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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.

What are Scleral Lenses?

what are scleral lensesCustom 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, Dr. David Folman and Dr. Martin Arkin at Norwalk Vision Scleral Lens and Keratoconus Center can help. We serve patients from all over Norwalk, Weston, New Canaan and Westport, Connecticut and provides the highest level of care.

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?

improved vision with scleral lensesIf 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 Norwalk Vision Scleral Lens and Keratoconus Center. 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 Norwalk, Weston, New Canaan, and Westport, Connecticut and surrounding communities.

“I loved my visit from start to finish. The Norwalk Vision Scleral Lens and Keratoconus Center staff is friendly, caring and knowledgeable. The eye exam that I had for keratoconus was incredibly thorough and Dr. David Folman and Dr. Martin Arkin 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.“

REFERENCES:

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).

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Scleral Contact Lenses For Post Corneal Graft

Patients may be concerned that achieving a clear and comfortable vision will be nearly impossible following corneal transplant surgery. Although corneal transplants have a high success rate, they do not entirely cure the eye of disease. Patients will certainly notice dramatic improvements, but their vision will still need to be corrected.

It can take more than a year for the eye to recover from a corneal transplant, as it needs time to adapt to the new cornea. Because this adjustment is unpredictable, nearsightedness or astigmatism may develop. Even after complete recovery, prescription glasses or lenses may still be required. For this and other reasons (explained below), scleral lenses are the optimal choice for vision correction.

Here at Norwalk Vision Scleral Lens and Keratoconus Center, we aim to provide the best possible vision for our patients who’ve had a corneal transplant. If you’ve undergone this procedure, speak with Dr. David Folman and Dr. Martin Arkin to determine whether scleral contact lenses are the best choice for you.

Understanding Corneal Transplants

There are two common types of corneal transplants:

Penetrating keratoplasty, also called “full-thickness corneal transplant”, is when the full thickness of the cornea (the clear front surface of the eye) is replaced with healthy donor tissue.

Endothelial keratoplasty replaces only the diseased corneal tissue, leaving healthy tissue behind.

woried old manWhy Would Someone Need a Corneal Transplant?

A corneal transplant is generally recommended in the following cases:

  • For those with vision problems caused by the thinning of the cornea (generally due to keratoconus) and only after less invasive treatments have been proven ineffective
  • Scarred cornea caused by severe injuries or infections
  • Vision loss caused by cloudiness of the cornea, typically due to Fuchs dystrophy

Scleral Lenses & Post-Corneal Transplant Surgery

Corneal transplants don’t cure irregular corneas, as the transplant doesn’t fully adapt to the eye. Some eye doctors may recommend rigid gas permeable lenses (RGP’s), hybrid contact lenses, or scleral lenses for clear and comfortable vision.

Of all the options, scleral lenses are the optimal choice. The fully customized contact lens vaults entirely over the cornea without adding any pressure to it, while allowing the cornea to remain hydrated for ultimate healing and comfort. Furthermore, because they are larger in size than any other contact lens, they are less likely to shift and move around on the eyes, thus reducing the risk of irritation or abrasion.

We Fit Scleral Lenses and Other Specialty Contact Lenses

Getting fitted for scleral lenses after a corneal graft can be life-changing. It can allow you to comfortably and safely drive at night or resume playing a sport that you thought you’d have to give up.

If you’ve had a corneal transplant or plan to do so in the near future, know that clear and comfortable vision after the surgery is possible. Don’t miss out on incredible life experiences because of poor vision — call Norwalk Vision Scleral Lens and Keratoconus Center today.

Our practice serves patients from Norwalk, Weston, New Canaan, and Westport, Connecticut and surrounding communities.

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Scleral Lenses for Keratoconus

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