Fill & rinse
Preservative-free saline
Goes in your eye
Sterile and preservative-free only. One vial per fill; throw the rest away.
Comfort
Preservative-free drops
Over the lens, as directed
Rewetting drops go over the lens, as your fitter directs. Adding anything to the fill is their call.
Nothing
Water of any kind
Never on lens or case
Tap, bottled, distilled, filtered: none are sterile enough. Not even to rinse the case.
Brand names on this page are examples of products wearers use, not endorsements. Your fitter’s instructions, your prescriber’s instructions, and each product’s label come first. This page never gives doses: those come from your prescriber.
Three places a drop can go
A drop can go over the lens while you wear it, in the bowl before insertion, or only when the lens is out. Fluid in the bowl sits against your cornea for hours, which is why it has the strictest rules. Our short answer on using eye drops with scleral lenses explains why; this page goes deeper on products.
| Kind of drop | Over the lens? | In the bowl? | Lens out? |
|---|---|---|---|
| Preservative-free rewetting drop | Yes, if your fitter approves | Only if your fitter directs | Yes |
| Thick preservative-free gel (e.g. Celluvisc) | Can blur and gum up | Off-label; only if your fitter directs | Yes |
| Preserved artificial tears | No | Never | Ask your doctor |
| Prescription dry-eye drop | No | Never | Yes, timed by your prescriber |
| Allergy or redness drop | Usually no | Never | Yes, per label and doctor |
| Milky, oily, or emulsion drop | Wearers report fog | Never | Yes |
Rewetting drops over the lens
A review of scleral lenses for eye surface disease says people can use preservative-free artificial tears directly over the lens as needed during the day.[1] “Rewetting drop” here just means a preservative-free drop that keeps the front of the lens and the eye around it comfortable.
Examples wearers mention most:
- Refresh Plus: preservative-free single-use vials of carboxymethylcellulose 0.5%.[2] The most-named drop over sclerals among wearers.
- iVizia: a preservative-free multi-dose bottle; its label says to use it up to 90 days after opening.[5]
- Systane Hydration PF: also sold in a preservative-free bottle, labeled to be discarded 90 days after opening.[4]
- Your fill saline: some wearers simply use a few drops from a fresh vial.
Thick drops are a different story over the lens. Celluvisc’s own label says it may cause temporary blurring because of its thickness.[3] Wearers report thick gels gumming up the front of the lens and drying out lashes.
If your lenses are coated, Tangible Science says wetting drops and artificial tears shouldn’t damage its Hydra-PEG coating, but to check with your practitioner.[15] Wearers advise avoiding oily drops on coated lenses.
How often? That varies a lot between wearers. If you need drops much more often than your fitter expects, tell them: fit, dry eye treatment, and the fill can all change that.
What goes in the bowl
By default, sterile preservative-free saline, from a fresh vial each fill, with the rest thrown away. See filling the lens for technique.
Many wearers add a few drops of a thick preservative-free drop, most often Celluvisc, before topping up with saline. They do it to reduce midday fogging, cushion the lens, or ease removal, and many say a fitter suggested it. Be clear about what it is: an off-label use. The label directs you to put the drops in your eye and discard the container.[3] It doesn’t cover mixing them into a lens fill. The risks wearers report include blurry vision after insertion, extra bubbles, stinging in a very dry eye, and, for some, more fog rather than less. Using a multi-dose bottle to add drops to the bowl adds contamination risk. This is a decision to make with your fitter, who should tell you which product, how much, and when to stop.
Never put these in the bowl: preserved drops, allergy or redness drops, prescription drops, milky or oily drops, cleaners, or anything from an opened vial you saved. Serum tears and other medicines go in the bowl only when the doctor who prescribed them says so.
Prescription dry-eye drops and timing
These are medicines, and the labels are clear that they don’t go in with a contact lens in place. The labels for Restasis, Cequa, Vevye, and Xiidra all say to remove contact lenses before using the drop and that lenses may be reinserted 15 minutes after.[8][9][10][11] Miebo’s label says lenses should be removed before and for at least 30 minutes after each use.[12] The scleral lens review advises using prescription drops before or after lens wear and waiting at least 10 minutes before putting lenses in.[1]
Your prescriber sets the dose and timing, and may want a longer gap than the label minimum. Ask them, and your fitter, to fit it around your lens day. Some wearers report burning after insertion on days they used cyclosporine, even hours earlier; a rinse of the eye with sterile saline before insertion helped some. If that happens to you, report it rather than stopping a medicine on your own.
Allergy and redness drops
Many over-the-counter allergy drops contain a preservative. Pataday Once Daily, for example, lists benzalkonium chloride, and its label says to remove contact lenses before use and wait at least 10 minutes before reinserting.[13] The redness reliever Lumify’s label says the same.[14] Wearers commonly use an allergy drop before insertion or after removal, and many say it cut down the white mucus that clouds their lenses.
Redness while wearing sclerals can also be a sign the fit, a solution, or your eye needs checking. Mention it to your fitter instead of masking it.
Oily and milky drops, and fogging
Some drops for oil-gland dry eye are emulsions or contain oils. Systane Complete PF is an emulsion that contains mineral oil and says to shake well.[6] Refresh Optive Mega-3 PF contains flaxseed oil and castor oil.[7] Restasis is also an emulsion.[8]
Wearers consistently report that milky or oily drops cloud the fluid in the bowl and smear over the front of the lens. Most save them for lens-free times. Night ointments can linger into the morning too; cleaning the lids and rinsing the eye with sterile saline before insertion helps many.
Single-use vials
Single-use means single use. Refresh Plus’s label says: do not reuse; once opened, discard.[2] Recapping a vial for later in the day is common, and it’s a contamination risk.
Check recalls, too. In December 2024, one lot of Systane Ultra PF single vials was recalled after material inside a sealed vial was found to be fungal.[16] The FDA advises stopping any eye drop that causes pain, discharge, or vision changes, and avoiding drops marketed as homeopathic, color-changing, or containing honey.[17]
What wearers report
- Refresh Plus is the drop wearers name most for use over sclerals: thin, single-use, rarely blurs. A few find it stings.
- iVizia and Systane Hydration PF are liked as preservative-free bottles; one or two wearers report stinging after a week or so.
- Celluvisc in the fill gets strong praise for fogging from many and complaints of blur, bubbles, and cost from others.
- Prescription dry-eye drops get the most mixed reviews: some wearers rely on them; others found they burned or did little.
- Pataday-type allergy drops before insertion are widely used in allergy season.
If this isn’t working for you
| What’s happening | What wearers often ask their fitter about |
|---|---|
| Vision blurs after a drop over the lens | A thinner preservative-free drop while wearing |
| Fogging by midday | Fit, a different fill, a thick add-in, allergy treatment |
| Every drop stings | Preservative-free versions, single-use vials, a dry eye work-up |
| Burning after insertion on medicine days | A longer gap, or rinsing the eye before insertion |
| Drops needed constantly | Fit, plugs or other dry eye treatment, moisture-chamber glasses |
| Mucus clouding the lens | Allergy drops before insertion, lid hygiene |
Do
- Use preservative-free drops over the lens.
- Use a fresh vial for every fill and throw the rest away.
- Take lenses out before prescription, allergy, and redness drops.
- Ask your prescriber and fitter to agree on timing.
- Check lot numbers against recalls.
Don’t
- Never fill or rinse with water of any kind.
- Never top off the bowl or reuse an opened vial.
- Don't add anything to the bowl your fitter hasn't approved.
- Don't put milky or oily drops over the lens.
- Don't keep wearing a lens that burns or stings.
Mistakes that come up again and again
- Recapping single-use vials for later, or filling from yesterday’s vial.
- Adding drops from a multi-dose bottle to the bowl. Single-use vials are the safer choice when your fitter has approved an add-in.
- Using numbing drops at home to make insertion easier. Wearers who’ve been warned say they’re for office use only.
- Self-treating a red, painful eye with leftover antibiotic or steroid drops. Get it examined.
- Using homemade or unapproved drops, such as homemade honey drops.
- Rinsing with or filling from a multipurpose or peroxide solution by mistake. Many of these bottles look alike, especially with poor vision. Keep them apart, and take the lens out if it burns.
- Changing several products at once after a reaction, which makes the culprit impossible to find. Change one thing at a time, with your fitter.
Common questions
Which rewetting drops can I use over scleral lenses?
Preservative-free ones your fitter approves. Wearers most often mention Refresh Plus single-use vials, preservative-free bottles such as iVizia and Systane Hydration PF, and simply a few drops of their fill saline. Thinner drops tend to blur less over the lens than thick gels.
Can I add Celluvisc or another thick drop to my lens fill?
Many wearers do, usually because their fitter suggested it for fogging. It's off-label: the drop's label is for putting in the eye, not mixing into a lens. Do it only if your fitter has told you what, how much, and how, and use a fresh single-use vial each time.
Can I use Restasis, Xiidra, Cequa, Vevye or Miebo with my lenses in?
No. Their labels all say to remove contact lenses before using them. Each label gives a wait before the lenses go back in, and your prescriber may set a longer one. Ask them to fit the timing around your lens schedule.
Can I use allergy drops with sclerals?
Usually with the lenses out. Pataday Once Daily, for example, contains a preservative, and its label says to remove contact lenses before use and wait at least 10 minutes before putting them back. Wearers commonly use their allergy drop before insertion or after removal.
Can I save the rest of a single-use vial for later?
No. Labels for single-use vials such as Refresh Plus say do not reuse; once opened, discard. Recapping a vial for later is a common habit and a contamination risk.
Why do some drops make my vision cloudy over the lens?
Thick gels and milky emulsion drops can smear over the lens and cloud the fluid in the bowl. Wearers usually save them for times the lenses are out and use a thinner preservative-free drop while wearing.
Can serum tears go in the bowl?
Only if the doctor who prescribed them says so. Some specialists advise against it because of infection risk; others prescribe a few drops in the bowl. It's a medical decision, not a comfort tweak.