens may be moving on the eye, or something under it is shifting |
| Haze that builds over hours and doesn’t clear with blinking | Usually fogging in the fluid behind the lens. See midday fogging |
Your fitter can tell the difference by looking at the lens on your eye under the microscope. Your notes help them know what to look for.
When the front surface dries between blinks
A scleral lens keeps the cornea under a pool of saline, but the front of the lens still depends on your own tears. Each blink spreads a thin layer of tear film over it. If that layer breaks up quickly, or the lens surface doesn’t hold it, vision is clear just after a blink and then turns smeary. Wearers describe it as looking through a smudged window that a blink wipes clean.
Common reasons:
- Dry eye and eyelid oil gland problems. An unstable tear film breaks up faster on the lens. Blepharitis and meibomian gland dysfunction are common in scleral lens wearers. See blepharitis and MGD and dry eyes while wearing sclerals.
- Film and deposits. Oils, proteins and makeup build up on the lens and stop tears spreading evenly. See film and deposits on the lens.
- Residue from hands or products. Moisturizing soap, hand cream, and makeup on your fingers can end up on the lens. The FDA advises putting makeup on after your lenses are in.[1] A thick conditioning solution that isn’t rinsed off before filling can also leave a film, so rinse the way your fitter showed you.
- A coating wearing off. A surface coating such as Hydra-PEG helps tears spread over the lens. As it wears, wearers notice the lens feels less slick and blur on blinking returns. See surface coatings and cleaners and coated lenses.
- Blinking less. Screens and concentration reduce blinking, which gives the surface longer to dry. See screen work.
When the lens shifts with each blink
If your vision jumps rather than smears, the lens itself may be moving. Right after insertion, a lens can float a little until it settles. A lens that keeps moving or bouncing with each blink after that, or drifts off-center, is worth showing your fitter. See should a scleral lens move when I blink?
A bubble, or debris such as mucus moving under the lens, can also cause a shifting blur. A fresh fill and reinsert usually tells you whether that’s the cause.
Fixes to ask about
- A cleaning check. Ask your fitter to watch you clean, or to check the lens for film. Rubbing both sides with your cleaner, as directed, matters more than soaking alone.
- Eyelid and dry eye treatment. Treating the lids and tear film can make the lens surface wet better.
- A coating, or a recoat. If your lens isn’t coated, ask whether a coating suits you. If it is, ask whether it can be recoated or the lens replaced.
- Drops over the lens. Ask which rewetting drops are safe with your lenses. See eye drops with sclerals.
- A midday reset. Some wearers remove, clean, refill and reinsert once a day.
- A fit check. If the lens moves, the fit may need adjusting.
What wearers say
Many say a coating, or a fresh coat on an old lens, made the biggest difference. Others found that switching to a plain, lotion-free soap or rinsing their storage solution off properly cleared it up. Some with significant dry eye say nothing fully stops it, and they manage with drops and a midday clean. A few found that what seemed like lens blur was a bubble, or, in one eye, a change in the eye itself, which is why a check matters.
What to ask your fitter
- When you look at my lens on my eye, is the front surface wetting well?
- Is my lens coated, and does the coating look worn?
- Is my lens moving more than it should?
- Which drops can I use over my lenses?
- Would treating my eyelids help?
Common questions
Can I clear the blur without taking the lens out?
Wearers often put in a rewetting drop and blink a few times, which can clear front-surface film for a while. Use only drops your fitter has said are safe over your lenses. If it keeps coming back quickly, a midday removal, clean and refill may work better. Ask your fitter which suits you.
My old coated lens has started blurring when I blink. Does it need replacing?
It might. A coating that is wearing off often shows as the lens feeling less slippery and film coming back faster. Older lenses can also scratch or warp. Take the lens to your fitter, who can tell you whether a recoat, a deep clean or a new lens makes sense.
Only one eye blurs when I blink. Why?
The two eyes can differ in tear film, eyelid health, lens surface and fit, so one-sided blur is common. Note which eye, and whether swapping to a fresh fill or a clean lens changes it. If one eye blurs even with the lens out, tell your eye doctor, since other eye conditions can cause that too.