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Michigan Contact Lens

Scleral Lens Care: Solutions, Cleaning, and the Daily Routine

Scleral lens care confuses people for one reason: there are three separate products doing three separate jobs, the bottles look alike, and the labels do not make the difference obvious. Get the three jobs straight and the routine takes about two minutes a day for the rest of the time you wear the lenses.

The three jobs, and why one product cannot do them all

Every safe scleral lens routine covers three things.

Filling. Scleral lenses vault over the cornea and hold a reservoir of fluid against it. That fluid goes in before the lens does, and it stays against your eye for the whole wearing day. It must be a preservative-free sterile saline — nothing else. This is the non-negotiable one.

Disinfecting. Organisms that land on the lens during handling have to be killed before the lens goes back on your eye. That is an overnight soak in a disinfecting system, most often hydrogen peroxide based.

Cleaning. Protein, lipid and general film build on the lens surface and cloud your vision. Removing them takes a gas-permeable lens cleaner and, more than anything, your fingers.

Some products combine disinfecting and cleaning. Nothing safely combines filling with either, and this is where most of the confusion — and most of the risk — lives.

Saline does not disinfect

Worth stating plainly, because it is the single most common misunderstanding in scleral lens wear: preservative-free saline has no antimicrobial action whatsoever. That is precisely why it ships in single-use vials — there is no preservative in it to stop the solution itself becoming contaminated once opened.

So a case filled with saline overnight has not disinfected anything. It has given whatever was on the lens a warm, wet place to sit for eight hours. If your routine is saline and nothing else, the two parts that protect your cornea are the parts you are missing.

For which saline to use, and how the common options compare, see our guide to scleral lens saline options. If you want the chemistry behind the labels, buffered versus non-buffered saline covers it properly.

Your daily routine

In the morning. Wash your hands with a non-moisturising soap and dry them completely on a lint-free towel. Rinse the lens with preservative-free saline, fill the bowl to the brim with fresh saline, and insert. Never top off yesterday’s fluid.

At the end of the day. Remove the lens over a towel rather than an open sink. Put a drop of gas-permeable cleaner in your palm and rub the lens gently on both surfaces for about twenty seconds — even with products labelled “no-rub,” rubbing removes far more film than soaking does. Rinse, then place the lens in a clean case filled with fresh disinfecting solution and leave it for the full time your system requires.

Every time. Fresh solution, every soak. Discard what was in the case, rinse the case, and refill it. Re-using or topping off solution is how a case becomes the problem instead of the solution.

A few habits that quietly prevent most damage: handle lenses over a towel, use fingertips rather than fingernails, and check each lens for a chip or crack in good light before it goes near your eye. A chipped edge on a lens this size is uncomfortable immediately and can abrade the conjunctiva.

If you use a peroxide system, the sequence matters — see our step-by-step Clear Care routine for scleral lenses, and note the one rule that catches people out: peroxide must fully neutralise in its own case before the lens touches your eye, and you never fill the lens with it.

Weekly deep cleaning

Daily cleaning keeps up with film. It does not keep up with bound protein, which accumulates slowly and shows up as vision that is slightly hazy even on a freshly cleaned lens.

A weekly or fortnightly protein-removal or deep-cleaning product handles that. Whether you need one, and how often, depends on your tear chemistry rather than on a general rule — some wearers never need it, and some need it weekly from the start. Dr. Kresch will tell you which you are, and it is worth asking specifically rather than waiting for the haze to become normal.

Do cleaning machines help?

“Scleral lens cleaner machine” is a common search, and the honest answer has two halves.

Ultrasonic and vibrating cleaning devices agitate the solution around the lens and can loosen surface deposits, particularly for wearers with heavy protein buildup who are already cleaning diligently. Some long-term wearers genuinely like them.

What a device does not do is replace either of the other two jobs. It does not disinfect, and it does not substitute for rubbing the lens between your fingers. A machine is an addition to a routine that already works — never a rescue for one that does not. They also vary widely in design and quality, so ask Dr. Kresch before buying one. She can tell you whether the deposits you are getting are the kind a device actually helps, which saves you the cost of finding out the hard way.

The case is part of the routine

Cases are one of the most common sources of contamination in contact lens wear, and they are the easiest thing to neglect.

Empty and rinse it daily, then let it air-dry face down on a clean tissue rather than closing it wet. Replace it every one to three months, and sooner if it has gone cloudy or developed a film you cannot rinse off. Peroxide systems use their own neutralising case with a catalytic disc that wears out — replace that one whenever you start a new bottle.

Never let a lens dry out in an empty case. A dried scleral lens can warp, and warping changes a fit you paid for in chair time.

Water, and why the rule has no exceptions

Tap water, distilled water, filtered water and bottled water can all carry Acanthamoeba, an organism that causes a corneal infection which is notoriously difficult to treat and can permanently reduce vision.

The rule covers more than you might assume: the lens, the case, the plunger, and your hands, which should be dry before you touch anything. It also covers showering and swimming in your lenses, which you should not do unless Dr. Kresch has specifically cleared it for your situation — and if you do swim, tight-fitting goggles are not optional.

There is no version of this rule with a sensible exception, including “just this once” and “it’s filtered.”

Travelling with scleral lenses

Take more single-use saline vials than the trip needs — they are the item you cannot improvise, and a pharmacy in an unfamiliar town is unlikely to stock preservative-free scleral saline. Pack a spare case and a spare plunger, keep your solutions in your carry-on rather than checked luggage, and bring your glasses. If your lenses become unwearable away from home, glasses are the difference between an inconvenience and a ruined trip.

Red flags — stop wearing the lens and call us

Take the lens out and contact us promptly if you have:

  • Eye pain, particularly pain that persists after removing the lens
  • Redness that does not settle within an hour of removal
  • New light sensitivity
  • Discharge
  • Blurred vision that does not clear after removing, rinsing and refilling with fresh saline

Caught early, nearly all of these are minor and quickly managed. Ignored while you keep wearing the lens, a few of them are how eyes get damaged. Nobody here will think you overreacted by calling.

Fogging that returns within an hour or two no matter how clean the lens is usually a fit issue rather than a cleaning one — our guide to scleral lens fogging explains the difference and what actually fixes it.

Where to go next

Questions about caring for your scleral lenses?

Dr. Shira Kresch, OD, MS, FAAO offers complimentary specialty consultations at Michigan Contact Lens in Southfield, serving patients across Metro Detroit. If your current routine is not keeping your lenses clear, bring your solutions with you — often the fix is a product change rather than more effort.

Book a Free Consultation or call (248) 545-2800

Frequently Asked Questions

What solution do I use for scleral lenses?

Three different products, each doing a different job. A preservative-free saline fills the bowl of the lens before you insert it. A disinfecting system — usually hydrogen peroxide based — kills organisms on the lens overnight. A gas-permeable cleaner removes the film and deposits that build up on the surface. Some products combine the last two, but nothing safely combines the first with either of the others, because the fluid that sits against your cornea all day has to be preservative-free and sterile.

Can I use saline to store my scleral lenses overnight?

No. Saline does not disinfect — it has no antimicrobial action at all, which is why it comes in single-use vials. A case filled with saline overnight leaves the lens undisinfected and gives anything already on it a warm, wet place to multiply. Overnight storage is the disinfecting solution's job.

Do scleral lens cleaning machines work?

Ultrasonic and vibrating cleaners can help loosen surface deposits, and some long-term wearers with heavy protein buildup find them useful. What they do not do is replace disinfection or replace rubbing the lens. A machine is an addition to a routine that already works, never a substitute for one — and because they vary a great deal, ask Dr. Kresch before buying one so she can tell you whether your deposit pattern is the kind a device actually helps.

How often should I replace my scleral lens case?

Every one to three months, and sooner if it looks cloudy, scratched, or has a film you cannot rinse away. Cases are one of the most common sources of contamination in contact lens wear, they cost very little, and replacing one is the cheapest risk reduction available to you. Peroxide systems come with their own neutralising case — that one gets replaced whenever you start a new bottle, because the neutralising disc wears out.

Why can I never rinse my lenses with water?

Because tap, distilled, filtered and bottled water can all carry Acanthamoeba, an organism that causes a corneal infection which is extremely difficult to treat and can cost you vision. The rule is absolute and covers the lens, the case, the plunger, and your hands being dry before you handle anything. It also means no showering or swimming in your lenses unless Dr. Kresch has specifically cleared it.

My lenses fog up during the day. Is that a cleaning problem?

Sometimes, but often not. If the fogging clears when you take the lens out, rinse it and refill it, the deposits are the issue and a better cleaning routine or a weekly deep clean will help. If it comes back within an hour or two no matter how clean the lens is, that is usually mid-day fogging — debris getting under the lens from the fit or the tear film, not dirt on it. That is a fit conversation, not a cleaning one.

Can I use my regular soft contact lens solution on sclerals?

Not for filling, and usually not for cleaning either. Multipurpose soft lens solutions contain preservatives that are fine for a brief rinse but irritating when trapped against the cornea for hours, which is exactly what happens in a scleral lens. Rigid lens materials also respond differently to cleaners than soft hydrogels. Use products intended for gas-permeable and scleral lenses, and check any new product with us before you switch.

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