Does Solution Choice Impact Midday Fogging? - Report - MDSpire

Does Solution Choice Impact Midday Fogging?

Explore effective management strategies for midday fogging in scleral lens wearers, including a breakthrough study on sodium hyaluronate's impact on vision quality.

  • By

  • Melissa Barnett, OD, FAAO, FSLS

  • November 1, 2025

  • 4 min

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Clinical Report: Does Solution Choice Impact Midday Fogging?

Overview

This study investigates the impact of high-viscosity sodium hyaluronate versus saline on midday fogging in scleral lens wearers. Results indicate that sodium hyaluronate may enhance low-contrast visual acuity without increasing post-lens fluid turbidity.

Background

Midday fogging, characterized by fluid reservoir debris, affects up to 46% of scleral lens wearers and can significantly impair visual quality. Understanding the factors that contribute to this phenomenon is crucial for improving patient outcomes. Effective management strategies, including solution choice, lens fit adjustments, and surface treatments, are essential in addressing midday fogging.

Data Highlights

Solution TypeLow-Contrast VA StabilityPost-Lens Fluid Turbidity
Sodium HyaluronateStableNo Increase
SalineDecreasedNo Increase

Key Findings

  • Midday fogging is prevalent among scleral lens wearers, impacting visual quality.
  • High-viscosity sodium hyaluronate solution maintained low-contrast visual acuity over 8 hours.
  • Saline solution resulted in decreased low-contrast visual acuity at 4 and 8 hours.
  • No significant differences in post-lens fluid turbidity or lens settling were observed between the two solutions.
  • Management strategies include lens fit optimization and the use of preservative-free solutions.

Clinical Implications

Clinicians should consider using high-viscosity sodium hyaluronate solutions for scleral lens wearers to potentially improve low-contrast visual performance. Additionally, maintaining rigorous cleaning and disinfection protocols is essential to minimize midday fogging.

Conclusion

The choice of filling solution plays a significant role in managing midday fogging in scleral lens wearers, with sodium hyaluronate showing promising benefits for visual acuity without compromising lens performance.

References

  1. Barnett M, Courey C, Fadel D, et al., Cont Lens Anterior Eye, 2021 -- CLEAR - Scleral lenses
  2. Postnikoff CK, Pucker AD, Laurent J, et al., Invest Ophthalmol Vis Sci, 2019 -- Identification of leukocytes associated with midday fogging
  3. Schornack MM, Fogt J, Harthan J, et al., Contact Lens Anterior Eye, 2020 -- Factors associated with patient-reported midday fogging
  4. Vurgun EB, Ozkan G, Turhan SA, Toker AE, Eye Contact Lens, 2025 -- The effect of scleral lens reservoir solution on post-lens fluid turbidity
  5. contact lens spectrum — Midday Fogging: What It Causes and What Causes It
  6. Contact Lens Spectrum — Midday Fogging: What It Causes and What Causes It
  7. Contact Lens Spectrum — Is This the New Norm?
  8. Contact Lens Spectrum — Treatment Plan
  9. Midday Fogging: What It Causes and What Causes It
  10. Scleral Lens Care Guide
  11. Wide-angle fluid reservoir thickness changes during short-term scleral lens wear | Eye and Vision | Full Text
  12. Changes in Symptoms of Midday Fogging with a Novel Scleral Contact Lens Filling Solution - PMC

Original Source(s)

Does Solution Choice Impact Midday Fogging?

  • by Melissa Barnett, OD, FAAO, FSLS

  • November 1, 2025

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