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Keratoconus is a progressive eye condition that causes thinning and bulging of the transparent, dome-shaped front of the eye, called the cornea. When keratoconus becomes advanced enough, glasses and traditional soft contact lenses cannot provide adequate vision correction. Fortunately, specialty contact lenses can provide clear vision and comfort.
What Is Keratoconus?
Usually, the cornea is smooth and round, allowing light to focus correctly on the retina at the back of the eye. However, keratoconus results in corneal thinning as it bulges outward into a cone shape. The change in shape disrupts how light enters the eye, leading to blurry, distorted vision. Because keratoconus is a progressive disease, vision may worsen over time, and careful management is necessary.
The corneal irregularities caused by keratoconus can interfere with the comfortable fit of traditional soft contact lenses. Soft lenses follow the curve of the cone-shaped cornea instead of lying flat against the eye’s surface, which is essential for optimal vision. Glasses also can’t change the shape of the cornea, so both correction methods are inadequate for keratoconus patients. However, scleral contact lenses correct vision and fit comfortably, allowing patients to see clearly.
What Are Scleral Contact Lenses?
Scleral lenses are rigid and larger than traditional lenses. Instead of resting on the sensitive and delicate cornea, scleral lenses rest on the sclera, the white part of the eye. The key feature that sets scleral lenses apart is their vaulting over the cornea. This vault is unique and has shown promise in treating several ocular disorders that cause surface deformity or sensitivity.
Due to the large diameter of scleral lenses, they create a small space between the eye surface and the back of the lens that can be filled with saline. The fluid reservoir fills the corneal irregularities, creating a smooth surface through which light can pass uninterrupted. The saline also helps keep the cornea hyrdated, combating dry eye; a common concern for keratoconus patients.
The main reason why scleral contact lenses work so well for keratoconus treatment is the fluid reservoir. The liquid smooths the eye surface, allowing light to focus correctly on the retina and resulting in clearer, sharper vision that cannot be achieved with traditional corrective methods. Because soft contact lenses sit directly on the cornea, they frequently fail to fit well on the irregular, cone-shaped cornea seen in keratoconus, which can lead to discomfort and suboptimal vision.
What Should Patients Expect From the Scleral Lens Fitting Process?
Every patient experiences keratoconus differently, so we approach the fitting of advanced contact lenses carefully. At Miami Contact Lens Institute, we use tools like corneal topography to map the exact shape of the cornea and sMap profilometry to map the scleral shape. These images are then used to design scleral lenses that fit precisely. The fitting process involves several visits during which your eye care practitioner will fit the lenses, check your comfort and vision, and assess how they sit on your eyes.
Your scleral lenses may require adjustment to find the best fit. The goal is to have lenses that rest on the sclera and provide clear vision, with no compression areas. Even though fitting can take time, a precise fit makes a significant difference in visual acuity and comfort. Most patients wear their lenses all day, so comfort is vital to avoid future complications.
Is Long-Term Monitoring Necessary for Keratoconus?
Although there is no cure for keratoconus, scleral lenses can help with keratoconus management by improving vision and protecting the delicate corneal tissue. Many of our patients wear scleral lenses long-term to avoid more invasive treatments like corneal transplants. In addition to scleral lenses, corneal cross-linking (CXL) is the only treatment proven to slow or stop the progression of keratoconus. While CXL helps stabilize the disease, scleral lenses are still needed afterward to provide clear, functional vision. Because keratoconus can continue to change over time, regular checkups are vital. Your eye care professional must monitor both your corneal health and lens fit to ensure the lenses are performing safely and effectively.
Your eye care specialist will also teach you how to properly care for your lenses, which is an essential part of wearing scleral lenses. Patients must follow their doctor’s instructions, as neglecting hygiene and care practices can result in lens damage, eye infections, and even corneal abrasions and scarring. Daily cleaning and disinfecting with the correct solution is critical. Do not use tap water. It can contain bacteria that could cause infections.
Experience the Benefits of Scleral Lenses
Scleral contact lenses are an essential eye management option that improves comfort and vision. The unique scleral lens design protects the eye and creates a smooth corneal surface, allowing for clearer vision. Scleral lenses also help to keep the cornea healthy by maintaining hydration, reducing irritation, and blocking external irritants. While fitting can take time, many of our patients have experienced life-changing benefits from these lenses.
If you have keratoconus and you’re looking for a management method that meets your unique needs, contact Miami Contact Lens Institute. Our expert eye care practitioners have extensive experience treating keratoconus patients with scleral lenses. Let us help you regain clear vision and restore comfort with specialty contact lenses.
