Sclerals on Safari

I recently participated in a two-week photo tour in Tanzania. This is something I have wanted to do for several years, and I had no intention of allowing high-maintenance eye care to keep me from achieving that goal.

I have traveled overseas with scleral lenses successfully in the past, most recently on a hiking trip in England, but Africa is another matter. I asked M&M Photo Tours to find out about the availability of ClearCare in Tanzania, but as I suspected, it is not readily available. I also considered buying plain hydrogen peroxide, but a Google search turned up evidence that the purity in Tanzania is not to the same standard as in the US, so I quickly discarded that plan.

Next, I thought I would carry on a travel size bottle of UniquePH and a couple of ClearCare, and alternate between the two. However an e-mail exchange with Dr. G (the developer of LaserFit lenses) along with input from the My Big Fat Scleral Lens Facebook group caused me to rethink that approach in favor of packing additional ClearCare in a checked bag.

This is my final packing list, in addition to the LaserFit lenses and progressive reading glasses (no distance correction) that I usually wear:

• LaserFit contact lenses – 2 backup pairs in carry-on
• Prescription glasses, in carry-on
• Ziena moisture chamber glasses fitted with progressive reading lenses (no distance correction), in carry-on
• Quartz silicon shield, in carry-on
• ClearCare – 2x 3-oz in carry-on, 2x 12-oz in checked bag
• Saline for Sensitive Eyes (Target brand) – 12-oz in checked bag
• 15ml Modudose sterile saline – 16 vials in carry-on, 6 in checked bag
• 5ml Modudose sterile saline – 16 vials in carry-on, 16 in checked bag
• Theratears Nighttime Liquid Gel – 16 vials in carry-on, 8 in checked bag
• UniquePH – 2-oz in carry-on
• LoBob ESC cleaner – travel size, in carry-on
• Muro128 – 1 tube in carry-on, 1 tube in checked bag
• Refresh PM – 1 tube in carry-on
• Cleaning sponges – 6 cut into 24 quarters, in carry-on
• Ocusoft hand soap – 1-oz travel size, in carry-on
• Sink catch mat – in carry-on
• Travel size cotton swabs – 1 in carry-on, 1 in checked bag
• Alcohol prep pads – some in carry-on, some in checked bag
• Prose Disinfection case – 2x in carry-on
• Small contact lens case – 2x in carry-on
• DMV vented scleral cup – in carry=on
• DMV ultra remover – in carry-on

I always carry an emergency scleral kit that contains a small contact case, a mirror, a few 5ml Modudose vials, a Theratears liquid gel vial, a tube of Muro128, a DMV vented scleral cup and ultra remover, and some cotton swabs. This was also in my carry-on.

That’s a lot of stuff, but as any photographer will tell you, it’s all in the optics – and that includes eyesight, my friends, And thus, I overpacked.

I have flown several times, including overseas, with scleral lenses. I pack two quart bags, one with my regular fluids and one marked “Medical Fluids,” and previously was never questioned. This time, a TSA agent at Kansas City International Airport stopped me to say that I was over my allocation. I explained that one of the bags was for medical purposes, but she remained steadfast. I then offered to show her a letter from my doctor, but before I was able to get it out, a supervisor came over and waved me through, explaining that the excess fluids were clearly medically necessary and all under 3.4 ounces. Disaster averted! In retrospect, I could probably have avoided the situation by putting each bag in a separate bin. It’s always a good idea to have a letter from your doctor listing medications and the need for extra fluids.

Part of my preparation for the trip was to plan scleral wear time during travel. I made a matrix with columns for home time and time at each intermediate stop before Kilimanjaro. I knew that I had 3-4 hour layovers at Minneapolis-St. Paul and Amsterdam, that I would have two 8-hour flights, and would be arriving at Kilimanjaro at night. I prefer not to insert or remove my contacts during flight, and I hoped to get a head start on adjusting my sleep schedule to Africa time. I also don’t want to go over 16 hours of wear time. Taking all of that into consideration, I determined that the best schedule on the way there was to wear them on the flight from Kansas City to Minneapolis, take them out just before boarding the flight to Amsterdam (and try to sleep on that flight), put them in upon arrival in Amsterdam, and remove them after arrival at the lodge in Tanzania.

Sound complicated? Welcome to the new normal for scleral lens patients.

The plan worked great, although the Amsterdam airport had some interesting sinks with footlong drains offering ample opportunity to lose a lens. I solved that problem by pulling out a small quick dry towel that I keep in my camera bag and using it to cover the drain while I inserted my lenses. I was a bit self-conscious about the amount of time and space I needed for all of my lens paraphernalia, but I did what I needed to do. During transit I disinfect with UniquePH rather than ClearCare so that spillage is not an issue.

Another small glitch came when I opened my suitcase at the first lodge and the first couple of layers of clothing in my checked bag were damp. The bottles of ClearCare and saline were intact, so some must have leached out. (I think it was likely the saline since none of the clothing showed signs of bleaching.) The clothing was all quick dry and all was fine by morning. However for the rest of the trip, I stowed all of my larger bottles of solution in a JetBag that I had brought with me. These bags are designed to absorb 750ml of liquid in case a bottle of wine breaks in a checked bag. I’m not sure why I didn’t think of this to begin with, but it is my takeaway travel tip for this trip.

All of my compulsive planning and supply redundancy proved invaluable during the actual safari. Game drives are extremely dusty. The Ziena moisture chamber glasses, which I am wearing in the photo above, worked perfectly to keep as much dust as possible away from my scleral lenses. I had them fitted with progressive reading lenses (no distance correction) so that I could easily see the settings on my camera. At night I used Muro128 to lubricate my left eye, which does not blink fully or produce tears. I took along a Quartz silicon shield in case I should need it, but never wore it.

There were two days when I wore each of the three pairs of LaserFit lenses. I established a rule that I would never reinsert lenses until they had been disinfected. One particularly dusty morning, I changed lenses when we returned to camp at noon, and again when I took a shower before dinner. I make it a practice never to wear my lenses in the shower, and in Africa that is an even more important safety rule. So one evening when I forgot and took a shower with the second set in, I immediately removed them for disinfection. It would have been possible to travel with one or two sets of lenses, but I was glad to have taken three.

I ended up using one 12-oz and one 3-oz bottle of ClearCare solution, and the 12-oz bottle of saline (for rinsing) during the trip. Each day I rinsed my disinfected lenses in the neutralized ClearCare solution, then used one 15ml Modudose vial and one Theratears vial for insertion, plus a 5ml Modudose vial if I needed to squeegee my left lens. I immediately discarded any unused solution in the vials, and used a fresh quarter of a cleaning sponge every time I cleaned my lenses.

On the trip home, we left Kilimanjaro on a late evening flight, so I had already removed my lenses. I reinserted them in Amsterdam (again utilizing my quick dry towel to cover the massive drain), and removed them in Minneapolis before my final flight to Kansas City. I was fortunate enough to be a guest in a Delta lounge, so the bathroom situation was much better.

It takes a lot of foresight and planning to travel with scleral lenses, but they needn’t keep us from pursuing our goals. I think the only thing I would have done differently – besides packing my checked fluids in a JetBag – is to forego the 12-oz bottle of saline and 15ml Modudose vials in favor of 5ml vials. They come in connected sets of four flat vials that are easy to pack, and I always ended up discarding extra fluid in the 15ml vials. I think a four-pack per day plus a few extra for insurance would have been sufficient.

So there you have it – sclerals on safari! Now to begin planning for my next big travel adventure.