Introduction – What is keratoconus – Recap
Check out our previous two posts to learn more about the condition of keratoconus. If you missed those, this paragraph is a quick recap of what it is. – Keratoconus is a progressive eye disease that affects the cornea, leading to a decline in visual clarity. The causes can range from hereditary factors to environmental triggers such as atopy, eye rubbing, or allergy-related eye problems. Early detection by an eye care professional is crucial to prevent the condition from worsening and to maintain good vision over time. This disease usually appears in the teenage years but may not show symptoms until later in life. Those with keratoconus may struggle with constantly changing glasses prescriptions and blurry vision, even with updated lenses. Fortunately, there are alternative solutions such as scleral contact lenses and surgical options that can improve vision in a way that glasses cannot.
Can people with keratoconus wear contact lenses?
Not only are you able to wear contacts with keratoconus, but it’s likely actually the best option for you. Contact lenses have the advantage of being able to accommodate higher levels of astigmatism and correcting irregular astigmatism and high order aberrations, something that glasses cannot achieve. Soft contact lenses, unfortunately, are not very effective for treating keratoconus. Fortunately, there are various alternative contact lens options available that can be used instead.
How do contact lenses correct keratoconus?
Hard contact lenses, specifically scleral contact lenses or rigid gas permeable (RGPs) lenses do this by “vaulting” the cornea. As discussed in previous posts, keratoconus causes significant irregularities to the shape and uniformity of the cornea. By vaulting these irregularities, there is a layer of tears and fluid between the contact lens and the cornea that is able to “mask” any irregularities that cause the blurry vision. This layer of tears essentially smooths out the surface of the cornea and fills in any gaps and holes that may exist.
What are hard contact lenses?
What is a an RGP (Rigid Gas Permeable) contact lens?
Rigid Gas Permeable (RGP) contact lenses are a type of hard contact lens made from a gas permeable material that allows oxygen to pass through to the cornea. These lenses are typically made from silicone containing compounds with better oxygen permeability and are more durable than traditional soft contact lenses. These lenses became popular in the 1980s and are small diameter lenes (approximately 8.5mm). They are often recommended for people with corneal irregularities or high levels of astigmatism, as they provide sharper and clearer vision. Unlike soft contact lenses, RGP lenses retain their shape, providing a more stable and accurate fit, leading to improved comfort and reduced risk of lens movement. RGP lenses can sometimes require a period of adaptation, as they feel more rigid compared to soft lenses, but once the wearer gets used to them, they can provide visual clarity that has the potential to be better than soft contact lenses.
What are scleral contact lenses?
A scleral contact lens is a type of rigid gas permeable (RGP) lens that is larger in diameter (usually greater than 15mm) than traditional RGP lenses and has a unique, dome-like shape. The lens rests on the sclera, the white part of the eye, rather than on the cornea. The lens is filled with a saline solution, which creates a fluid reservoir between the lens and the cornea, providing a protective barrier and ensuring a stable, comfortable fit. Scleral lenses are often recommended for people with severe corneal irregularities, such as keratoconus, or for those who have previously struggled with traditional RGP or soft contact lenses. These lenses provide sharp and clear vision, even in cases where other types of lenses have failed. Scleral lenses are custom-made to fit each individual’s eye, ensuring the best possible fit, comfort, and visual acuity.
Can anyone fit scleral contact lenses?
All eye doctors have the permission and right to fit their patients with scleral lenses, but not all eye doctors have undergone additional training to properly fit them. Scleral lenses became a popular technology in the 2010s, and subsequently became part of the curriculum at most of the optometry schools over the following years. While most graduating optometrists are now exposed to scleral lens fitting and training, most practitioners do not regularly fit scleral lenses in their clinics and daily practices.
What is FSLS (Fellow of the Scleral Lens Society)?
The Fellow of the Scleral Lens Education Society (FSLS) is a distinction awarded to eye care professionals who have demonstrated a high level of expertise in fitting and managing scleral contact lenses. The FSLS is a recognition of an individual’s commitment to providing the highest level of patient care and education in the use of scleral lenses. The FSLS designation is earned through successful completion of a rigorous examination, submission of clinical case reports, and ongoing continuing education in scleral lens fitting. Eye care professionals who hold the FSLS designation have demonstrated exceptional knowledge and experience in scleral lens fitting and management, ensuring that patients receive the best possible care and the most appropriate scleral lens solution for their specific needs.
How long do scleral contact lenses last?
Scleral contact lenses, given that they are manufactured with the same material used in RGP lenses, typically last around 2 years assuming they are cleaned and cared for properly.
Can glasses glasses correct keratoconus?
Glasses are not able to fully correct the visual distortions caused by keratoconus because the condition affects the shape of the cornea, which is a critical component in how the eye focuses light. In keratoconus, the cornea becomes thin and bulges outward into a cone shape, distorting the light entering the eye and causing visual distortions like blurriness, halos, and glare. Glasses rely on the cornea and lens of the eye to properly refract light, and when the cornea is misshapen as in keratoconus, glasses are not able to effectively correct the visual distortions. This is why many people with keratoconus find that their glasses prescription frequently changes and that their vision remains blurry, even with updated lenses. Scleral lenses, as discussed earlier, can optimize vision by masking these irregularities in ways that glasses can not.
Can anyone wear scleral contact lenses?
Yes! Even though this post focused on using scleral contact lenses to correct keratoconus, there is a variety of other reasons why people might benefit from wearing them. Scleral contact lenses can be used optimize vision in other conditions such as pellucid marginal degeneration, corneal scarring from infection and trauma, eyes that have undergone surgery, and any more reasons. Individuals who have healthy corneas but suffer from dry eyes may also benefit from scleral lenses as well. Even people wanting a more comfortable option to maximize their visual potential can benefit from switching to scleral contact lenses from their RGPs.
Scleral contact lenses and keratoconus – conclusion
In conclusion, keratoconus is a progressive eye disease that affects the cornea and leads to a decline in visual clarity. Early detection is crucial for maintaining good vision over time. While glasses are not effective for correcting keratoconus, there are alternative solutions available, such as specialized contact lenses. Hard contact lenses, including RGP and scleral lenses, correct keratoconus by “vaulting” the cornea, which creates a layer of fluid to mask any irregularities and optimize vision. Scleral lenses are custom-made to fit each individual’s eye, providing the best possible fit, comfort, and visual acuity. Optometrists who have earned the Fellow of the Scleral Lens Society (FSLS) designation, such as our very own Dr. Petar Prpic, have demonstrated exceptional knowledge and experience in correcting keratoconus scleral lens fitting and management.
This article aimed to address any queries you may have had regarding the use of scleral contact lenses to correct keratoconus. Many people do not realize that options other than glasses exist; your corneal condition does not have to limit your vision. If you or someone you know may benefit from our specialty contact lens clinic, please feel free to give us a call for a consultation. To enhance your ocular health and protect your vision, learn more about Prpic Eyecare Centre’s services by calling 604-337-2575 or sending an email to info@prpiceyecare.com
