Film and deposits on the lens

What the film is

Every day of wear leaves something on your lens: proteins and oils from your tears, and anything that was on your fingers or face. If it isn’t fully removed each night, it builds up. You might notice:

• A cloudy or milky look when you hold the lens to the light.
• Greasy smears or spots that rinsing doesn’t remove.
• Vision that’s less crisp than when the lens was new.
• Tears that don’t spread smoothly over the front of the lens, so vision looks smeary.

Deposits are a recognized problem with scleral lenses. In a study of 157 keratoconus eyes wearing scleral lenses for at least a year, deposits were recorded in 8.9% of eyes and poor wetting of the lens surface in 1.9%.^[1]

Clean it properly

• Rub and rinse. Rubbing removes film that soaking alone doesn’t. The FDA advises rubbing and rinsing your lenses as directed by your eye care professional.^[3] In a report of infections in scleral lens wearers, not rubbing the lens during cleaning was among the risks the authors identified.^[6]
• Saline rinses; it doesn’t clean. The FDA advises using sterile saline only for rinsing, not for cleaning and disinfecting.^[3]
• Fresh solution every night. Don’t top off the solution in your case, and never reuse it.^[3]
• Keep water away. Don’t expose your lenses to tap, bottled, or distilled water.^[3]

Stop it at the source

• Wash with plain soap before handling your lenses, and dry your hands well. Moisturizing soaps and hand creams leave a film.
• Makeup after lenses. The FDA advises applying makeup after inserting lenses, removing lenses before removing makeup, and using sprays such as hairspray and cologne before you insert.^[5]

Upgrading your cleaning routine

If film keeps coming back, your fitter may change your products. In an international survey of scleral lens practitioners, 62% of patients used a daily surfactant cleaner (a cleaner you rub onto the lens) and 47% used hydrogen peroxide disinfection.^[2]

Hydrogen peroxide and multipurpose solutions both help break up and remove trapped dirt, protein, and fatty deposits. Peroxide solutions are generally preservative-free, which can suit people who are sensitive to preservatives. But peroxide must be fully neutralized before the lens goes in, using the case that comes with each new bottle; otherwise it can cause stinging, burning, or eye damage. The FDA advises talking to your eye care professional before changing your care system.^[4]

Your fitter may also suggest a stronger cleaner for occasional use. If your lens has a surface coating, ask which products are compatible with it before trying anything new.

When it’s time for a new lens

Scleral lenses don’t come with a fixed replacement date, and lenses age quietly. Signs a lens may be near the end of its life include:

• Cloudiness that cleaning won’t remove.
• Scratches or chips on the surface.
• Vision that’s no longer as sharp as when the lens was new.
• More discomfort by the end of the day than you used to have.

Mention any of these at your next visit, and bring the lens. Researchers have explored ways to measure how well tears spread over the lens surface, partly to help decide when a lens needs its coating renewed, reconditioning, or replacement.^[7] Your fitter can tell whether the lens itself is the problem.