Scleral Lenses for Keratoconus
Keratoconus (keh-rah-toe-cone-us) is a non-inflammatory eye disorder in which the round dome-shaped cornea progressively thins causing a cone-like bulge to develop.
Hence the name keratoconus, from the Greek word ‘kerato’ (cornea) and ‘conus’ (cone-shaped).
Because those with keratoconus have irregular, cone-shaped corneas, glasses cannot conform to the shape of the eyes and thus cannot adequately correct the patients’ vision. The best solution, therefore, is scleral contact lenses, since they sit on the sclera without touching the cornea and deliver maximal clarity while being perfectly comfortable in most cases.
How Does One Develop Keratoconus?
There is a genetic factor but not always. Another possibility is due to our environments. Young patients who are exposed to digital screens early on will develop dry eye and end up rubbing their eyes aggressively. When patients rub their eyes over time, this may cause the cornea to become thinner. The reason your eye doctor checks the pressure of your eye for glaucoma is because 45% of people have some level of glaucoma later on in life. So, if you consider the pressure you exert on the eye, this ends up leading the eye’s pressure to change, which can result in a bulging of the cornea or keratoconus. There’s a LOT more to define keratoconus from a disease point of view, but the bulge of the cornea is the simplest definition of keratoconus.
What are Scleral Lenses?
Custom-designed scleral lenses help patients with corneal irregularities achieve dramatic improvements in visual acuity and comfort. Scleral lenses vault over the cornea and rest on the sclera while avoiding the diseased cornea. This creates a new optical surface instead of the damaged cornea and prevents discomfort by resting on the sclera of the eye. Moreover, the reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a liquid environment – making it optimal for healing.
Both rigid gas permeable (GP) lenses and scleral lenses provide the eyes with sufficient oxygen. However, scleral lenses provide more comfort and stable vision than traditional GP lenses. In most cases, scleral contact lenses are the optimal choice of treatment for patients with keratoconus and irregularly-shaped corneas.
If you have Keratoconus and are interested in scleral lenses, Patricia Jitodai, OD at Patricia Y. Jitodai, OD can help. We serve patients from all over Tukwila, Renton, Kirkand, Redmond, Kent and Seattle, Washington and provides the highest level of care.
At What Stage Should a Patient Keratoconus Consider Scleral Lenses?
A lot of doctors will fit RGPs on patients with early stages of keratoconus to give them good, clear vision. However, there are new scleral lenses with WaveFront technology to give patients even clearer vision with less or almost no distortion. When should someone consider scleral lenses? It varies. Patients with severe dry eye, struggling with their standard multifocal contact lenses, or simply don’t like wearing RGPs all could benefit from scleral lenses.
Now, a patient with a diseased cornea who may have cornea deterioration, can experience visual problems and problematic ups and downs with their eye health like infections or dry eye would enjoy these lenses. The improvements from scleral lenses is up to the patient, but for anyone who decides to consider scleral lenses, will find there are many benefits.
Two Major Benefits of Scleral Lenses for Keratoconus
1) Scleral Lenses Provide More Comfort
Our patients report comfort as the most prominent feature of the scleral lens. Throughout the fitting process, we survey our patients on how the lenses feel, and not surprisingly, the usual response we get is “fine” or “I can’t feel them at all”.
The size of a scleral lens is one of the reasons it is more comfortable than a traditional gas permeable contact lens. A traditional contact lens is much smaller, typically 9 -10 mm in diameter. With each blink, this contact lens moves a bit over the cornea and the lid tends to roll over the edge of the lens as well. Many patients report being unable to wear them for more than a few hours at a time due to discomfort.
The scleral lens, on the other hand, is larger in diameter and spreads its weight over a much greater, less sensitive area so that when you blink, the eyelid doesn’t catch the edge of the lens. Moreover, because the lens vaults over the bulging cornea, it protects the cornea from any abrasion caused by blinking or external irritants. Furthermore, the scleral lens is made up of highly oxygen permeable materials and provides a soothing bath of artificial tears that refresh the ocular surface.
2) Scleral Lenses Offer Improved Vision
Patients with keratoconus have a clearer vision with scleral lenses than with glasses. With glasses, patients usually see 20/200, whereas with scleral lenses their vision typically improves to 20/30 or even 20/20. Furthermore, because the lenses sit firmly on the eye, they offer more stable vision than traditional lenses. The scleral lens not only offers comfort but also improves vision acuity.
What Changes Will I Notice with Scleral Lenses?
Once you have been properly fitted for scleral lenses, you can expect to gradually see improvements in clarity, color and detailed contrast between multiple images and objects within your visual field. The comfort you’ll experience will enable you to wear your custom-made scleral lenses all day long so that you can keep doing all the things you enjoy – but with better vision.
Should I See An Eye Doctor Experienced in Fitting Keratoconus Patients with Scleral Lenses?
If you are interested in seeing whether scleral lenses are right for you, make sure that the eye doctor you visit has the knowledge and experience required to correctly fit the lenses on patients with keratoconus. Scleral lenses require precise customization, and every patient’s case of keratoconus varies in degrees of severity and corneal measurements.
To check if you are a good candidate for scleral lenses, contact us at The Patricia Y. Jitodai, OD. Our staff has the expertise in fitting specialty contact lenses. Call or book online and regain your quality of life.Our practice serves patients from Tukwila, Renton, Kirkand, Redmond, Kent, and Seattle, Washington and surrounding communities.
“I loved my visit from start to finish. The Patricia Y. Jitodai, OD staff is friendly, caring and knowledgeable. The eye exam that I had for keratoconus was incredibly thorough and Patricia Jitodai, OD explained all the results very clearly. He fitted me for scleral lenses, and now my eyes feel so comfortable that I frequently forget that I’m wearing contact lenses.“
Ariela Gordon‐Shaag, Michel Millodot, Igor Kaiserman, Tzahi Sela, Guy Barnett Itzhaki, Yaffa Zerbib, Efrat Matityahu, Shira Shkedi, Svetlana Miroshnichenko and Einat Shneor, Risk factors for keratoconus in Israel: a case–control study, Ophthalmic and Physiological Optics, 35, 6, (673-681), (2015).