whats that guy doing with surgury? Hes had three surguries and damaged
his eyes and still has a refractive error and needs glasses! Ironic and
sad

Probably a scleral with cylinder ground into the front of the lens.
The scleral portion of the lens will prevent it from rotating, unlike
the intralimbal which needs to rotate freely if it has a front cylinder
prism ballast correction.  Or, wear the astigmatic correction in
spectacles over the contact lens.

DrG

I didn't phrase my question very well.  Let's see if I can do a bit
better this time....

I wear CooperVision Hydrasoft DW lenses normally (nearly every day;
nearly all day).  As you know, I have chronic eye pain and dry eye.

It's my understanding that SEAL *is* induced by soft contact lens
wear.  It's also my understanding that many people who have it are
asymptomatic until evaluated with fluorescein and ye olde slit lamppe.
So there I went ... up to SCCO to be fit for the intra-limbals,
thinking all was well.  I've inserted a total of three pair into my
eyes on two different occasions, wearing none of these pair for more
than ten minutes and experiencing severe pain on each occasion.  

On the first occasion, the intern looked at my corneas after I removed
the GP and told me that he saw SPKs at that point that he did not see
pre-insertion.  He told me to baby my eyes for a bit.  I'm presuming
that he neither looked for, nor saw, the SEAL.

Second visit -- last Wednesday.  Presumably, I arrived with SEAL,
though--again--nobody saw it prior to insertion of the GPs.  The GPs,
again, hurt a great deal.  The doc put in the fluorescein--his goal:
to check fit--and identified the SEAL at that point.

What I'm wondering is this: I came away from each of these
appointments in signifcantly worse shape/pain than I arrived in.  It
surely seems possible that I had SEALs all along from ill-fitting/long
wear of my SCLs, but ... I didn't seem to notice it.  It seems like
the mere trial of the GPs brought it on.

My question is: assuming the SEAL was there all along, does it make
sense that the intra-limbal lens--big and hard and sharp-edged as it
is--at 11.2mm dia--would have rested on, and further damaged, the
superior epithelium with just a couple of insertion, trial, and
removal maneuvers?  I'm picturing the plastic lens scraping over this
raw area of epithelium that my SOFT CLs had made relative peace with.

I'll be calling my regular docs in San Diego this a.m., to see if
anybody can look at my corneas today, but ... I'm certainly confused
... and certainly saddened by this event.

If it IS the soft CLs ... and if they DID cause this SEAL ... then I'm
in a pickle.  Can't really try to refit new soft CLs ... OR the
intra-limbals ... until the SEAL clears, I presume.  That, again,
leaves me a relative captive of the indoors until all is better ...
which is a really draconian sentence.

TIA,

Neil