Do You Suffer from Bubbles in Your Scleral Lens?

If you wear scleral lenses in Las Vegas and have noticed bubbles trapped under the lens, you are not alone. Air bubbles are one of the most common issues scleral lens wearers encounter, and understanding why they happen is the first step toward solving them. There are two main types of scleral lens bubbles, each with a different cause and a different solution.

Large Bubble Right After Insertion

The first type is a large, easily visible air bubble that appears the moment you insert the lens. You will usually notice it immediately because your vision through that eye becomes very blurry, and the lens may feel noticeably uncomfortable. When you look in the mirror, you can often see the bubble sitting under the lens.

What Causes a Large Insertion Bubble?

In most cases, a large bubble forms because of an error during the insertion process. Common causes include:

• Not filling the lens bowl completely with preservative-free saline before applying it
• Blinking or flinching as the lens approaches the eye, which traps air between the lens and the cornea
• Tilting the lens slightly during application so one edge contacts the eye before the rest of the lens settles into place

How Do You Fix a Large Bubble?

Unlike soft contact lenses, a trapped air bubble will not work its way out of a scleral lens on its own. You need to remove the lens, rinse it, refill the bowl completely with fresh preservative-free saline, and reinsert it. Taking your time during insertion and keeping your eyes wide open as you bring the lens toward the eye can help prevent the bubble from forming again. Some patients find it helpful to use a lighted mirror, tilt their chin down, and look straight into the mirror during application to keep the saline from spilling out of the bowl.

Small Bubbles That Appear After Wearing

The second type involves one or more small bubbles that appear after the lens has already been on the eye for several minutes or even hours. These bubbles are smaller and may not cause as much blur, but they can gradually affect comfort and vision quality over the course of the day.

Why Do Small Bubbles Form Later?

Small delayed bubbles usually indicate a fit issue rather than an insertion error. When a portion of the scleral lens edge does not align closely enough with the surface of the sclera, a tiny gap forms. Each time you blink, a small amount of air can seep under the lens edge and collect as a bubble. This is referred to as edge lift, and it typically occurs in a specific area of the lens rather than all the way around.

Can Small Bubbles Be Fixed?

Yes, but the fix requires an adjustment to the lens itself rather than a change in your insertion technique. Your doctor can identify the exact location and amount of edge lift using a slit lamp examination and diagnostic dyes such as sodium fluorescein. Once the problem area is mapped, the lab can steepen or reshape the lens edge in that specific zone to eliminate the gap. In some cases, a new diagnostic lens or a full reorder may be needed if the lift is significant.

When Should You Contact Your Eye Doctor?

Any persistent bubble, whether large or small, should be addressed rather than ignored. A large bubble that you cannot clear after two or three careful reinsertion attempts may indicate that your insertion technique needs hands-on coaching from your doctor. Recurring small bubbles are a sign that the lens fit should be re-evaluated.

You should also contact your doctor promptly if you notice redness, pain, or a white spot on the cornea after wearing a lens with a trapped bubble, as prolonged bubble contact with the cornea can, in rare cases, cause a localized dry spot or irritation.

Expert Scleral Lens Care in Las Vegas

At Insight Vision Optometry, Dr. Stephanie Woo, OD, FAAO, FSLS, Dr. Nathan Schramm, OD, FSLS, FBCLA, and Dr. Thanh Mai, OD, FSLS, specialize in scleral lens fitting and troubleshooting. Whether you need help perfecting your insertion routine or your lenses need a fit adjustment, our team can evaluate the issue and get you back to clear, comfortable vision. Call 702-747-4070 or visit www.insightvisionlv.com to schedule an appointment.