November 10 is National Keratoconus Day. Keratoconus is an ocular condition causing debilitating decreased vision in approximately 1 in 400 to 1 in 2000 Americans. Below is a brief overview of keratoconus. For a complete review of keratoconus, including background information, diagnosis, treatment, and prognosis can be found here. Spread the word and help someone with keratoconus.
What is Keratoconus?
Keratoconus develops when the cornea becomes progressively thinner. The cornea is made of collagen fibers. The collagen fibers in a patient with keratoconus do not have links between the fibers. This causes the collagen to be weak. Over time, the weak collagen fibers allow the cornea to become thin and progressively steeper. This change in shape causes the cornea to take on an irregular shape which is poorly corrected with glasses.
How is Keratoconus Diagnosed?
During a regular eye exam, your eye doctor will be able to tell if you have keratoconus. Corneal topography is usually used to confirm a diagnosis of keratoconus.
How is Keratoconus Treated?
Keratoconus doctors agree contact lens are the treatment of choice. Various types of contact lenses are used to treat keratoconus; however, the best success, comfort, and vision is achieved with scleral contact lenses.
Finding a Keratoconus Doctor
If you have keratoconus or know someone that does have it the Keratoconus Doctors have over 25 years of experience in treating patients with keratoconus and irregular corneas.
Scleral lenses have been around for over 100 years. Until the new gas permeable lens materials were developed patients could only wear scleral lenses for a few hours a day. With the highly oxygen permeable lens materials now in use, patients can comfortably wear these lenses all day. Scleral lenses are most commonly used to treat eyes with irregular corneas such as keratoconus and post surgical eyes (usually following corneal transplant surgery or related to complications from refractive surgery). Another common use for scleral lenses is in the special effects industry where they are used to protect the cornea and/or to give the eye an exotic appearance.
What Is A Scleral Lens?
Scleral lenses are large contact lenses that rest on the sclera (white part of the eye) with the remainder of the lens vaulting over the cornea. Tears are trapped between the lens and the cornea allowing sclerals to treat irregular corneas. The average soft contact lens has a diameter of about 14 mm whereas scleral lenses typically have a diameter exceeding 14.5 mm.
How Are Scleral Lenses used?
At Total Eye Care Dr. Driscoll has used scleral lenses to treat many conditions such as irregular astigmatism, keratoconus, high myopia, dry eye syndrome, and complications related to LASIK and PRK. Because of their size, sclerals are quite comfortable. Patients often report the comfort being similar to that of a soft contact lens. Most patients with irregular corneas will see better with a scleral lens than with glasses.
Below is a good video that shows how scleral lenses are cared for and how to insert and remove them.
Due to the fact that one of the specialties at Total Eye Care is keratoconus we see many patients with this condition. We recently updated our patient information on keratoconus page to reflect some of the new technologies available to our patients such as;
Mini scleral lenses, which provide excellent vision like that of traditionally fit gas permeable lenses, however with markedly improved comfort.
Corneal collagen cross linking, though not yet FDA approved, is a new technology that I expect will be of a tremendous benefit to our patients.