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Clinical pearls, fitting tips, case studies, and patient outcomes.


How to Order an InSight Scleral Lens

Our methodology is designed to simplify the fitting process and optimize your chair time. Provide us with your clinical observations, and we’ll handle the lens parameters.

Simply, place a diagnostic lens on the eye with sodium fluorescein (NaFl), evaluate the fit, and share your observations with our consultants. From there, we can design and deliver an initial lens within a few days.

Checklist for Simplified Ordering:

1. → Diagnostic Lens Selection

The initial diagnostic lens is selected based on the overall curvature of the cornea.

      • Steep/Ectatic Corneas: Start with the Prolate 5.000 SAG
      • Flatter/Oblate Corneas: Select the Oblate 4.500 SAG

2. → Evaluation

  • 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.
  • Limbal 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.
  • Landing zone / edge alignment: The lens should sit comfortably on the conjunctiva. Check for signs of impingement or blood vessel constriction.
  • Patient comfort: Note any lens awareness or discomfort.
    • 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, when fit properly.
  • Quick Tip: After lens removal, check for staining and report it to consultation if present.

3. → Topography

  • AS-OCT, if available

4. 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.

  • 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.

5. → Relevant Patient Information

    • Previous contact lens wear
    • Ocular surgeries
    • Visual demands
    • Hydra-PEG consideration, if appropriate
      • Improves wettability by lowering the wetting angle
      • Reduces deposits and fogging

Your Metro Optics Team

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

Do you have questions about fitting one of our lenses?
CONSULTATION: 800-223-1858
EMAIL: info@metro-optics.com

Sincerely,
Your Metro-Optics Team



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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