What do I fill my sclerals with?

Your provider should guide your filling solution choices. Determining the right solution to fill your lenses can easily turn into a surprise challenge when you are new. The choice of filling solution may affect your safety, vision and comfort. There are also practical matters of managing costs and finding reliable sources to purchase your saline.

Filling solutions MUST be preservative-free

If you have been told to use a contact lens saline solution or multi-purpose solution to fill your lenses such as those pictured above, this is incorrect. All conventional contact lens solutions contain preservatives. Your scleral will hold this solution against your eye all day long, bringing risk of irritation from preservative toxicity.

• If it's preservative-free, it will say so on the front of the box.

• Preservative free saline solutions are not normally found in local stores.

• Preservative free salines can be used for filling lenses, but never for soaking or storing lenses.

Saline options and considerations

pH

Salines are either buffered, meaning they have additives that stabilize the pH to match the eye, or non-buffered, meaning that they will be acidic (lower pH than the eye).

Packaging

Most preservative-free salines are in 5mL or 10mL single use vials. One is available in re-usable bottles of 2oz or 4oz.

Costs

Preservative-free saline costs are a significant part of the overall cost of using scleral lenses. Safety should not be compromised for cost.

However, 0.9% sodium chloride vials sold as inhalation solution are sometimes recommended by providers despite being acidic, if the patient tolerates it well, partly because this type of solution is more accessible to low income patients.

On-label vs off-label

Five preservative-free saline solutions are labeled for filling scleral lenses, i.e. they are “on-label”. This means, among other things, that they will have suitable instructions and are compliant with FDA guidelines for this product class. These are listed in MBFSL’s product guide.

Filling sclerals with any other salines, whether labeled for ocular use or some other health care use, is considered “off-label”. This does not mean it’s unsafe, but that you should not do it without your provider’s approval.