Are your patients’ scleral lenses going in clean but coming out foggy? Before you reach for topography or tweak the fit, try something else: After filling the lens with your preferred filling solution, hold it up against a plain white tissue. That’s it.
The white tissue test is a no-cost, high-yield method to catch surface or reservoir contamination that’s easy to miss under room lighting or even at the slit lamp. When viewed against a bright white background, subtle particulate matter such as lipids, proteins, or even tap water residue suddenly becomes obvious. If the lens doesn’t look crystal clear over the tissue, the patient’s vision won’t be either.
This test often uncovers the root cause of early discomfort or postapplication blur. Sometimes it’s an issue with incompatible application fluids or poor storage hygiene. Other times, it’s related to lid debris that are introduced during the blink just before application.
The best part? It’s a visual you can share with patients. When they see the cloudy bowl themselves, your advice on proper lid hygiene or lens handling becomes far more compelling.
In addition to this test, we’ve talked about Lissamine green strips and the fenestrated DMV plunger as simple tools to elevate your contact lens practice. Next week, we’ll close out the series with a look at one of the simplest tools in your drawer and how it can help you avoid fitting surprises before a lens ever touches a patient’s eye.
