Word of Wisdom From Custom Contact Lens Residents
Three stars in specialty lens care share their insights, lessons, and little-known gems from the front lines of residency.
We recently held a writing contest for custom contact lens residents, inviting them to share short, powerful pieces based on their clinical experiences. The winning submissions came from three outstanding residents—each offering a unique pearl of wisdom. From scleral lens application hacks to clinical “aha” moments and a deeper dive into dry eye therapies, these mini-articles remind us how every detail counts in the art of fitting custom contact lenses.
🧰 I was today-years-old when I learned that there are SO many tools to help get a scleral lens onto the eye!
By Tiffany Park, OD
I was today-years-old when I learned that there are SO many tools to help get a scleral lens onto the eye! The most simple of them all: A styrofoam cup (with a hole poked on top to hold a vented plunger) to act as a stand + a blue tealight underneath to act as a fixation target. Believe it or not, many patients have been successful with this! If you want something more sturdy, there are other options like the SeaGreen or DMV stand. If you are always on the go, the LensBase is a great option.
Most intriguing of them all is the EZI suction-less ring applicator, which you can even turn UPSIDE DOWN and the lens still stays in place. Very neat!
💡 Unpopular Opinion: Artificial Tears Aren’t Really “Tears”
By Pooja Alloju, OD
Despite the name, artificial tears don’t truly mimic natural tears. They provide temporary lubrication but lack the complex biological components of real tears, such as growth factors, enzymes, and anti-inflammatory proteins that help maintain the ocular surface.
The closest thing to real tears? Autologous serum tears. Made from a patient’s own blood serum, they contain essential nutrients, antibodies, and healing factors that artificial drops simply can’t replicate. While more expensive and less convenient, serum tears can promote true healing rather than just masking symptoms.
If we want real, lasting dry eye relief, we need to move beyond artificial solutions and consider treatments that restore, rather than replace, natural tear function.
👠 When Cinderella's Slipper Doesn't Fit
By Wincy Chung, OD
Halfway through residency, I confidently reached for the scleral diagnostic kit for an advanced keratoconus fit, ready to impress with my bbibbidi-bobbidi-boo. But just when you hit a groove, residency throws you a curve ball.
The scleral insertion alone was difficult; their lids stayed shut and they dodged my every attempt. Then, every scleral sat low and was incredibly unstable. A freeform design was ideal, but there were financial limitations. After several failed fit changes, a GSLS lecture hit me with the obvious - their centered nipple cone was PERFECT for a corneal gas-permeable. I had been forcing Cinderella's slipper to fit, much like her stepsisters.
Lesson: Don't refrain from changing lens types; we can't all fit into Cinderella's slipper.