Medically reviewed by Dr. Shira Kresch, OD, MS, FAAO — optometrist specializing in keratoconus, scleral lens fitting, and ocular surface disease
The rule of thumb: only preservative-free drops should go anywhere near a scleral lens — and only preservative-free saline made for scleral filling goes inside the bowl. Over the lens during the day, preservative-free artificial tears are fine and often helpful. What you should never do is fill the lens with multipurpose solution, tap water, or preserved drops. Here’s the full compatibility rundown.
Inside the bowl: preservative-free saline only
Whatever fills your scleral lens sits sealed against your cornea for the entire wearing day. Preservatives that are harmless in a quick rinse become irritating — even toxic to surface cells — when trapped against the eye for hours. That’s why the bowl gets preservative-free saline made for scleral lenses (LacriPure and ScleralFil are our go-tos) and nothing else. Never tap, distilled, or bottled water: water exposure risks Acanthamoeba, a rare but serious corneal infection.
Over the lens during the day: preservative-free artificial tears
If your eyes feel dry around the lens mid-day, preservative-free lubricating drops (the single-use vials) applied right over the lens are safe and effective. Avoid preserved bottled drops while lenses are in — preservatives like BAK can bind to the lens surface and build up. And skip “redness relief” drops entirely; they constrict blood vessels, mask symptoms, and cause rebound redness.
Prescription drops: timing is everything
Using prescription eye drops — for glaucoma, inflammation, or dry eye disease — doesn’t rule out scleral wear; it just needs a schedule. Most prescription drops are applied before insertion and after removal, not over the lens, so the medication reaches the eye without pooling in the reservoir. Bring every drop you use to your fitting and we’ll build the routine together.
If you’re using drops constantly, treat the dryness itself
Scleral lenses are themselves one of the best therapies for severe dry eye — the reservoir bathes the cornea all day, which is why we fit them for dry eye disease. But if you’re reaching for drops every hour, the underlying ocular surface disease deserves its own treatment plan — from prescription therapy to in-office treatments like IPL. Our dry eye treatment page covers the options, and our dedicated dry eye practice, 1-800-DRY-EYES, goes even deeper on advanced dry eye care.
Can I use artificial tears with scleral lenses in?
Yes — preservative-free artificial tears applied over the lens are safe and helpful for mid-day dryness. Avoid preserved drops while lenses are in, and never use redness-relief drops.
What solution goes inside a scleral lens?
Only preservative-free saline made for scleral lens filling, such as LacriPure or ScleralFil. Never multipurpose solution, preserved saline, or any form of water — preservatives and microorganisms held against the cornea all day cause harm.
Can I use my glaucoma or prescription drops with scleral lenses?
Yes, with the right schedule — most prescription drops are applied before lens insertion and after removal rather than over the lens. Your specialist will build the timing into your daily routine.
Not sure whether your drops belong in your routine? Bring them to your free specialty consultation and we’ll sort it out together — Dr. Shira Kresch serves patients across Metro Detroit from our Southfield office. Book online or call (248) 545-2800.
