Step 3: Disinfect
What solution to use for disinfection
On this page, we offer general advice and practical tips. As with all scleral lens care steps, your provider should guide your choice of a disinfection solution. Different patients have different needs.
Option 1: Hydrogen peroxide systems
Hydrogen peroxide 3% lens disinfection systems tend to be preferred as the most effective, particularly for people with ocular surface diseases. However, they are certainly less convenient for scleral lens users, particularly those with larger lenses.
The specific inconveniences include:
Hydrogen peroxide solutions require a special case which contains a neutralizing disc, and attention has to be paid to how long you use the case because the disc can only be used a specified number of times.
Hydrogen peroxide solutions are “red cap” solutions that cannot be used to rinse lenses prior to insertion or for casual short-term storage in a flat case.
Larger sclerals require “frankensteining” of a Clear Care case with a PROSE case.
Your provider may prefer you to use hydrogen peroxide because of its efficacy. Some providers recommend weekly use of hydrogen peroxide and daily use of a multi-purpose solution. Some providers prefer multi-purpose solutions in general.
Some users determine on their own that daily use of hydrogen peroxide improves their comfort or vision by removing deposits more effectively. Some users prefer hydrogen peroxide solutions because they are preservative-free.
Hydrogen peroxide solutions are compatible with Hydra-PEG coated lenses.
Option 2: Multi-purpose solutions
Multi-purpose solutions are formulated for lens rinsing, cleaning and disinfection. They are effective for disinfection with the advantage o being versatile, since they can be used for general rinsing and short-term storage needs. They can be used with standard contact lens cases.
Some scleral lens users use a multi-purpose solution as a true multi-purpose, while others use it solely for rub cleaning or for temporary storage purposes such as a midday lens break. Some use it for travel because multi-purpose solutions, so long as a travel size bottle is chosen, will not trigger potential TSA confiscation (a risk for hydrogen peroxide solutions).
Only three multi-purpose solutions are compatible with Hydra-PEG coated lenses: Tangible Clean, Unique pH and Boston Simplus.
Don’t confuse cleaning with disinfection!
Cleaning and disinfection are two different things. Scleral lenses must always go through a complete disinfection cycle (a multi-hour process) between uses, in an approved disinfection solution.