Your Comprehensive Guide to Vision Solutions
Keratoconus is a progressive eye disease that causes the normally round cornea to thin and bulge into a cone-like shape. This causes vision distortions that can make everyday tasks like reading or driving challenging. Fortunately, keratoconus treatment options like custom keratoconus contact lenses can help individuals manage their vision.
We’re taking a look at the diagnosis and causes of keratoconus, and the different types of contact lenses for keratoconus, including hard contacts for keratoconus, soft contacts, hybrid contacts, and piggyback lenses. Additionally, we will delve into the cost of keratoconus surgery.
What is Keratoconus?
Keratoconus occurs where the cornea weakens, causing it to change shape from round to cone-like. This changes the way light hits the retina at the back of your eye, distorting vision, which can lead to ghosting, glare, and halos. It often begins in the late teenage years or early twenties.
Keratoconus Diagnosis
Diagnosing keratoconus starts with a comprehensive eye exam. Key diagnostic tools include:
- Slit-lamp examination: Allows the doctor to look for signs of corneal thinning and irregularities, like Fleischer’s ring – a ring of iron deposits found at the base of the cornea, often associated with keratoconus – and Vogt’s striae, which are stress lines in the cornea caused by thinning.
- Corneal topography: A mapping system that measures the curvature of the cornea to assess any distortions and their severity. This helps detect keratoconus in its earliest stages before noticeable changes in vision occur and will influence treatment recommendations following diagnosis.
Keratoconus Treatment: Contact Lenses
As keratoconus advances, treatment will shift as eyeglasses eventually become ineffective at correcting the condition due to how irregular the shape of the cornea becomes. Special custom contact lenses are the next effective non-surgical treatment option.
There are several options available that we will recommend based on your unique needs:
- Hard Contacts for Keratoconus
Rigid Gas Permeable (RGP) lenses are the most recommended for keratoconus treatment. They cover the irregular shape of the cornea with a smooth, hard regular surface that allows for tears from your tear film to remain between the lens and corneal surface for more stable, comfortable, and accurate vision correction. RGP lenses are custom-made to fit the unique shape of your cornea. - Soft Contacts for Keratoconus
Custom soft contacts for keratoconus can be great for mild to moderate cases. Advancements in lens materials have allowed for specialized soft lenses for keratoconus to be designed according to your specific eye measurements and can be made thicker as and when necessary to accommodate corneal irregularities. - Hybrid Contacts for Keratoconus
Hybrid contact lenses combine the benefits of both RGP and soft lenses. They have a hard center that provides sharp vision, surrounded by a soft lens edge for enhanced comfort. Hybrid lenses are an excellent option for individuals who have mild to moderate keratoconus and require a lens that provides more stability during eye movement and if they haven’t been able to adapt to RGP lenses. They are available in a multitude of designs to accommodate your individual vision requirements. - Piggyback Lenses for Keratoconus
Piggyback lenses are a combination of a soft lens worn beneath a rigid gas permeable (RGP) lens. This two-lens system provides the benefits of both types—soft lenses for comfort and RGP lenses for sharp vision. This option is ideal for individuals with keratoconus who cannot tolerate wearing RGP lenses alone, as the soft lens provides a cushion to improve comfort. Piggyback lenses are a great solution for people with advanced keratoconus. - Scleral Lenses for Keratoconus
Scleral lenses are large-diameter lenses that span over the cornea, resting on the white part of the eye (the sclera). These lenses offer excellent comfort, with fewer chances of dirt or debris being caught under them, and do not fall out easily. They are best suited for anyone with more advanced keratoconus, as they can be custom made to correct virtually any type of corneal irregularity and may be more comfortable to wear than regular RGP lenses. They can also be designed to accommodate multifocal vision and more, making them convenient for daily wear.
Surgical Options for Keratoconus
When keratoconus becomes advanced to the point where contact lenses are no longer effective or tolerated, eye surgery for keratoconus may be necessary. Surgical options include:
- Corneal Collagen Cross-Linking: A minimally invasive and painless procedure that may be recommended if your keratoconus has reached a moderate stage. It uses riboflavin drops and UVA light to create new bonds between corneal collagen fibers to strengthen the cornea and make it more stable. It has been shown to halt or slow the progression of keratoconus, potentially preventing you from having to undergo a corneal transplant. Recovery is usually relatively quick, providing you follow aftercare instructions strictly, and you should be able to return to your normal daily activities within two weeks.
- Intacs: Another minimally invasive surgical procedure, this involves placing very thin, semi-circular inserts in the cornea to flatten its cone-shape. It takes approximately fifteen minutes and aims to improve some or all corneal irregularities for better vision or more stable contact lens fitting. It may also prevent progression to the point of needing a corneal transplant.
- Corneal Transplant: At the most advanced stage, you will need corneal transplant surgery to replace the damaged cornea with a donor cornea. It takes around an hour to complete, and medication is necessary afterwards to facilitate healing and prevent transplant rejection. In most cases, it will take three to six months to acquire stable vision, and you will need to wear eyeglasses or contact lenses to fully correct your vision.
It is important to note that keratoconus treatment in any form does not cure the condition but does enable easier management and may prevent disease progression in the long run.
Cost of Keratoconus Surgery
The cost of keratoconus surgery and treatment options like custom keratoconus contact lenses can vary depending on the type of procedure you have. Insurance may cover the procedure if deemed medically necessary, but it’s essential to consult with our contact lens specialists to discuss the best options for your vision and budget needs and your insurance provider for coverage details.
Keratoconus Self-Care and Lifestyle Adjustments
While keratoconus self-care won’t stop the condition from progressing, certain lifestyle changes can help manage symptoms and allow for timely treatment if required:
Protect your eyes from UV light: Wear sunglasses to prevent further damage to the cornea.
Avoid eye rubbing: This can worsen the condition and lead to corneal scarring.
Follow your doctor’s recommendations: Regular eye exams and proper contact lens care are crucial for managing keratoconus and maintaining healthy eyes.
FAQ: Common Questions About Keratoconus
The best lenses depend on the severity of the condition. Rigid gas permeable lenses (RGP) are commonly used, but hybrid lenses, piggyback lenses, scleral lenses, and soft lenses can also be effective in specific cases.
While astigmatism is not a direct cause of keratoconus, both conditions involve irregularities in the shape of the cornea, which can contribute to vision distortion.
Symptoms of keratoconus include blurred vision, sensitivity to light, halos around lights, difficulty seeing at night, and frequent changes in glasses prescriptions. An eye doctor can diagnose keratoconus through a comprehensive eye exam and a specialist assessment to measure the curvature of the cornea called corneal topography.
The cost of keratoconus surgery, such as corneal transplants, is dependent on whether your insurance covers medically necessary procedures or not and can be discussed with our eye doctors and your provider.
While eye surgery for keratoconus, such as corneal transplants or Intacs, can improve vision, keratoconus itself is not curable. These procedures aim to halt or slow progression and improve visual outcomes.