Keratoconus is a condition in which the normally round shape of the cornea is distorted due to thinning of the cornea. The cornea is the transparent front “window” of the eye, admitting light and focusing visual images as light begins its journey into the eye. When the cornea becomes distorted, visual impairment may be significant. As keratoconus progresses, the cornea becomes thinner and more irregular, sometimes forming scars as well.
Early signs of keratoconus are primarily blurred and distorted vision. Early stages may be adequately corrected with glasses, though frequent changes may be required to obtain the best vision. As the cornea continues to thin, contact lenses may be necessary to correct the astigmatism generated. Sometimes soft contact lenses that correct for astigmatism work fine, but more often rigid gas permeable lenses provide for clearer vision.
There have been many advances in the design of gas permeable lenses for keratoconus over the years. If you have tried contact lenses in the past with poor success it is worth re-evaluating with newer designs and products. There are several lens designs specific for keratoconus which allow for custom designs for the unique shape of each keratoconic eye. Synergeyes is also a new lenses frequently used for patients with keratoconus. It is a unique product with a gas permeable center and a soft lens skirt bonded to the periphery. For patients with intolerance to gas permeable lenses this lens can provide clear vision with less irritation to the cornea. Piggyback lenses where the gas permeable lens is worn over a thin, permeable soft lens can also provide relief for those with intolerance to gas permeable lenses.
It is important to remember that contact lenses will provide for improvement in clarity of vision for those with keratoconus, but it will not cure keratoconus or alter the course of the disease.
It is important to seek the care of an optometrist who specializes in the fitting of contact lenses as corneas affected by keratoconus can be challenging to fit and require a provider who is current with new contact lens technologies. Select a provider you have confidence in and develop a good relationship as you will receive the best, most consistent care over a long period of time with a doctor who knows your unique situation.
Author: Dr. Joanne Hendrick