Diving with Scleral Lenses

[divesergeant]

If you have these you know about them. If not, you probably don't know much about them but probably wouldn't be reading this anyway so I'll not go into what they are, just why I have them and my diving experience with them.

Typically these are used for folks with Keratoconus which is not me. My issue is that my corneas are hopelessly buggered up with scar tissue from old refractive surgeries. (I do not know if Keratoconus in contraindicative for diving or not, so I can't give advice on that.) My vision fluctuates greatly during the day and the scars result in halos and stars of glare as well as seing several ghost images of whatever I look at. At night it was much worse. Neither glasses nor regular contacts gave me reliably useful vision, and that lead me to sclerals.

While I was getting fitted I searched for good advice on whether I could dive or not wth these. Since there is basically no exchange of fluid/tears behind the contact I didn't know if there might be pressure issues or not with descent and/or ascent and if I would experience discomfort and/or changes in vision as a result.

The results of my search were mixed and not very encouraging. I was getting fit for a just-released type called Ampleye by Art Optical and the company didn't offer much help either way since they are not diving experts. My optometrist isn't a diver either. He didn't see a problem diving but wasn't sure.

I called DAN which I should have done first.

Ther guy on the phone knew instantly what I was talking about. He said there was absolutely no reason in my case that I could not dive with them. So I went to Grand Cayman and did so.

I found no noticeable changes in vision during the dives, nor did I feel any pressure or discomfort. With old smaller hard or soft contacts there is a fear of losing a lens if you flood your mask. I do not think this is a concern with sclerals since, at least in my case, they are pretty well suctioned on. As hard as they come out sometimes, I'm sure they won't wash out!

So, my experience was very positive. I hope this helps others out and, of course, if you have any doubts call DAN!

Cheers,
DS

 

[BRT]

Gas permeables didn't help? I had corneal grafts 30 years ago for kerataconus right when I started scuba diving. I eventually couldn't get vision with soft lenses but do fairly well with gas perms.

 

[divesergeant]

Hi BRT,

The sclerals actually are a type of rigid gas perm lens. They seat on the sclera, (the whites of the eyes) and vault over the cornea. You fill them with fluid and place them on your eye while looking straight down, trapping the fluid between the lens and your eye. The fluid-filled space mostly negates the uneven cornea. They're hugely frustrating to put in until you figure out the technique, but work wonders once in.

Cheers!
DS

 

[Bratface]

This information is valuable to me. Thanks, divesergent. I too, had the RK, ALK surgery of the past that was meant to improve our vision. I also have the daily, hourly, you name it, fluctuation of my vision and it has gotten worse. I'm going to the eye doctor this week to see about being fitted with scleral lenses. I'm glad it's no issue diving with them.

 

[divesergeant]

Hi Bratface,

I am glad to hear the info helped. I found pretty much nothing on my searching about sclerals and diving so to help others was my goal in posting!

I hope sclerals give you better vision like they have for me. I'm still getting my final fit and prescription narrowed down (it is not a quick process) but the results have been life-changing.

I think that the treatment of others like us in the "post-refractive surgery sucky vision club" will be a booming industry soon!

Feel free to post any questions you have about my experience so far. I'm far from an expert, but am learning as I move along in the process.

 

[BRT]

Regular gas perms didn't help much?

 

[divesergeant]

Regular gas perms didn't help much?

Didn't try smaller rigid gas perms, but tried all sorts of soft gas perms.

They all apparently rest on the cornea and rely on tears to pad underneath. The uneven and constantly changing shape of the cornea still causes the vision fluctuation, starring effect and glarey halos. The Scleral lenses actually trap fluid under them so that fluid helps negate the mis-shapen cornea. In effect, the retina 'thinks' that the clearly focused image from the front surface of the lens is coming from the cornea.

But here, this is a way better explanation than I can give!

Scleral Lenses Have Many Uses, Including in the Movies!

Cheers,
DS

 

[BRT]

Probably should have tried regular gas perms first. I can't get vision with any sort of soft lenses but the rigid gas permeables do the function that you are looking for. Water behind them and a fixed surface out front corrects all the funny curves and bumps of a bad cornea.

 

[tholden1]

Thank you DS. I am 18 years after LASIK and need something again to correct my distance vision. It would be great too if I could correct my night vision issues but that has existed ever since right after LASIK. I can't tolerate soft contacts due to dryness, and my doctor is about to fit me with sclerals. I didn't think you could dive with them but hearing that DAN said you could and that you don't have any issues with them getting lost in the water (since they are very expensive) and that they are working for you while diving is good to hear.

 

[Bratface]

Divesergeant, how many dives have you made with your sclerals? The reason I ask is there is a FB page for LASIK and refractive cripples like us. There is another woman on the page who has tried and was unable to use scleral lenses. She wonders about an air bubble getting trapped under the lens while you are diving. From the videos and information I have read, that shouldn't happen because of filling the bowl of the lens with fluid and the suction it creates. Have you been given any information about that?

I used to wear gas permeable lenses before the eye surgeries and swam in them. They do have the ability to dislodge but I never had any problems with bubbles under them.

Your feedback is so helpful. Thank you so much for sharing your experience.