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


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
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.

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.

Tagged , , , , , , , , , , , , , , , , , , , , , ,

Bowman’s layer transplantation shows promise for keratoconus

Bowman’s layer transplantation reduced or stabilized corneal ectasia in eyes with keratoconus that were not eligible for corneal collagen cross-linking or intracorneal ring segments, according to a study presented here.

“Historically, the treatment of keratoconus was limited to fitting contact lenses for as long as possible . . . and the patient was normally referred for a PK or [deep anterior lamellar keratoplasty],” Korine Van Dijk, said at World Cornea Congress. “What has been lacking so far is a way to arrest ectasia.”

Crosslinking effect

The technique involves making a scleral tunnel and a mid-stromal pocket. A stained donor Bowman’s layer is positioned onto a glide and inserted into the pocket, unrolled and stretched to the periphery of the cornea, Van Dijk said.

The study included 22 eyes of 19 patients with a mean age of 32 years. Mean preoperative corneal thickness was 332 m.

Mean follow-up was 21 months, and follow-up ranged up to 36 months.

Investigators evaluated complications, endothelial cell density, corneal tomography and best corrected visual acuity.

Intraoperative Descemet’s membrane perforation occurred in two eyes. However, no postoperative complications were reported.

Endothelial cell density and best corrected visual acuity did not change from before surgery to after surgery, Van Dijk said.

“This may indicate that potential candidates for Bowman’s layer transplantation should present with subjectively acceptable vision with their contact lenses,” Van Dijk said. “For these kinds of keratoconus cases, Bowman’s layer transplantation may effectively reduce and stabilize the ectasia, keeping these eyes in their contact lenses with a relatively low risk of complications, and so postpone a potential PK or DALK.”

Corneal flattening occurred after surgery and remained stable for up to 2 years, Van Dijk said. by Matt Hasson

Disclosure: Van Dijk reports no relevant financial disclosures.

Article first appeared here

Tagged , , , , , , , ,

Cornea specialist outlines ideal candidate for cross-linking for keratoconus

As corneal collagen cross-linking (CXL) makes its slow way through the USA FDA approval process, a presenter at SECO shared pearls of wisdom for patient selection and explained the procedure’s mechanism of action.

Terry Kim, MD, chairman of the cornea department at Duke University School of Medicine, shared guidelines that he said are based on more than 20 clinical trials.

“Your ideal candidate for corneal collagen cross-linking will have a diagnosis of progression over 12 to 24 months,” he said. “He or she will have an increase of more than 1 D in terms of the steepest keratometry readings, an increase of at least 1 D in regular astigmatism and a myopic shift of at least 0.5 D.

“The patient will have the presence of central or inferior steepening, axial topography consistent with keratoconus/ectasia, the steepest manual K of at least 47 and pachymetry of at least 300 microns to 400 microns at the thinnest point,” he added.

Kim explained that with the corneal collagen cross-linking procedure, the central 7 mm to 9 mm of epithelium is removed. Riboflavin B2 in 20% Dextran is applied 5 minutes prior to the procedure and every 5 minutes during the procedure. UVA (365 nm to 370 nm) is applied for 30 minutes. Patients are treated with a bandage contact lens and topical antibiotics and steroids for 2 weeks.

Kim said that the procedure creates covalent bonds between collagen molecules.

“You’re cross-linking the cornea by this effect,” he said. “We naturally self cross-link our corneas as we get older. A 70-year-old patient is at much less risk of developing keratoconus than a 20-year-old because that cornea has already been cross-linked. It’s debated whether there’s a benefit to treating older patients.”

Kim said a debate also exists regarding removing the epithelium.

“We know that riboflavin B2 penetrates better if you take it off,” he said. “The problem is that some patients have had delayed healing because of epithelial infections or scarring.

“You can apply the riboflavin by doing stromal punctures to help it penetrate,” he continued. ”The issue is: Will you get a sustained and high enough level to have the effect of cross-linking? The other issue is changing the energy. Some use a high fluency treatment.”

Kim explained an alternative treatment.

“Some are treating patients with oral vitamin B2 and asking them to sunbathe to get the same effect,” he said. “A small German study showed some stabilization of keratoconus just doing this. We had a young basketball player a few years ago with keratoconus and we recommended this to him.”

Kim said it is important to convey to patients that keratoconus is a progressive disease.

“We know that eye rubbing has a lot to do with it,” he said. “My Down’s syndrome patients are always rubbing their eyes and they typically have advanced keratoconus. We need to try to stabilize the disease process in this condition that progresses.” – by Nancy Hemphill, ELS, FAAO

Disclosure: Kim has no relevant financial disclosures.

Article first appeared here

Tagged , , , , , , , ,

Eye Rubbing as a Possible Cause of Clinical Progressive Keratoconus in a Forme Fruste Keratoconic Family

Originally posted on Scientific Research Publishing:

Read  full  paper

We report a case of a 21-year-old male patient who underwent corneal cross-linking (CXL) due to bilateral progressive keratoconus. Topographical screening of his family members was performed for the detection of possible familial keratoconus and showed abnormal topographical patterns resembling to Forme Fruste Keratoconus (FFK) in all the members of his family. The reported keratoconic patient that underwent CXL was the only individual of this family that referred eye rubbing in his personal ocular history; ocular and medical history of the other family members was clear. Eye rubbing could be a possible adjuvant risk factor that contributes to conversion of FFK to clinical progressive keratoconus.

Cite this paper

Kymionis, G. , Tsoulnaras, K. , Blazaki, S. and Grentzelos, M. (2015) Eye Rubbing as a Possible Cause of Clinical Progressive Keratoconus in a Forme…

View original 199 more words

Corneal Cross Linking Is A Very Effective Eye Treatment

Originally posted on Keratoconus Contact Lenses:

Corneal Cross LinkingThere are numerous individuals who don’t think about Keratoconus. On the off chance that you are among such individuals, then you have to realize that this truth be told is a sickness of the cornea which can bring about make the vision blurry and phantom pictures. Individuals having Keratoconus need to realize that the front straightforward surface of eye gets slim, which brings about cornea extends and hangs into a sporadic “cone” shape. In the event that you or anybody you know is enduring such eye issue, then you on the double need to counsel masters. The purpose behind this is that if Keratoconus advances, it can result in a diminishing of the cornea. Then again, because of mechanical advances, there is successful methodology accessible for those patients whose condition advances unabated. In the event that you have Keratoconus, then you have to realize that Corneal Cross Linking is an…

View original 303 more words

Northampton optometrist saves man’s sight with new contact lens after 10 year battle

Monday, March 9, 2015
Northampton optometrist saves man’s sight with new contact lens after 10 year battle 
kcgb blog
An award-winning contact lens expert from Northampton has stepped in to help a patient witness the birth of his baby daughter, despite fears he would never be able to see again.
Kevin Marshall, aged 30 from East Hunsbury, has fought a 10 year battle with Keratoconus – a degenerative eye disorder which distorted his vision to such an extent that he could no longer drive or see more than three feet in front of him.
Having been told by several eyecare professionals there was nothing they could do for him, Mr Marshall was eventually referred to Brian Tompkins, owner of Tompkins, Knight & Son Optometrists in Kingsley Road, Northampton.
Within a matter of minutes, a state-of-the-art scleral lens, which creates a tear-filled vault over the cornea, had been fitted and Mr Marshall’s sight had been restored.
He said: “It felt like a miracle. I had got to the point where I genuinely thought I wouldn’t be able to see again.
“I had to give up work, I couldn’t go out and I was worried I wouldn’t be able to see my baby, but literally within minutes of meeting Brian it had all been resolved. The word ‘life-changing’ doesn’t even come close.
“I can now do all the little things people take for granted but which I wasn’t previously able to do. I can watch the TV at night, I can go swimming and I can play with my little girl, Lalie, which means the world to me.”
Kevin’s condition meant his corneas were conical rather than spherical, distorting his vision.
He underwent a full corneal graft on his left eye but the surgery meant that normal lenses would irritate the scar tissue, making the problem worse.
Mr Tompkins said: “It was a tricky one as we had to find a lens which didn’t sit directly on either eye. The left eye had the graft scars and the right eye still had Keratoconus.
“The scleral lens creates a vault over the cornea, removing any chance of irritation of either the graft scars or the sensitive thin conic cornea but still achieving superb vision.
“I’m delighted that it has had such a positive impact on Kevin and he is now able to enjoy family life once again.”
Kevin has now secured a new role as a recruitment manager and added: “I feel as though I have been given a second chance in life and I can’t thank Brian and the staff at TKS Optometrists enough for what they have done for me.”
For more information on Tompkins, Knight & Son visit
Notes to editors
• For further details, to arrange an interview or more photographs, email or call 07909 916668.
• For more information about keratoconus join us on Facebook or Twitter @keratoconusGB


Tagged , , , , ,

1 Year, 10 Months Post-Op (Corneal Transplant Update)

Originally posted on Life's a Performance:

It’s been a while since I last updated you guys, but here we are again.  You know how they say that no news is good news right?  Well you can probably expect why I’m writing.

This is a post that I had hoped I wouldn’t have to write.

Today I had made an appointment at my ophtalmologist’s office to talk about surgery for my left eye.

I went into the doctor’s office as usual.  The assistant gives me the usual vision test, and I did pretty well.  Then the doctor came in and looked at my eyes and said that my cornea was rejecting.  He asked me what drops I was using and how often, and I told him that I wasn’t because he told me I could go off my eye drops unless I was sick.  He proceeds to tell me that he never said that, implying that this…

View original 229 more words

KERATOCONUSGB The biggest most active keratoconus community online

How as 2014 for you?

We hope you had a good year and that having KC was not too troublesome. If you would like to share your keratoconus story or chat with other KC’ers in 2015 get in touch with us here, or or one of our social sites:

Facebook Page

Facebook Group

Twitter – find us at Follow us @KeratoconusGB



We now have over 8,500 members right across the world! Join us and get support and learn more about #keratoconus! plus this blog now has

We published and shared over 90 keratoconus and eye related blog posts in 2014- that’s a lot of information! The most popular post was with over 5,000 views alone. Over 26,000 people have visited this blog in 2014.


2004-2010 – The missing years…

Originally posted on My Life With Keratoconus:

These are the years I can say I was truely depressed, not knowing what was wrong with my vision, believing it ws something serious about to strike me down was soul destroying.

It was around this time that my parents got the internet package from NTL (virgin) and I was able to hook my pc up, instead of helping myself by looking up things related to the vision problem I took to playing Wolfenstein:Enemy Territory.

Somehow I was a very good natural aimer on this game, I ended up making my own clan, had our own servers and gained many friends along the way. but what they didnt know was the person they played with was sat there depressed, comfort eating, gaining weight, becoming more unhealthy by the day, I would literally play untill 5 am and sleep untill 1pm. It had become my life, my only life.

I ballooned…

View original 5 more words

AJPorter Accounting

We are the BEST at sums

Failure is Fuel

This is not just a list of bullshit that I've done in the past, it's a chronicling of my rise to power*

My Life With Keratoconus

A fight that never ends, NHS, Gps, misdiagnsosis

I Hate These Blurred Lines

Dealing with Keratoconus

Big Girl In A Small World

Good things come in BIG packages!!

The Musings of The Masked Gentleman.

Thoughts and opinions on day to day life from The Masked Gentleman.

A Quest For Happiness

My personal journey


If you got the blood, then you got the heart to give yourself a chance ...

The VisionHelp Blog

Re-train the Visual Brain…Advancing awareness, understanding and best practices

pinkglitter1974's Blog

Smile! You’re at the best site ever

VS EYE Observer

The Worlds Largest Inventory of Optical and Ophthalmic Equipment

Specialised Ophthalmic Services

Equipment for Minor Eye Conditions schemes such as PEARS and ACES, and equipment for the management of dry eye conditions

keratoconus sucks

my corneal transplant journal

Rushabh Eye Hospital

lasik surgery , Cataract Surgery and Glaucoma surgery

Aniridia Network UK

Supporting people with aniridia and their families

Memoirs of an English Wolf

A Half Remembered Life - 1988 - 2013

Liveken - my chronic life journey

Life with Foggy Frog and the Pain Gang


Get every new post delivered to your Inbox.

Join 6,069 other followers

%d bloggers like this: