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Keratoconus Patients Can Avoid Corneal Surgery With Scleral Lenses 1280

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Keratoconus Patients Can Avoid Corneal Surgery With Scleral Lenses

All surgical procedures come with risks, which is why they are usually prescribed as a last resort after trying other interventions.

This is equally true for keratoconus—an eye disease that causes the cornea to become misshapen. Although corneal surgery is generally safe, it can at times lead to complications like infection, permanent corneal scarring, transplant rejection and corneal haze.

Research has shown that patients with severe keratoconus who wear scleral lenses significantly reduce their need for corneal surgery.

Below, we’ll cover the ins and outs of keratoconus and explain how scleral lenses can safely and effectively manage the condition.

What is Keratoconus?

Keratoconus affects approximately 0.05-0.25% of the global population. It is a progressive eye condition that causes the cornea to thin and become cone-like in shape, affecting how light enters the eye. It usually affects both eyes but may lead to differing vision in each eye if a single eye is affected.

Symptoms of keratoconus include:

  • Blurred or distorted vision
  • Increasing sensitivity to light or glare
  • Red or swollen eyes
  • Increasing nearsightedness or astigmatism
  • Frequent changes in lens prescription
  • The inability to wear standard soft contact lenses

The exact cause of keratoconus isn’t well understood, but risk factors for developing the disease include genetics, oxidative damage, eye rubbing and certain health conditions like allergies, asthma, Down syndrome and retinitis pigmentosa.

In the early stages of keratoconus, soft contact lenses or glasses may be enough to successfully correct vision. But over time, the cornea becomes so misshapen that these methods are no longer effective. Surgical procedures performed on keratoconus patients include corneal cross-linking, refractive surgery and keratoplasty (corneal transplant).

What are Scleral Lenses?

Scleral lenses have a larger diameter than standard soft lenses and cover most of the sclera (the white part of the eye).

Because they don’t put any pressure on the cornea or sclera, they are very comfortable to wear—even for patients with corneal disease. The lens prevents the bulging cornea from rubbing against the eyelid and protects it from environmental irritants.

The space between the scleral lens and the eye is filled with a nourishing liquid that allows oxygen to reach the eye while keeping it hydrated. It also acts as an artificial cornea that helps focus light into the eye, providing sharp and clear eyesight.

Scleral lenses are tailor-made for each eye to ensure the patient achieves the best vision possible.

How Scleral Lenses Can Reduce the Need for Corneal Surgery

In a study involving 51 eyes with severe keratoconus, 40 of them were able to avoid surgery by wearing scleral lenses. While all patients in the study were candidates for corneal transplants, scleral lenses cut the need for keratoplasty by more than half over a 5-year span.

In fact, the study found that managing stage 4 keratoconus with scleral lenses was more effective and safer than keratoplasty.

The features of scleral lenses are ideal for keratoconus patients in several ways. Because they don’t touch the cornea, the rate of scar formation slows down and the cornea isn’t irritated. Moreover, scleral lenses are very stable and fit securely to the eye’s surface. This prevents them from moving around with each blink (as standard lenses do), making them much more gentle on the patient’s sensitive eyes.

If your or a loved one has been diagnosed with keratoconus or is experiencing any of the associated symptoms, we can help. A consultation with Dr. Nadine Humen Forché will help determine the best-suited treatment for your eyes.

Schedule an appointment by calling one of our friendly staff members at Five Points Eye Care today.

Our practice serves patients from Athens, Augusta, Lawrenceville, and Gainesville, Georgia and surrounding communities.
Call Us 706-222-1682
Learn More About Scleral Lenses for Keratoconus
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What Is Keratoconus?

Keratoconus (keh-rah-toe-cone-us) is a condition in which the structure of the cornea is not strong enough to maintain its spherical shape, causing the cornea to bulge outward into a shape resembling a cone. This leads to a host of symptoms, including blurred and double vision, as well as halos around objects and streaks of light.

Below you’ll learn more about this condition and discover how Dr. Nadine Humen Forché at Five Points Eye Care can offer a wide range of successful options, so you can keep enjoying clear and comfortable vision.

What is Keratoconus?

Keratoconus is a progressive eye disease in which the dome-shaped cornea thins, causing the cornea to develop a cone-like shape. The misshapen cornea deflects light, causing distorted vision and may result in blurred vision, double vision, myopia, irregular astigmatism and sensitivity to light.

This rare eye condition affects 1 out of every 2,000 people and typically begins in the teenage years and early 20s, with vision deteriorating over a period of about 10 to 20 years. It’s common for people with this disease to see prescription changes with each eye exam.

Keratoconus often runs in families, so if you or your children are at risk or are experiencing any of the symptoms mentioned below, contact Five Points Eye Care for an eye exam. Keratoconus can only be diagnosed through a thorough eye exam, where Dr. Nadine Humen Forché will examine your cornea and measure its curvature.

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What Causes Keratoconus

Your cornea is held in place by very small collagen fibers. When they are weakened, they cannot preserve the spherical dome-like shape of your cornea. The exact cause of keratoconus, however, is still unknown.

Weakening of the cornea tends to happen in those with a genetic predisposition, which is why keratoconus may affect several people in a single family.

Keratoconus has also been linked to:

  • Excessive exposure to UV rays
  • Excessive eye rubbing
  • Difficulty wearing contact lenses
  • Certain eye injuries
  • Retinitis pigmentosa
  • Marfan syndrome
  • Ehlers-Danlos syndrome

Symptoms of Keratoconus

As the shape of your cornea begins to bulge, it alters your eyesight. Your normally smooth corneal surface becomes wavy and expands, becoming cone-shaped. This causes irregular astigmatism or nearsightedness. The condition tends to begin in one eye and later develops in the other eye as well.

Typically, one’s prescription will change frequently as vision worsens, over time it will also become more difficult to wear contact lenses due to the changing shape of the cornea. If the contact lenses are not properly fitted on someone with Keratoconus, the lenses may rub against the most vulnerable part of the cornea. The excessive rubbing then causes symptoms to worsen by aggravating the already thin cornea. When the symptoms of keratoconus intensify, the cornea can begin to swell and form scar tissue. This scar tissue can result in worsening visual distortion and blurred vision.

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Symptoms during the early stages of keratoconus:

  • Mild blurred vision
  • Slightly distorted vision (straight lines appear bent or wavy)
  • Some sensitivity to light and glare
  • Red-eye and/or swelling
  • Chronically irritated eyes

In its later stages, one tends to experience:

  • Increased blurred and distorted vision
  • Nearsightedness or irregular astigmatism
  • Inability to wear regular contact lenses

Keratoconus Treatments

There are several ways to treat this condition. When the symptoms are still mild, you can correct your vision using eyeglasses. As the condition progresses, there are several treatment options.

  • Scleral contact lenses. For improved visual acuity, gas permeable scleral lenses are usually the preferred treatment. Scleral lenses vault over the cornea, replacing its irregular shape with a smooth, uniform refracting surface that provides clarity and comfort.
  • Custom soft contact lenses. These customized soft lenses are specially designed to correct mild-to-moderate keratoconus.
  • Piggyback contact lenses. For those with keratoconus, fitting a gas permeable (hard) contact lens over a cone-shaped cornea may at times prove uncomfortable. “Piggybacking” involves placing a soft contact lens over the eye and then placing a GP lens over the soft lens. This increases wearer comfort because the soft lens acts like a cushioning pad under the rigid GP lens.
  • Hybrid contact lenses. These lenses combine a highly oxygen-permeable rigid center with a soft peripheral “skirt”. Some hybrid lenses are specifically designed for keratoconus, with the central GP area of the lens vaulting over the cone-shaped cornea.
  • Intacs. This small curved device is surgically placed in your cornea to help flatten the corneal curvature and improve vision.
  • Corneal collagen cross-linking. Used together, special UV light and eye drops can strengthen the cornea, thus flattening your cornea and preventing further expansion.
  • Corneal transplant. As a last resort, you may be advised to undergo a corneal transplant, where all or part of your distorted cornea is replaced with healthy donor cornea tissue. Even after a transplant, however, you may still need to wear glasses or contact lenses for clear vision.

Contact Dr. Nadine Humen Forché at Five Points Eye Care to find out whether scleral lenses are right for you.

Our practice serves patients from Athens, Augusta, Lawrenceville, and Gainesville, Georgia and surrounding communities.
Call Us 706-222-1682
Learn More About Scleral Lenses for Keratoconus
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