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InSight Scleral Lens Checklist

What Information Do You need to order an InSight Scleral Lens?

Our methodology focuses on simplicity and optimizing your chair time. Provide us with your observations, and we’ll handle the lens parameters.

If you can place a diagnostic lens on the eye with sodium fluorescein (NaFl), note your observations, we can deliver an initial lens within a few days.

Corneal and scleral GP lenses typically take 2–3 days to manufacture; Hydra-PEG adds one day to the process. Standard shipping is 2-3 business days.

Checklist for Simplified Ordering:

1. Initial Lens Selection
Based Selection on Sagittal Height
This reflects the overall curvature of the cornea.

  • Steep/Ectatic Corneas: Start with the Prolate 5.000 SAG
  • Flatter/Oblate Corneas: Select the Oblate 4.750 SAG

2. Evaluation (Three Steps)

  1. Central Clearance:
    Aim for ~250 microns of clearance, represented by a 1:1 ratio—250 microns of post-lens tear film and 250 microns of lens center thickness.
  2. Peripheral Clearance:
    Ensure NaFl clears the limbus 360° with 50–80 microns of peripheral clearance. Look for any areas of bearing or blanching; the limbus should always be vaulted.
  3. Edge Alignment:
    The lens should sit comfortably on the conjunctiva. Check for signs of impingement or blood vessel constriction.

    Please send images or short 2-3 second videos of the lens on the eye.

    Quick Tip:
    After lens removal, check for staining and report it to consultation if present.

3. Patient Feedback

Ask the patient how the lens feels:

  • Lens Awareness: If the patient feels the lens, it’s likely a landing issue.
  • Discomfort: If the lens is uncomfortable, remove it immediately. Scleral lenses should be very comfortable.

4. Topography:

Provide topographical data for consultation—it gives a clearer picture for customized lens fitting.

5. Anterior Segment OCT (Optional):

If available, AS-OCT images offer additional data to help understand what is happening with the lens on the eye, though it is not required.

6. HVID (Horizontal Visible Iris Diameter):

This measurement is essential for incorporating multi-focal optics, optimizing visual acuity and customizing the lens to the patient’s lifestyle.

7. Sphere-Cylinder Over-Refraction:

The SCOR provides the most accurate visual acuity and avoids inducing astigmatism. The InSight Scleral Lens can incorporate up to +3.00 D of ADD power.

8. Pertinent Patient Information:

Provide details such as:

  • Previous contact lens wear
  • Surgical procedures
  • Visual demands
  • Any factors that could significantly impact the lens design

9. Hydra-PEG (Optional):

Ask during consultation if Hydra-PEG is suitable for the patient.
Hydra-PEG Benefits:

  • Improves wettability by lowering the wetting angle
  • Reduces deposits and fogging

Please call consultation with the above information to discuss further, and we will have the lenses to you in a few short days.

If you don’t have all the information listed above, don’t worry! Our experienced consultants can design a lens based on the details you provide. The more accurate information we receive, the faster we can get the final lens to you.

We are here to support you every step of the way!

Sincerely,
Your Metro-Optics Team

CONSULTATION: 800-223-1858
EMAIL: info@metro-optics.com

 

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InSight Scleral Lenses for Keratoconus

Anterior Seg OCT
Practice: Illinois College of Optometry
Patient: 36 YO Male
Condition: Keratoconus

Presentation:
Patient was diagnosed with keratoconus when he was 26 years old. He was referred by his OMD for a contact lens fitting. He had never worn glasses or contacts. He reported difficulty driving at night and was concerned about getting his driver’s license renewed.

Ocular History:
His entering uncorrected acuities were 20/70 OD and 20/200 OS. Manifest refraction improved his vision to 20/30 OD and 20/70 OS. Slit lamp examination revealed corneal apical thinning and steepening, meibomian gland dysfunction, and 1+ conjunctival papillae OU.

Prescribed Lenses:
InSight scleral lenses
Learn More

Outcome:
20/20 OD
20/25 OS
Patient LOVES his lenses. He has been wearing the InSight Scleral lenses since 2017 and reports he will never wear anything else!

Help More Patients in Your Area:
Find the Illinois College of Optometry on our Physician Locator page as a specialty contact lens practice. Is your practice on the map? Check here.

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Patient Outcome: Successful InSight Scleral Lens Fitting of Corneal Transplant

Dr. Lechlitner

Optometrist: Stephanie Lechlitner, O.D.
Practice: Oak Hill Eye Care, Austin, Texas
Patient: 72 YO Female
Condition: Repeat Corneal transplant and repaired retinal detachment OD

Presentation:
Patient presented with high myopia OU. Irregular corneal surface OD due to corneal graft.

Ocular History:
The patient has been functioning with monocular vision for about 10 years. She experienced a failed corneal transplant and recently experienced a full retinal detachment OD.

Prescribed lenses:
InSight scleral in Optimum Extra 100Dk material with Hydra-PEG surface treatment.

                  Base Curve       Power       Diameter       SAG PC
OD             6.96                    -14.50       15.6                4.342 Toric
OS             6.78                    -8.50         15.6                4.393 Toric

Outcome:
OU VA 20/25
The patient is over the moon with how well these scleral lenses are working and is very grateful for this technology.

Learn more here

Help More Patients in Your Area:
Find Oak Hill Eye Care on our Physician Locator page as a specialty contact lens practice. Is your practice on the map? Check here.

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Successful Treatment of Keratoconus with InSight Scleral Lens

Dr. Arun Kaistha

Doctor: Dr. Arun Kaistha
Practice: Cooper River Eye Eye Associates, New Jersey
Patient: 15-year-old male
Condition: Undiagnosed Keratoconus

Background:
A 15-year-old male patient had been struggling with deteriorating vision for several years, visiting multiple doctors. Despite numerous consultations, the root cause of his vision issues remained unidentified, leaving the patient barely able to count fingers.

Treatment:
Upon visiting Dr. Kaistha, the patient was properly diagnosed with Keratoconus. The patient was fit in the InSight Scleral Lens.

Learn more here

Outcome:
VA of 20/20 with comfortable all day lens wear. The successful diagnosis and treatment significantly improved his vision and quality of life.

Help More Patients in Your Area:
Find Dr. Kaistha on our Physician Locator page as a specialty contact lens doctor. Is your practice on the map? Check here.

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Properly Care for Scleral lenses with the Metro Optics Care Kit

Proper contact lens hygiene plays a significant role for successful scleral lens outcomes. One study found that 66% of complications in contact lens wearers were due to poor hygiene.1 

We offer a scleral lens care kit to improve compliance and overall lens performance. The care kit includes a ten day supply of the highest quality products and how to order more.

Care Kit Contents

  • Tangible Clean MPS 3.4 oz
  • Nutrifill Sterile Saline Insertion Solution with electrolytes
  • DMV Vented Scleral Cup for insertion
  • DMV Ultra Remover
  • Mirror
  • Clear travel bag
  • Tangible Clean 15% Discount Code
  • Care instructions

InSight Scleral Len Care Kit

Scleral Care Kit inside of clear travel bag

Autoship Option
Many of our accounts elect to automatically ship a scleral care kit with their scleral lens order. They incorporate the cost into their scleral lens fitting and materials fees. If you’re interested in the care kit auto ship option, please complete the form in the link below.

SCLERAL LENS AUTO SHIP REQUEST

Request Samples
If you’re interested in using these products in your practice, Tangible Science and Nutrifill offer samples to practitioners who open wholesale accounts.

Visit our Scleral Lens Success Guide to see the step by step instructions on how to request samples.

References
1. Dumbleton, K., Caffery, B., & Jones, L. (2020). Contact lens-related complications and the importance of compliance with lens care. PLOS ONE, 15(9), e0239116.

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Metro Optics Multifocal Quick Reference

Health, Happiness & Multifocal Lenses

Metro Optics custom multifocal lenses fill a niche commodity lenses can’t touch.

By using Metro Optics proven presbyopic lens designs, you will realize how simple and rewarding it is to fit custom multifocal contact lenses. 

Metro Optics Multifocal Quick Reference:

Our design portfolio includes soft, corneal GP and scleral lens designs proven to enhance the vision of thousands of presbyopic patients:

MetroFocal  – Center distance soft multifocal, normal cornea profile, up to 2.50D add power, available in toric parameters for patients with 0.75 to 8.00D cornea astigmatism – best suited for the mild to moderate presbyope who desires a soft lens. Empirically order lenses using manifest and keratometry readings. Available in Definitive 74% SiHy, 60 Dk which provides three times the oxygen to the cornea in comparison to other hydrogels (1).

Metro Progressive  – Center distance corneal GP aspheric multifocal, normal cornea profile, up to 2.50D add power, rotation-free optics for patients with less than 2.75D astigmatism, available in back-toric and bi-toric for patients with over 3.00D corneal astigmatism – best suited for the mild-to-moderate presbyope who is a current GP wearer or desires the crispest vision possible in a multifocal design. Empirically order lenses using manifest and keratometry readings.

Metro SEG  – Translating crescent bifocal with an aspheric intermediate zone, normal cornea profile, unlimited add power, available in back toric and bi-toric for patients with over 3.00D cornea astigmatism – best suited for the moderate to advanced presbyope who is a current GP wearer or desires the crispest distance and near vision possible. Empirically order lenses using manifest and keratometry readings.

InSight Scleral – Center distance multifocal scleral, normal to highly irregular cornea profiles, up to 3.00D add power, thin design maximizes Dk/t of the chosen lens material – best suited for the mild to moderate presbyope who needs a medically necessary lens for keratoconus, post-surgical ectasia or severe ocular surface disease. Diagnostic fitting is required with live virtual training available with a Metro Optics consultant.

An Infinitely Better Material for Corneal GP and Scleral Lenses

When it comes to quality, Metro Optics ensures all lenses are manufactured with the best materials available in the market. To provide your patients with the healthiest contact lens environment, it is recommended to choose a high dK/t lens material such as Optimum Infinite, which has a hyper oxygen permeability value of 180Dk and a high flexural modulus of 1341MPa, defying the high Dk/low flexural modulus convention (2). This material also has excellent surface wettability, which can be further enhanced through the addition of Tangible hydra-PEG coating to make Infinite the healthiest choice for your corneal GP and Scleral lens wearers. 

Metro Cares About Your Practice

Other than manufacturing high quality custom lenses, Metro Optics also provides many benefits to ensure our customers have a profitable custom lens practice. We have always offered 90-day warranties on all lens designs, easy return policies, competitive pricing and expertise consultation to finalize fittings quickly. We will also continue to support our customers by extending warranties on fittings performed prior and during the rebuilding phase of the COVID-19 pandemic. Visit our website at metro-optics.com to learn more about our entire line of custom contact lenses.

PUBLISHED IN THE JUNE 2020 CONTACT LENS SPECTRUM ISSUE

References 

  1. https://www.clspectrum.com/issues/2010/november-2010/contact-lens-design-materials)
  2. https://www.contamac.com/product/optimum-infinite
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