Saline for Scleral Contact Lenses

Saline for Scleral Contact Lenses

by Brian Chou, OD, FAAO, FSLS

  • October 23, 2022


If you wear scleral contact lenses, which saline solution should you fill your lenses with? The answer is simple: preservative-free saline. Learn below what preservatives are, what happens if you do not follow this guidance, and the benefits of adhering to using preservative-free saline. Also learn the three types of preservative-free saline and what to do in an emergency if you cannot find it.

Preservative-free saline

Multipurpose contact lens solutions and many saline solutions have preservatives. Preservatives are substances that prevent contamination by micro-organisms including bacteria. Without preservatives, solutions contaminated with bacteria can transfer and colonize on the eye surface, and in the worst cases, lead to sight threatening eye infection. While preservatives have an important role in minimizing infection risk, their prolonged contact against the eye can irritate the delicate corneal tissue. Scleral contact lenses form a sealed chamber on the eye, where filled solution is put against the eye for the duration of wear. Toxicity of the eye due to preservatives can cause abnormal eye redness, discomfort, and light sensitivity. In other words, using the wrong saline solution with scleral contact lenses is bad for your eyes and can reduce your tolerance for scleral contact lens wear. A common mistake is using “sensitive eyes” saline, which is not preservative free. To keep your precious eyes in tip-top condition when wearing scleral lenses, only using preservative-free saline to fill your lenses.

Three kinds of preservative-free saline

After your scleral contact lenses are cleaned and disinfected, they are ready to apply onto the eye with non-preserved saline. There are three types of non-preserved saline for use with scleral contact lenses.

  • Inhalation saline. Examples include Addipak and Modudose saline. These packets of saline come in individual containers for nebulizers for those with breathing problems, like asthma or cystic fibrosis. Inhalation saline is also suitable for filling scleral contact lenses. It is relatively inexpensive, is readily purchased online, and handy for travel. ReVision Optometry recommends inhalation saline for most of our scleral contact lens patients.
  • Branded preservative-free saline marketed for scleral contact lenses. Examples include LacriPure, Nutrifill, and ScleraFil. These saline solutions work well for scleral contact lens wearers. However, they are more expensive. Some patients believe they offer superior outcomes. Most of our patients cannot discern a different wearing experience using branded preservative-free saline versus Addipak or Modudose saline.
  • Bottled preservative-free saline. The only bottle choice now is PuriLens Plus saline, which originally was intended for an ultraviolet light contact lens disinfection system. Today, PuriLens Plus is more commonly used for rinsing and applying scleral and hybrid contact lenses. Previously, the only bottled non-preserved saline was Unisol but the manufacturer, Alcon, discontinued its production in 2015. PuriLens Plus is valuable for patients that use more non-preserved saline than average. However, each bottle is to be discarded 15 days after opening to avoid potential contamination. As a result, most scleral lens wearers may find that they need to discard the bottle before all the solution is consumed. To open PuriLens Plus saline, do not puncture the plastic top with a sharp object like a knife to avoid injury. Instead, remove the white plastic collar to allow the screw cap to twist and prick into the bottle top.

What to use in an emergency?

Say you are on travel but do not have non-preserved saline. Even though it is difficult to find non-preserved saline in a regular store, don’t panic! As an alternative, you can safely use non-preserved artificial tears, such as preservative-free Refresh Plus. You can find and purchase these in just about any large grocery or department store. The reason these are not usually used on a regular basis is because they are much more expensive over the long run compared to using one of the preservative-free saline solutions.

ReVision Optometry is a referral-based practice in San Diego providing scleral contact lens services for patients with keratoconus and other complex eye conditions. To schedule, request your examination online or call our office at 619.299.6064.