How to Insert and Remove Scleral Lenses: Step-by-Step Guide for New Wearers

The first time you insert a scleral lens, it feels awkward. By the end of the first week, it feels routine. By the end of the first month, most of our patients insert and remove their lenses faster than they can find their car keys. The only thing standing between you and crisp, stable vision all day long is a short learning curve — and a few techniques that are not always obvious from the packaging insert.

This is the same guide we walk every new scleral lens wearer through in person. Read it slowly the first time. Practice at a clean counter with good light. Do not worry if it takes 20 minutes on day one. By day four, it will take you two.

Your First Week With Scleral Lenses: What to Expect

The first day you wear scleral lenses, your vision will likely be clearer and more stable than anything you have experienced — especially if you came from an irregular cornea, keratoconus, or post-surgical vision. You may also notice:

Lens awareness for the first few days — you feel the lens, but it should not hurt
Some midday blur as the saline solution slowly mixes with natural tear debris inside the bowl
Mild pressure around the edges that fades as you adjust to the fit

None of these should include pain, redness, or blurry vision that persists after removal. If any of those show up, call us.

What You'll Need

Set up a clean, flat, well-lit surface — a bathroom counter works, but many patients find a kitchen or dining table easier because you can lay a mirror flat on it.

Your Scleral Lens Kit

Your scleral lenses in their case
Preservative-free saline solution in single-use vials — this is non-negotiable. Preservatives can irritate the cornea when sealed inside a scleral bowl for hours. We recommend brands like ScleralFil or Nutrifill.
A plunger (DMV insertion tool) — the small suction-cup device used to insert and remove scleral lenses. Most patients use a small-diameter plunger for insertion and a large-diameter plunger for removal.
Rigid gas-permeable lens cleaner — approved for scleral and RGP lenses (not soft lens solution)
A clean, lint-free towel laid flat under your work area. If a lens falls, you want it to land on something soft and findable.
A flat-laid mirror angled so you can look straight down into it
Good lighting — overhead light is fine; avoid windows in direct sun that create glare in your mirror

Step-by-Step: Inserting Your Scleral Lens

Wash your hands thoroughly with unscented soap and dry them with a lint-free towel. Lotion residue, sunscreen, and fragrance oils are the leading causes of lens cloudiness on day one. Hands first, always.
Remove the lens from its case and rinse it briefly with preservative-free saline. Inspect the lens briefly — it should be clear, free of chips or cracks, and oriented bowl-side up.
Place the lens on the small-diameter plunger. The lens sits in the concave bowl. The plunger holds it from underneath.
Fill the bowl with preservative-free saline until it domes above the rim of the lens. This is the single most important step. The saline must form a visible meniscus — a slight bulge — rising above the edge. If the bowl is not completely full, an air bubble will form between the lens and your cornea when you insert it, and you will need to start over.
Position your flat mirror on the counter and lean over it. Tip your head parallel to the floor so you are looking straight down into the mirror. Your face should be roughly 6 to 10 inches from the mirror surface.
Hold your eyelids wide open with your free hand. Use your middle finger to pull down the lower lid and your thumb or ring finger on the upper lid. Make sure you are pinning the lashes out of the way — not just the skin.
Bring the lens straight up to your eye — slowly, and without tilting. The saline should stay domed in the bowl because you are moving perpendicular to gravity. When the saline touches your cornea, press the lens gently but firmly onto the eye.
Release the plunger by gently squeezing or rocking it to break the suction. The lens will stay on your eye. Release your eyelids.
Tilt your head back up to upright slowly. Blink several times. The lens should settle into comfortable position within a few seconds.
Check for bubbles. Look in the mirror. If you see a small circle near the bottom of your iris that is not moving with your eye, you have an air bubble. Remove the lens, refill with saline, and try again. An air bubble left in place leads to corneal dryness and reduced vision.

Repeat for the second eye. Total time on day one: 15 to 20 minutes. Total time by day seven: two to three minutes.

Step-by-Step: Removing Your Scleral Lens

Wash your hands thoroughly and dry them with a lint-free towel. Every time. No shortcuts.
Moisten the tip of your removal plunger with saline. A dry plunger will not seal against the lens. A plunger should always be slightly wet.
Stand in front of your mirror and gaze slightly down. This positions the lens so the lower portion is accessible.
Place the plunger tip on the lower third of the lens surface — not the center. Applying suction to the center of the lens creates a tight seal to the cornea and can cause a painful pop when it releases.
Gently press and tilt the lens outward and down, away from the eye. The motion is more of a "rock and pull" than a straight pull. The lens will break free from the tear film underneath and come off smoothly.
Slide the lens off the plunger. Clean it immediately with rigid lens cleaner, rinse with preservative-free saline, and store it in fresh disinfecting solution in the case. Do not top off old solution — dump it and replace it.

If the lens resists removal, it usually means the plunger slid toward the center. Reposition on the lower edge and try again. Never pry at the edge with a fingernail.

Troubleshooting Common Issues

Air Bubble at Insertion

The most common day-one problem. Almost always caused by not filling the bowl full enough or tilting the plunger on the way up. Remove the lens, refill saline until it domes above the rim, and insert perpendicular to the floor. Do not tilt.

Midday Fogging or Cloudy Vision

Over 4 to 6 hours of wear, saline inside the bowl mixes with small amounts of debris and mucus from your tear film. Some patients notice mild fogging in the afternoon. The solution is to remove, rinse, refill with fresh saline, and reinsert. This is normal and not a fitting problem.

Redness

Mild redness on day one or two is expected. Redness that increases, does not fade within 20 minutes of removal, or is accompanied by pain or discharge is not. Remove the lens, do not reinsert, and call the office.

Lens Feels Tight at End of Day

As the day wears on, a lens can develop mild suction against the eye. The fix is to remove it at your normal time — do not extend wear hoping it will "settle." If it feels tight within the first hour of insertion, that is a fit issue and we want to see you.

A Ring of Conjunctival Pinch

If you see a ring of red, raised tissue on the white of your eye after removal, the lens edge is pinching the conjunctiva. This is a fit adjustment, not a technique problem. Call us — we will bring you in for a fit check.

What Not to Do

Never use tap water to rinse lenses, fill the bowl, or clean your case. Tap water contains Acanthamoeba, a microorganism that causes a rare but sight-threatening corneal infection. This is the single most important rule of scleral lens wear. Distilled water, bottled water, and even purified drinking water are not safe either.
Never use saliva to moisten a lens or plunger.
Never substitute soft contact lens solution for scleral-rated saline. Multipurpose solutions are formulated for short exposure to the corneal surface, not for hours of sealed contact inside a scleral bowl.
Never sleep in scleral lenses unless we have specifically approved it for a medical reason. The cornea needs overnight oxygen exposure that a scleral lens does not allow.
Never swim or shower in your lenses. Water, again — Acanthamoeba risk.
Never ignore pain. Discomfort on day one is normal. Pain is not.

When to Call Us

Remove the lens and contact EyeCare Center of Orange County immediately if you experience:

Sudden sharp pain during wear or after removal
Decreased vision that does not clear within 30 minutes of removal
Persistent redness or eye irritation that lasts more than an hour after removal
Discharge — yellow, green, or white — from the eye
A lens that feels stuck and will not come off with the plunger after several attempts
Light sensitivity disproportionate to what you have experienced before

Any of these can signal an infection, corneal abrasion, or fit problem that needs prompt attention. Do not wait until morning — call (949) 323-3600.

Long-Term Care

Clean lenses every night with rigid gas-permeable lens cleaner, rinse with preservative-free saline, and store in fresh disinfecting solution. Replace the solution daily — never top off.
Replace your lens case every three months. Case biofilm is a leading source of contamination.
Deep-clean lenses weekly with a hydrogen peroxide system or the enzyme cleaner we recommend.
Keep annual evaluation appointments. Corneas change. Lenses wear. We want to check the fit, the lens surface, and your corneal health every year — more often if you have keratoconus or are post-surgical.
Replace lenses per our recommendation — typically every 12 to 18 months for most patients. Older lenses develop surface scratches and deposits that impact comfort and vision.

New to scleral lenses and feeling unsure? That is what we are here for. Every first-week wearer at EyeCare Center of Orange County gets a hands-on training session, a written instruction packet, and direct phone access for questions during your adaptation period. If you are considering scleral lenses for keratoconus, post-LASIK vision, severe dry eye, or another complex cornea, start with a scleral lens fitting consultation. Call (949) 323-3600 to schedule.