Contact lenses for Keratoconus

Luckily for us, there is a wide choice of contact lenses available for those with keratoconus. Fitting contact lenses on a keratoconic cornea is challenging and time-consuming. You can expect plenty of return visits to fine-tune the fit and the prescription, especially if the keratoconus continues to progress. It’s very unlikely that any lens will fit first time, so patience and perseverance is key.

Here’s a guide to what’s on offer, so you can ask your contact lens fitter what they can offer you:

Custom soft contact lenses

Recently, contact lens manufacturers have introduced custom soft contact lenses specially designed to correct mild-to-moderate keratoconus. These lenses are made-to-order based on detailed measurements of the keratoconic eye(s) and can be more comfortable than gas permeable (GP) or hybrid contact lenses for some wearers.

KeraSoft by Bausch & Lomb lenses can correct up to -30 diopters (D) of myopia and up to -15 D of astigmatism and are available in silicone hydrogel and regular hydrogel materials with high water content (74 to 77 percent). Kerasoft lens are great for early stage Keratoconus and also post graft eyes. KeraSoft IC lenses are designed to fit irregular corneas, including keratoconus, post laser refractive surgery, pellucid marginal degeneration, and other corneal irregularities. Each KeraSoft IC lens is custom-made for your exact needs, and KeraSoft IC lenses can offer increased wear time and improved comfort and are a patented combination of the latest technologies in silicone hydrogel materials using geometries from complex mathematics to offer comfortable wear and excellent vision.

NovaKone lenses (Alden Optical) can correct up to -30 D of myopia and up to -10 D of astigmatism and are available in a hydrogel material with medium water content (54 percent).

Both lenses have a very wide range of fitting parameters for a customized fit and are larger in diameter than regular soft lenses for greater stability on a keratoconic eye.

In a recent study of the visual performance of toric soft contacts and rigid gas permeable lenses for the correction of mild keratoconus, though GP lenses provided better visual acuity in low-contrast situations, soft toric lenses performed equally well in high-contrast acuity testing.

Custom soft toric lenses also can be a good option for part-time wear for people with keratoconus who cannot tolerate wearing gas permeable lenses full-time.

Custom toric soft contacts for keratoconus are significantly more expensive than regular soft contacts

Hybrid contact lenses

Synergeyes hybrid lens

ClearKone® hybrid contact lenses offer all the benefits of rigid gas permeable (RGP) and soft contact lenses without any of the disadvantages for an overall good contact lens experience.

ClearKone® is an NHS approved and FDA-cleared hybrid contact lens specifically designed for the treatment of keratoconus and other corneal irregularities. Using a revolutionary technology, ClearKone® combines the best of both worlds – the crisp vision of a high-oxygen rigid RGP contact lens with the all-day comfort and convenience of a soft lens.

ClearKone® is specifically designed to restore vision to patients with the many types and stages of keratoconus, including post graft lens wear. Because the ClearKone® lens vaults over the cornea, there’s minimal risk of corneal scarring, making ClearKone® hybrid contact lenses a healthy treatment option for keratoconus. In addition, the soft skirt of the ClearKone® design helps to center the contact lens over the visual axis regardless of where the cone is located on the cornea or how large it is, thereby decreasing visual distortions and providing superior vision. The ClearKone® design also prevents dirt from getting under the lens and will not pop out unexpectedly.
Hybrids use soft lens cleaning solutions.

 

Ultrahealth hybrid lenses

UltraHealth, available in 2013, from Synergeyes,  is the only irregular cornea hybrid contact lens with highly breathable, healthy materials and an advanced lens design especially suited for patients with irregular cornea conditions. UltraHealth corrects vision problems, is healthy for your eyes and delivers exceptional comfort, too.

UltraHealth delivers vision benefits only available in hybrid contact lenses. The “rigid” (GP) material optimizes vision; while the soft skirt centers the lens over the cornea, providing enhanced stability and clarity. The soft silicone hydrogel material that surrounds the GP portion of the lens provides longer-lasting comfort for irregular cornea and keratoconus patients. UltraHealth is made with materials that allow very high oxygen transmission. The lens design also promotes tear circulation throughout the day, which delivers even more oxygen to the eye.

Ideal for Patients with:

  • Irregular cornea
  • Keratoconus
  • Ectasia
  • Intacs®
  • Post-Surgical

Eyebrids

The launch in France of the first range of Hybrid Contact Lenses, combining quality of vision with rigid lens wearing comfort soft lens was announced by the French laboratory LCS (Contact Lens Service) in early 2013. The new patented range of lenses named EyeBrid is the result of four years of research by teams at LCS. These innovative lenses need renewal every 4 months but also offer a high oxygen permeability (Dk strong). This new lens is as comfortable as a soft lens and offers the visual quality of a hard lens.

Gas permeable contact lenses or RGP

By far the most widely used contact lens for keratoconus, with the most popular RGP being the RoseK. it is essential RGP lens are fitted by an expert.
If eyeglasses or soft contact lenses cannot control keratoconus, then rigid gas permeable (RGP or GP) contact lenses are usually the preferred treatment. Their rigid lens material enables GP lenses to vault over the cornea, replacing its irregular shape with a smooth, uniform refracting surface to improve vision.

Rose K was established to market the Rose K lens invented by Paul Rose, an optometrist from Hamilton, New Zealand.  Paul was concerned about what could be done for patients with keratoconus – a progressive condition in which the surface of the cornea becomes cone shaped.  Realising that the problem with traditional contact lenses was that they did not fit unusual corneal shapes or mimic the eye shape well, he sought to develop a contact lens that would be more comfortable for patients, be easier to fit and provide better vision to those with the condition. Paul Rose began developing the Rose K keratoconus lens in 1989.  After testing 700 lenses and 12 different designs, he produced a set of 26 lenses from which all patients are fitted.  A further two years was spent to perfect the lens design before it was launched in the New Zealand market.  In 1995, the Rose K lens gained approval from the Federal Drug Administration (FDA) of America.

Since then advances in technology have resulted in the introduction of the Rose K2 lens, the Rose K2 Irregular Cornea (IC) lens and the Rose K2 Post Graft lens designed for patients with specific conditions.  These conditions include Pellucid Marginal Degeneration, Keratoglobus, Lasik Induced Ectasia and for patients who have undergone Penetrating Keratoplasty.

The Rose K family of lenses are now manufactured in 13 countries, distributed in over 60 countries and have become the most frequently prescribed lenses for keratoconus in the world. RGP contact lenses can be less comfortable to wear than soft contacts, and really need expert fitting and patience. Looked after they are durable and cost effective.

“Piggybacking” contact lenses.

Because fitting a gas permeable contact lens over a cone-shaped cornea can sometimes be uncomfortable for a person with keratoconus, some eye care practitioners advocate “piggybacking” two different types of contact lenses on the same eye.

For keratoconus, this method involves placing a soft contact lens, such as one made of silicone hydrogel, over the eye and then fitting a GP lens over the soft lens. This approach increases wearer comfort because the soft lens acts like a cushioning pad under the rigid GP lens.

Your eye care practitioner will monitor closely the fitting of “piggyback” contact lenses to make sure enough oxygen reaches the surface of your eye, which can be a problem when two lenses are worn on the same eye. However, most modern contacts — both RGP and soft — typically have adequate oxygen permeability for a safe “piggyback” fit.

Scleral or ‘sceral’ lens (spelling)

Many optometrists and ophthalmologists recommend scleral contact lenses for a variety of hard-to-fit eyes, including eyes with keratoconus. The first scleral lenses were made in glass, blown and fashioned into shape by craftsmen in the 1880′s. They were also the only lens available up until the 1950s.

In cases of early keratoconus, a standard RGP lens can be used. However, if the lens does not centre properly on the eye, moves excessively with blinks and causes discomfort, switching to a large-diameter scleral contact lens may solve the problem. Scleral lenses were made in rigid gas permeable (RGP) materials in 1983, and today are highly oxygen permeable.

Scleral lens are designed to vault the corneal surface and rest on the less sensitive surface of the sclera, so these lenses often are more comfy for a person with keratoconus. Scleral lenses are designed to fit with little or no lens movement making them more stable on the eye, compared with traditional corneal gas permeable RGP lenses.
The newest scleral lens is the ICD 16.5. With only three fitting zones, ICD™ 16.5 is easy to evaluate, consistent in lens performance and is the “go-to” lens for problematic corneas.

Scleral Lenses for Other Eye Problems

In addition to keratoconus, scleral lenses can be used for eyes that have undergone a cornea transplant, and for people with severe dry eyes caused by conditions such as Sjogren’s syndrome, graft-versus-host disease (GVHD) and Stevens-Johnson syndrome.

Large-Diameter Contact Lenses
LENS DIAMETER* CLASSIFICATION EXAMPLES
12.9 to 13.5 mm Corneal-scleral SoClear (gt_eq13 mm; Art Optical, Dakota Sciences)
13.6 to 14.9 mm Semi-scleral Tru Scleral (gt_eq13.5 mm; Tru-Form Optics)
Perimeter (14 or 14.8 mm; Abba Optical)
Dyna Semi-Scleral (gt_eq13.5 mm; Dyna Lenses)
14.5 mm Hybrid
(RGP center with a silicone
hydrogel skirt that rests on
the sclera)
ClearKone – for keratoconus
Duette – indicated for use in healthy eyes, up to ±20 D
sphere, astigmatism of lt_eq –6 D
Duette Multifocal – indicated for healthy presbyopic
eyes (all hybrid examples, 14.5 mm; SynergEyes)
15 to 18 mm Mini-scleral Jupiter† (15 or 18 mm; Visionary Optics, Abba Optical)
Maxim (16 mm; Accu-Lens)
18.1 to 24 mm Scleral Jupiter† (18.8 or 22 mm; Abba)

*Upper and lower boundaries are approximate; sizing and terminology vary among lens makers.
†Manufacturers of RGP materials with FDA-approved lens designs provide the raw material to multiple labs, which produce the lenses under their own brand.

http://www.aao.org/aao/publications/eyenet/201201/feature.cfm?RenderForPrint=1

Lens care

Contact lens case

Whatever lens you wear It is important to clean your contact lenses daily to maintain the highest standards of comfort and visual clarity. Each day after you remove your lenses, you must clean them prior to overnight storage.
Always use the correct solution, never use tap water. Change your contact lens case regularly as bacteria will happily live in the little damp case, that could damage your eyes and cause infections.

Try not to overwear your lens especially in the early days of getting used to them. If they hurt – take them out and clean them, and let your eyes rest. Try to avoid aircon and get fresh air to your eyes when you can. There are various rewetting and comfort drops available from pharmacies and your doctor. Always check that they’re suitable to use with your type of contact lens.

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My Eye!

Originally posted on Big Girl In A Small World:

image

I had my Corneal Cross-Linking done last week. It was a trying experience since I had to watch the whole thing. I say that because they do not put you to sleep. They use a reverse clamp to hold your eye open, add some numbing drops and then do what they do. They sterilized my eye using giant betadine swabs. There were a lot of drops and then he cleaned cells off of my eye using an alcohol solution and a cotton swab on a stick. Then, there were more drops followed by some pics on a machine, more drops and then 2,000,000 mins (or 5 mins) under the UVA lamp including two breaks for more drops. Then, they placed a contact bandage and we were done.
I got the bandage removed today and found out that I have to be without contacts for another week; that’ll be 3wks total…

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Living with Keratoconus

Originally posted on The Musings of The Masked Gentleman.:

Hey everyone, this is the first post on this blog, and is going to be more serious than my usual posts, which tend to be game reviews. If you’d like to check them out then click here, there are also other reviews and posts from good friends of mine. Anyway, back to the purpose of this post which is to cover what Keratoconus is, how I was diagnosed with it, what it has been like living with the condition and what the future holds. This should also provide a place to direct people when they ask about my condition rather than trying to remember everything off the top of my head, skimming over facts so quickly that I never really get into any depth about the condition. It also means I can put up pictures to better illustrate what it is like to live with Keratoconus, because yay pictures.  As a…

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Career & KC

Originally posted on Living With Keratoconus:

Hello everyone!

I am back. I was in the middle of many things but I am back and celebrating a new job!!

So somewhere along the way, you may have caught on to what I do for work… if not, I work in communications and social media management.  Recently, I shared with a member of my church that I work in communications and spend a lot of time writing and staring at a screen and she asked me why did I choose this career considering all of my eye issues.

I thought to myself “Yeah, why did I?

Ironically, around that time I was reconsidering my place of employment. So I did what an anxiety-prone person does… over-keratoconus and workanalyze and jump to the worst conclusions. My career was doomed. “Why on earth did I choose communications?” “I was always so good at science… should have…

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Being Diagnosed

Originally posted on I Hate These Blurred Lines:

I was diagnosed with Keratoconus in early 2012. I had gone for a routine check up at the opticians; I’d had some difficulties with my eyesight shortly before the appointment but nothing what I would have considered to be out of the ordinary. It had been two years since my last visit and I was simply keen to get an updated prescription.

I knew something was up when in the initial screening tests, one of them didn’t work. The assistant couldn’t get a reading and needed the optician to come out and check. For those who are veterans of the eye test, it’s the one where you stare at a balloon in a distance and it goes in and out of focus. I believe this is an autorefractor, although I could be mistaken. The optician couldn’t get a reading either, for the record.

The rest of the eyesight test went…

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Much Ado About Eyes

Originally posted on A Quest For Happiness:

anime-art-girl-glasses-1094551This is just a long personal story, with no real flowery “lesson” or conclusion to it. Feel free to skip it, I am not offended. :lol:

Well, last week, I was given a definite diagnosis of “Keratoconus”, which is a degenerative eye disease. The cause of it is unknown, the guess is that it may be genetic. And there are treatments but no proven “cure” for it yet.

I was diagnosed with this disorder at age 21, before this final wake-up call. At that time, I lived in Philadelphia and noticed that I couldn’t see well with my left eye, after nearly getting hit while crossing the road. I swear, I didn’t see the massive SUV thundering my way from my left view, as I stepped off the curb. It wasn’t one of my suicide attempts either (will mention more on that sob-story past some other time!).

Thankfully, the car…

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Right Corneal Graft Rejection

Originally posted on Life from a Wheelchair:

This last week last been been stressful and I’ve yet something else vision-wise to adjust to.

Last Sunday I noticed mistiness, pain and weeping in my right eye. Having had similar symptoms when the 25 year old corneal graft in my left eye began to reject and I needed a partial re-graft in May last year, I feared the same thing was happening again, but this time in my right eye, which had originally been grafted 22 years ago.

My vision in that eye has never been good. As a child I had a pellet flicked into to it from a catapult and that caused me some vision loss. Eighteen months ago I was assaulted by someone with mental health problems. She punched the right side of my face causing me to sustain a retinal bleed. Both of these things affected my distance vision considerably but I have retained some…

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Cornea Connect brings researchers and patients together

Originally posted on Aniridia Network UK:

Woman next to a microscope and the cornea under it shown on a screen beside it.

Researcher Victoria giving a tour of a lab where cornea stem cells are studied

Researchers into aniridic keratopathy held a event so they could meet people affected by the condition so they could learn about each other.

Corneal opacification affects people with aniridia because of deficiencies in the eye’s limbal stem cells. The Cells for Sight Transplantation and Research team at University College London (UCL) is working to understanding it and develop treatments.

The Cornea Connect meeting on 14 February 2014 was the first of its kind at the UCL Institute of Ophthalmology which is attached to Moorfields Eye Hospital.  It aimed to bring together scientists and patients with a common interest in the cornea and to talk about the challenges faced by both parties.

Several members of Aniridia Network UK attended and some gave presentations. Chair Katie Atkinson said afterwards “We want to say thank you for organising this…

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KERATOCONUSGB KCFAMILY KERATOCONUS MEET UP LONDON 2014

Hello everyone

We thought that now we have so many members across this blog, Facebook, Twitter and so on that we ought to meet up and put faces to names, to share our KC stories and learn more about each other and living with Keratoconus.

ALL WELCOME

This meet up is entirely informal and open to anyone with or without KC (perhaps you are a parent of a KC child), it is free and will be held in London. It an informal social event!

Sunday November 23rd 2014, Hard Rock Cafe Backroom, 150 Old Park Lane, London, United Kingdom W1K 1QS

From 12 noon.

For further information please visit the event page on Facebook https://www.facebook.com/events/583256505116468/

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