4317 Factoria Blvd SE Ste A
Bellevue, WA 98006
425-641-2020

Mon-Fri 9 a.m. to 5:30 p.m.

September 22nd, 2014
Exciting New Options for Keratoconu
The past few years have brought exciting advancements for contact lenses for keratoconus and other irregular corneas.
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June 2nd, 2014
Update on contact lenses for irregu
So many exciting advancements in contact lenses for irregular corneas within the past few years! If your have irregular...
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There are a variety of reasons a patient may need a specialty lens.  These include irregular corneas due to scarring or keratoconus, changes in corneal shape after LASIK, dry eyes, corneal reshaping, and even some high prescriptions.

Keratoconus 

Definition:

Keratoconus is a condition in which the normally round dome-shaped cornea progressively thins, causing a cone-like shape to develop. This usually results in significant vision impairment. For more information about keratoconus please visit www.nkcf.org

Management:

In the early stages of keratoconus, many patients will see adequately with glasses or soft contact lenses. As the keratoconus progresses and the cornea thins and becomes more irregular, the vision is often not adequate unless a custom contact lens is used. The contact lenses for keratoconus must be carefully fitted and monitored. Because the cornea continues to change shape, the lenses may need to be re-fitted in one to two years. It is important to have the fit of lenses for keratoconus evaluated every year for any needed changes.

Keratoconic corneas all have a unique shape. Because these shapes are irregular, keratoconus lenses must be custom designed and manufactured for each eye. Trying diagnostic lenses on the eye during the fitting process speeds things up considerably. We carry many fitting sets in stock and can borrow fitting sets from our laboratory when we need additional options.   Lenses we consider for keratoconus include rigid lenses such as RoseK, scleral lenses such as Jupiter and Maxim, soft lenses such as Kerasoft, and finally hybrid lenses (rigid lens with a soft skirt).  We have been having great success with these newer lenses for keratoconus due to increased patient comfort versus conventional sized rigid lenses.

Post-Lasik

Some patient experience regression or even corneal irregularities after LASIK. Because LASIK removes some of the tissue from the cornea, these eyes can be a bit more complicated to fit. The normally round dome-shaped cornea is now flat across the top and may no longer do well with a round dome-shaped contact lens draped across the front of the eye. In these cases we use specialty contact lenses such as reverse-geometry RGPs, Kerasoft or scleral lenses.

Post-RK

Patients who have had radial keratotomy often experience fluctuation in vision throughout the day.  In the worst cases, they experience blur that is not correctable with glasses or even conventional contact lenses.  For these patients scleral lenses can often provide stable, clear vision.

Astigmatism

For high astigmatism there are custom soft and rigid gas permeable contact lenses.

Dry Eyes

For mild to moderate dry eyes, some of the newer daily disposable soft contact lenses can be a viable option.  For moderate to severe dry eye, scleral lenses can be life-changing.  Scleral lenses keep a bath of fluid in front of the cornea while the lens is on the eye--often greatly improving comfort.  Insurance will often cover these lenses as medically-necessary.

Corneal Reshaping

We have seen an increase in patients getting fit for CRT corneal reshaping lenses.  Recent studies show that CRT can slow down the progression of myopia in children.  Patients love that the lenses are worn only at night, allowing for clear vision during the day without lenses.

Scleral Lenses

These are large diameter rigid gas permeable lenses that rest on the white part of the eye, called the sclera, and vaults over the cornea. The size can be an alarming prospect for some, but scleral lenses have many advantages. Because of their size, they do not fall out and dust or dirt particles cannot get under them during wear. They are surprisingly comfortable to wear, because the edges of the lens do not interact much with the eyelid.

Hybrid Lenses

Hybrid contact lenses are a rigid gas permeable contact lens with a soft skirt. The soft skirt can increase comfort and help with centration. These lenses can be a nice option for both regular and irregular corneas.

Kerasoft Soft Contact Lenses

Kerasoft lenses are an exciting new addition for mild to moderate keratoconus as of 2012.  These lenses are highly customizable soft contact lens for irregular corneas.  They are made of an extremely oxygen permeable silicone hydrogel material.  They are quarterly replacement.

Prosthetic Contact Lenses

Prothstetic contact lenses may be soft or a rigid scleral lens. They are most often used in patients with scarred corneas or patients with no iris. These lenses have an iris (the colored part of the eye) painted on the front.   These lenses can be made with a blocked pupil for patients with non-seeing eyes to cover a scar for aesthetic reasons. They can also be made with a clear pupil for sighted patients and can greatly improve cosmesis. For patients with aniridia (no iris) the lenses help block peripheral light rays—greatly increasing patient comfort.

Please call our Bellevue office at 425-641-2020 or email us to schedule an eye exam appointment.