World Keratoconus Day is dedicated to raising awareness about keratoconus (KC), as well as educating and advocating for those living with keratoconus and ectatic corneal disorders.

Keratoconus, or KC, is a degenerative non-inflammatory eye condition affecting the cornea. In KC, the cornea, which is normally dome-shaped, gradually becomes thinner and bulges out as it begins to assume a cone shape.

Keratoconus tends to develop during the early teens, with mild symptoms. As the disease progresses, the cornea’s shape changes to a point where wearing regular contact lenses is no longer an option and eyeglasses cannot fully correct one’s vision.

Fortunately, with the right contact lenses, those with keratoconus can once again see the world clearly and comfortably.

Keratoconus and Contact Lenses

In its early stages, people with keratoconus can usually wear glasses or standard soft contact lenses to correct resulting astigmatism and improve clarity. As the condition progresses, however, your eye doctor will prescribe the most suitable contact lens to accommodate a cone-shaped cornea to provide you with the clearest vision possible.

There are a variety of contact lens options for keratoconus, all of which depend on the severity of the condition.

1. Soft Toric Lenses

Astigmatism can be corrected with soft toric lenses, a comfortable and effective solution during the early stages of KC. However, this may not be a good treatment option as the condition worsens.

2. Custom Soft Contact Lenses

Custom soft contacts are an improvement over soft toric lenses since they are designed to match the exact contour of your cornea. Soft contact lenses can be custom-made for KC patients and may eliminate the need for glasses by fully correcting astigmatism.

3. Gas Permeable Contact Lenses

Gas permeable contact lenses (hard lenses) allow more oxygen into the eye than standard soft lenses. A gas permeable lens has a somewhat different shape than soft contact lens alternatives, as it rests on the cornea, and because the lens is hard, it creates a new optical surface. These lenses are suitable for people with moderate KC.

4. Hybrid Contact Lenses

These lenses are a cross between hard and soft lenses. The hard center provides a flat surface, which helps alleviate the issues associated with a misshapen KC cornea. The lens is rendered more comfortable by the soft outer ring. Hybrids combine the convenience and comfort of soft lenses with the crisp, clear vision of rigid gas permeable contacts.

5. Scleral Lenses

Scleral lenses are larger than standard hybrid, gas permeable or custom soft contact lenses. They vault over the cornea and rest on the sclera, the white of the eye. The advantage of scleral lenses is that they do not sit on the cornea, which removes any rubbing and irritation on the corneal bulge. This reduces the risk of corneal injury from the contact lens.

Furthermore, as the scleral lens vaults above the cornea, the reservoir of pure saline solution between the underside of the lens and the front of the cornea keeps the eye in a liquid environment at all times. This enables the eye to receive an abundance of oxygen.

While both rigid gas permeable (GP) and scleral lenses deliver enough oxygen to the eyes, scleral lenses provide more comfort and better stability than regular GP lenses. For this reason, scleral contact lenses are a very successful option for people with keratoconus and irregularly shaped corneas.

Treatment for Keratoconus

We offer treatment for keratoconus that is tailored to each patient based on the severity and progression of the condition, as well as the patient’s lifestyle.

Contact Norwalk Vision Scleral Lens and Keratoconus Center to learn more about scleral lenses and to discover ways we can help you manage your keratoconus.

 

Q: For how many hours can scleral lenses safely be worn in a day?

• A: Scleral lenses can be worn for 12-14 hours per day. To preserve the greatest possible vision and comfort, some patients may need to remove the lenses, clean them, and reapply fresh saline several times a day.

Q: Can scleral lenses completely correct my vision?

• A: Scleral lenses hide abnormalities on the eye’s surface and may improve vision over other types of correction. However, you’ll probably need to wear glasses over the lenses to see clearly at all distances, particularly if you’re over 40 and require reading glasses for close work.

Norwalk Vision Scleral Lens and Keratoconus Center provides scleral lenses to patients from Norwalk, Weston, New Canaan, and Westport, Connecticut and surrounding communities.

If you wear glasses or contact lenses, you probably have some degree of astigmatism. But how much do you really know about this all-too-common refractive error?

Below, we answer some of the most frequently asked questions about astigmatism and explain why scleral contact lenses are often prescribed to astigmatic patients.

1. What is Astigmatism?

Astigmatism is a common refractive error caused by a cornea that isn’t perfectly spherical. The cornea is the outer front covering of the eye and is partially responsible for refracting light onto the retina. When the cornea is misshapen, it refracts light incorrectly, creating two focus points of light entering the eye. Since the light is no longer focused on the retina, it results in blurred vision at all distances.

2. What are the Symptoms of Astigmatism?

The main symptom of astigmatism is blurred vision, but it can also cause symptoms like:

• Objects appearing wavy or distorted
• Squinting
• Headaches
• Poor night vision
• Frequent eye strain

3. How Common is Astigmatism?

Astigmatism affects approximately 1 in 3 individuals around the world. Most people with myopia (nearsightedness) or hyperopia (farsightedness) also have some level of astigmatism.

4. What’s the Difference Between Astigmatism, Nearsightedness and Farsightedness?

Although all 3 of these refractive errors negatively affect visual clarity, they are caused by different mechanisms.

Astigmatism is a result of a non-spherical cornea, which causes two focal points and blurry vision. Myopia occurs when the corneal focusing power is too high and the light focuses in front of, instead of directly, on the retina. Hyperopia occurs when the corneal power is too weak, so the light rays focus behind the retina, not on it. Both myopia and hyperopia can occur with a spherical cornea.

5. How is Astigmatism Corrected?

In cases of mild to moderate astigmatism, the blurred vision can be easily corrected with prescription glasses or contact lenses. But for patients with high levels of astigmatism, standard contact lenses may not be an option. Toric contact lenses are a popular choice for patients with mild or moderate astigmatism due to their unique focusing features and oblong shape. Scleral contact lenses are suitable for moderate to severe astigmatism.

Refractive surgery is also an option, but comes with the risk of surgical complications.

6. Why Can’t Individuals With High Astigmatism Wear Standard Contact Lenses?

A highly astigmatic cornea has an irregularly shaped surface that isn’t compatible with standard soft contact lenses. Standard soft lenses are limited in the amount of astigmatism they can correct, as these lenses move around on the cornea due to the cornea’s irregular shape. This, in turn, reduces visual clarity and comfort.

Regular hard lenses can often correct astigmatism better than soft lenses, but they, too, have limitations: these lenses are smaller and may also move around too much.

7. Why are Scleral Lenses Ideal For Astigmatism?

Scleral contact lenses are customized to each patient. They have a larger diameter than standard lenses, and thus cover the entire front surface of the eye. These specialized rigid lenses gently rest on the white part of the eye (sclera) and don’t place any pressure on the sensitive cornea, making them suitable for even highly astigmatic eyes.

Furthermore, scleral contact lenses contain a nourishing reservoir of fluid that sits between the eye and the inside of the lens, providing the cornea with oxygen and hydration all day long. In fact, patients typically report that sclerals provide sharper vision than other types of contact lenses.

Have Astigmatism? We Can Help

If you’ve been told that you have astigmatism and that your current contacts or glasses just aren’t cutting it, ask your optometrist whether scleral contact lenses are right for you.

At Norwalk Vision Scleral Lens and Keratoconus Center, we provide a wide range of eye care services, including custom scleral lens fittings and consultations. Our goal is to help all patients achieve crisp and comfortable vision, no matter their level of astigmatism or corneal shape.

To schedule your appointment or learn more about what we offer, call Norwalk Vision Scleral Lens and Keratoconus Center today!

Norwalk Vision Scleral Lens and Keratoconus Center serves patients from Norwalk, Weston, New Canaan, and Westport, Connecticut and surrounding communities.

Q: Can a person outgrow astigmatism?

• A: About 20% of all babies are born with mild astigmatism, but only 1 of those 5 babies with astigmatism still have it by the age of 5 or 6, at which point it is unlikely to diminish or disappear. Astigmatism can continue to change and even progress as the child grows, but tends to stabilize at around age 25.

Q: Can eye surgery cause astigmatism?

• A: Yes. For example, cataract surgery may cause or worsen astigmatism as the surgeon makes a tiny incision in the cornea to replace the lens. During the healing process, the cornea may change its shape and lead astigmatism to develop.

For some people, standard soft contact lenses are a great way to conveniently correct vision. For those with very dry eyes or corneal conditions like keratoconus, standard contacts simply aren’t an option.

Scleral contact lenses, however, are a great alternative for these patients with hard-to-fit eyes. They provide several benefits, such as reducing sensitivity to light (photophobia).

What Does Light Sensitivity Feel Like?

Patients with keratoconus and other corneal conditions tend to experience discomfort or unclear vision in brightly lit environments, even after undergoing treatment for their conditions.

They may see halos around lights while driving or may not be able to drive at all due to the worsening or clouding of vision that comes with light sensitivity. Bright fluorescent lights, like in an office setting, can trigger eye pain and interfere with their productivity and creativity.

Moreover, a photophobic person may not be able to comfortably look at a computer screen or other digital device. Even with the brightness setting turned all the way down, the light that’s emitted from the screen may be too intense.

How Can I Reduce Light Sensitivity?

While implementing the following suggestions can ease your symptoms of light sensitivity, we recommend that you speak with your optometrist for a more personalized approach.

• Try to stay out of the sun whenever possible, but when you do go outside, wear dark sunglasses to block out the light.
• Consider installing filters on fluorescent light sources.
• Take frequent breaks when using a digital device.
• Reduce glare in your home by turning mirrors away from light sources and keeping windows clean and streak-free. You may want to consider removing reflective surfaces from your home altogether.
• Speak with your optometrist about whether scleral contact lenses can help you.

What are Scleral Contact Lenses?

Scleral lenses are larger in diameter than standard lenses and rest on the white part of the eye (sclera). Their large surface area vaults over the entire cornea (the eye’s top layer), and thus avoid placing pressure on the sensitive corneal tissue.

The scleral lens holds a reservoir of nourishing fluid between the inside of the lens and the surface of the eye, providing visual clarity and optimal comfort. In fact, many patients report that they are able to wear scleral contacts for longer amounts of time as compared to standard contacts.

Scleral lenses are customized to fit each individual eye, and are suitable for patients with keratoconus, dry eye syndrome, irregular/excessive astigmatism, Sjorgen’s syndrome, other corneal abnormalities and for those having undergone LASIK surgery.

How Do Scleral Lenses Reduce Light Sensitivity?

Light sensitivity, or photophobia, is a common side effect of several eye conditions, such as dry eye syndrome and keratoconus. When the cornea is irregularly shaped, it doesn’t properly reflect light onto the retina, which can lead to light sensitivity.

Thanks to their unique and customized design, scleral lenses act as a new, accurately curved cornea that is able to reflect light in a healthy way. Because of their large diameter, scleral lenses are more stable and have a wider optic zone than other lenses. They offer a more accurate perception of peripheral vision and help minimize glare and sensitivity.

An irregularly shaped cornea is not the only reasons one experiences photophobia. In fact, there are several conditions that can cause it. Your optometrist will determine what’s causing your discomfort through a comprehensive eye exam and will determine whether scleral lenses are the optimal solution for you.

Norwalk Vision Scleral Lens and Keratoconus Center serves patients from Norwalk, Weston, New Canaan, Westport, and throughout Connecticut.

 

Q: How long does it take to adjust to scleral contact lenses?

• A: Scleral lenses are usually very comfortable right off the bat, but some patients may find that it takes up to 10 days to get used to the lenses. Your optometrist will guide you on how to shorten the adjustment period.

Q: How long do scleral contact lenses last?

• A: Under normal conditions, scleral lenses last between 1 and 3 years — far longer than standard lenses. Your tear film composition and your lens care habits will influence your lenses’ lifespan.