Scleral

6 Things To Know About Keratoconus

Keratoconus is an eye disease that causes the cornea, the clear dome-shaped front surface of the eye, to become misshapen and bulge. This progressive disease usually occurs in both eyes and affects approximately 50-200 in every 100,000 individuals.

People who have keratoconus often experience problems like blurred vision, distorted vision, night blindness and sensitivity to light. Clear vision correction for keratoconus can be challenging to achieve because the irregular corneal shape makes it difficult or impossible for standard eyeglasses or contact lenses to provide you with sharp vision.

Thankfully, there are ways for people with keratoconus to achieve clear and comfortable vision, something we explore below, along with several other key points about keratoconus.

1. Everyone has different risk factors for developing keratoconus

Some risk factors for developing keratoconus include:

• Hereditary predisposition
• Eye rubbing
• Other medical conditions like Down syndrome, allergic dermatitis and connective tissue disorders
• Eye inflammation

2. Keratoconus can develop at any age

Although most cases of keratoconus are first diagnosed in adolescence or young adulthood, it can appear during any stage of life. That’s why regular eye exams are crucial, even if your vision seems clear and your eyes appear to be healthy.

3. Early diagnosis is key

This rings true for almost every eye disease, especially keratoconus. Catching it early in its tracks can allow the eye doctor to implement various treatments to slow down its progression during the initial stages, when this condition tends to worsen more rapidly.

4. Keratoconus progresses at different rates throughout life

Keratoconus progression varies from person to person, and one person can experience varying degrees of progression in each eye. Some patients live with mild keratoconus their entire lives, while other patients develop severe keratoconus early on.

Often, optometrists will recommend that patients undergo certain procedures to strengthen the cornea and prevent or slow down further progression.

5. Keratoconus can be treated with surgery or scleral contact lenses

Corneal cross-linking surgery is an effective option to provide enhanced strength to the cornea and is the only FDA-approved method of stopping or slowing keratoconus progression. However, if the condition develops into severe keratoconus, a corneal transplant may be the best option for treating the condition and restoring clear vision.

Scleral contact lenses offer another option to surgery. They are ideal for patients with early or moderate levels of keratoconus because they safely and effectively correct vision without irritating the misshapen cornea. In fact, studies have shown that patients with keratoconus who wear scleral contact lenses greatly reduce their risk of needing keratoplasty (corneal transplant surgery).

The large diameter of scleral contact lenses allows them to vault over the sensitive corneal tissue and then also coat the cornea in a nourishing reservoir of fluid for optimal comfort and visual clarity. Because eye rubbing and corneal irritation are significant risk factors for the progression of keratoconus, the protective qualities of scleral lenses can help to minimize keratoconus progression.

6. You can live a normal life with keratoconus

With the proper care and treatment from your optometrist, keratoconus shouldn’t stop you from living your life to the fullest. Although it can be discouraging to experience vision problems that can’t be resolved with standard lenses or glasses, know that there are other options available.

At Harrel Scleral Lens and Keratoconus Center, we help patients with keratoconus and other corneal abnormalities achieve crisp and comfortable vision using scleral contact lenses and other specialty lenses.

Our practice provides scleral lenses to patients from Tulsa, Broken Arrow, Oklahoma City, and Fort Smith, AK, Oklahoma and surrounding communities.

Q: Who else can benefit from wearing scleral contact lenses?

• A: Scleral contact lenses are ideal for patients with any of the following conditions: corneal abnormalities, severe dry eye syndrome, post-LASIK or corneal transplant, eye allergies, high refractive error or corneal trauma. Speak with your optometrist to find out if scleral lenses are right for you.

Q: Do all optometrists fit specialty contact lenses like sclerals?

• A: No. If you are interested in scleral contact lenses, be sure to choose an optometric practice that has years of experience fitting specialty lenses. At Harrel Scleral Lens and Keratoconus Center, we have the knowledge, skill and experience necessary to provide you with the best lenses for your eyes. Call us to learn more or schedule your scleral lens fitting.

6 Tips For Adjusting To Wearing Scleral Lenses

Congratulations on your new pair of customized scleral contact lenses! As with most new things, there can be a learning curve when getting your scleral contacts to feel and fit just right.

Whether you’ve been prescribed sclerals for keratoconus, dry eye syndrome, corneal abnormalities or other conditions, it can take up to two weeks for you to feel completely comfortable in your new contacts.

Here are some tips to help shorten the adjustment period on your scleral lens journey:

1. Stick to proper hygiene protocol

Even the most perfectly fitted scleral lenses won’t feel right if they aren’t cleaned and cared for properly. Carefully follow the hygiene guidelines prescribed by your optometrist without cutting any corners. Although it may seem tedious at first, your efforts will be well worth the results.

2. Practice makes progress

The only way to make inserting and removing your lenses second nature is to wear them. Don’t be discouraged if it takes a bit more time to insert them than you’d anticipated. Wearing your sclerals daily will give you the opportunity to practice wearing and caring for your lenses.

3. Try out different insertion tools and techniques

At your initial fitting or follow-up consultation, your eye doctor will show you ways to safely and comfortably insert your lenses. Some patients prefer using a large plunger, while others prefer the scleral ring or O-ring. If neither of these recommended techniques are working for you, seek advice from your eye doctor.

4. Overfill the lens

A common problem that many patients encounter when they begin wearing scleral contact lenses is how to get rid of tiny air bubbles that get trapped in the lens’ bowl. Try filling up the lens with the recommended solution until it is almost overflowing. That way, you’ll have enough fluid left in the lens even if some spills out when you bring it up to your eye.

5. Give it time

If your scleral lenses feel slightly uncomfortable upon insertion — don’t worry. It’s recommended to wait 20-30 minutes to allow them to settle on the eye’s surface before attempting to readjust or remove them. Of course, remove them immediately and try again if you feel significant discomfort.

6. Follow up with your optometrist

Even once you leave your optometrist’s office, we encourage you to remain in touch with your eye doctor if something doesn’t feel right or if you have any questions regarding your scleral lenses.

To learn more or to schedule a scleral lens consultation, call Harrel Scleral Lens and Keratoconus Center today!

Harrel Scleral Lens and Keratoconus Center provides scleral lenses to patients from Tulsa, Broken Arrow, Oklahoma City, and Fort Smith, AK, Oklahoma and surrounding communities.

Q: What are scleral contact lenses?

• A: Scleral contact lenses are rigid gas permeable lenses with a uniquely large diameter. They rest on the sclera (whites of the eyes) instead of the cornea, making them a more comfortable and stable option for people with corneal irregularities or dry eye syndrome. Scleral contacts hold a reservoir of nourishing fluid between the eye’s surface and the inside of the lens, providing the patient with crisp and comfortable vision.

Q: Who is an ideal candidate for wearing sclerals?

• A: Patients with keratoconus, corneal abnormalities, ocular surface disease (dry eye syndrome) and very high refractive errors can all benefit from scleral lenses. Moreover, those with delicate corneas due to disease or after surgery find scleral lenses to be comfortable and therapeutic, as the lenses don’t place any pressure on the sensitive corneal tissue.

World Keratoconus Day + Keratoconus Treatment Options

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 Harrel 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.

Harrel Scleral Lens and Keratoconus Center provides scleral lenses to patients from Tulsa, Broken Arrow, Oklahoma City, and Fort Smith, AK, Oklahoma and surrounding communities.

7 Questions And Answers About Astigmatism

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 hig