Dry Eye Dx and Tx: <br>Tailoring the Tear Reservoir</br>

By
STEPHANIE PISANO, OD
May 1, 2026
4 min

Contact Lens Spectrum

Objective:

To explore the use of scleral lenses and filling solutions for managing dry eye and ocular surface disease, emphasizing their importance in symptom control.

Approach:

Key Findings:

67% of patients use nonpreserved saline vials for scleral lenses.
41% of practitioners recommend nebulizer saline, while 37% recommend specific scleral lens filling solutions.
Adding artificial tears to saline improves symptoms compared to saline alone.
Autologous serum in the lens reservoir can aid in healing persistent epithelial defects.
Nonpreserved cyclosporine in the lens reservoir improves OSDI scores and ocular surface staining.

Interpretation:

The choice of filling solution and potential additives are crucial for optimizing scleral lens therapy in dry eye patients, impacting their quality of life.

Limitations:

The study does not address long-term effects of various filling solutions, which may limit understanding of their sustained efficacy.
Limited data on the efficacy of newer filling solutions compared to traditional options may hinder informed clinical decisions.

Conclusion:

Tailoring the filling solution and considering additives can significantly enhance symptom control in dry eye patients using scleral lenses, highlighting the need for personalized treatment strategies.