For scleral lens users with MGD or ocular surface disease, I recommend pairing gentle lens hydration drops midday with preservative-free saline for lens filling. Insertion is most effective when the lens bowl is filled, and the lens is positioned to prevent bubbles. Maintaining a routine that adds consistent lens cleaning and hydration minimizes deposits and maximizes comfort. These minor adjustments are intended to maintain clear vision and all-day wear.
For mid day fogging in scleral lens wearers with MGD, my go to protocol focuses on filling solution and insertion control. I've seen consistent improvement by switching to preservative free saline paired with a small amount of non preserved lubricant in the bowl. I also coach patients to avoid air bubbles by inserting with a steady forward lean and proper lid control. One care tweak that helped was reinforcing nightly lid hygiene. Wear time improved because surface debris was reduced. Small consistency changes often matter more than switching lenses or chasing complex fixes.