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5 Common Keratoconus Questions, Answered

5 Common Keratoconus Questions, Answered 640If you’re reading this, you or someone you care about may have been recently diagnosed with keratoconus. We’ve compiled a few commonly asked questions about keratoconus to help you understand what it is, what causes it, and how your eye doctor can help.

1. What Is Keratoconus?

Keratoconus is a progressive, non-inflammatory disease that causes the cornea to thin and bulge, resulting in a cone-shaped cornea. Over time, this bulge leads to myopia and irregular astigmatism, and vision becomes progressively distorted. Ongoing treatment is crucial to prevent significant vision loss.

2. What Are the Symptoms of Keratoconus?

Many patients aren’t aware that they have keratoconus, which typically begins during the teenage years.

Symptoms of keratoconus include:

  • Difficulty seeing at night
  • Blurry vision
  • Halos and glare around lights
  • Increased sensitivity to bright light
  • Headaches or eye irritation associated with eye pain
  • Progressively worsening vision that’s not easily corrected

3. What Causes Keratoconus?

While there is no one cause of keratoconus, a paper published in Biomed Research International (2015) identified these risk factors:

  • Genetics. About one in 10 people with keratoconus also has a family member with the condition.
  • Inflammation. Irritation and inflammation from allergies, asthma and other atopic eye diseases can lend to the development of keratoconus.
  • Frequent eye rubbing. Intense and frequent eye rubbing is thought to thin out the cornea and can worsen the condition.
  • Underlying disorders. Keratoconus has been associated with several conditions, including Down syndrome, Ehlers-Danlos syndrome, Leber congenital amaurosis, Marfan syndrome and Osteogenesis imperfecta.
  • UV light. UV light can cause oxidative stress, which weakens the corneas in predisposed eyes.
  • Weak collagen. In a healthy eye, small protein fibers called collagen help keep the cornea in a dome-like shape and free from bulges. In the case of keratoconus, the collagen fibers become weak and therefore can’t maintain the shape of the eye, which causes the cornea to bulge.

4. How Is Keratoconus Treated?

Scleral lenses are the most common and successful treatment for patients with keratoconus. These are specialized rigid, gas permeable contact lenses that have a very wide [diameter] and vault over the entire corneal surface, making them effective and comfortable for people with keratoconus.

5. Is There a Cure for Keratoconus?

Currently, there is no cure for keratoconus. However, in most cases, it can be successfully managed.

For mild to moderate keratoconus, scleral contact lenses are typically the treatment of choice, as they provide clear, comfortable vision.

A relatively non-invasive procedure called corneal cross-linking (CXL) can stabilize and strengthen a thinning and irregularly shaped cornea.

At The Scleral Lens and Keratoconus Center at Pacific Rims Optometry, we can recommend the best treatment options for your keratoconus, to help preserve your vision, and ensure the highest level of comfort and visual acuity. Call to schedule an appointment to start discussing your keratoconus treatment options.

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry serves patients from San Francisco, Oakland, Berkeley, and San Mateo, all throughout California.

Frequently Asked Questions with Dr. Selena Chan

Q: Can You Go Blind If You Have Keratoconus?

  • A: Keratoconus does not typically cause total blindness. However, as keratoconus progresses it can cause visual impairment including blurred distance vision, distortion, glare, astigmatism, extreme light sensitivity and even vision loss that can be classified as “legal blindness.

Q: Does keratoconus affect both eyes?

  • A: Yes, in approximately 90% of keratoconus cases, the disease will manifest in both eyes. However, the rate of progression and the timing of the onset of the disease is different for each eye.



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4 Reasons Why Scleral Lenses Are a Big Deal

happy girl wearing contact lenses 640Scleral contact lenses have been called “life-changing” and “transformative” by patients who wear them.

What makes these contact lenses so revolutionary?

What Are Scleral Lenses?

Scleral lenses are contacts that vault over the entire cornea and rest on the white part of the eye (sclera). Their diameter is much larger than standard lenses, which adds to their comfort and compatibility with hard-to-fit eyes.

Here’s why they’re gaining popularity in the contact lens world and why patients and doctors are calling sclerals a big deal.

1. Sclerals are Ideal for People with Corneal Irregularities or Dry Eyes

There was a time when patients with corneal irregularities or severe dry eye syndrome weren’t able to wear contact lenses at all, due to the discomfort associated with direct corneal contact. Nowadays, patients with keratoconus, other corneal aberrations or dry eye can successfully wear scleral contact lenses and enjoy comfortable and crisp vision.

Scleral lenses are also great for patients with corneal dystrophy, high astigmatism, Sjorgren’s syndrome, corneal trauma and corneal ectasia, or who have undergone cataract surgery.

2. They’re Completely Custom-Made

Each pair of scleral contact lenses is custom-designed to gently and securely rest on your unique eyes. The fitting process for scleral lenses starts with corneal topography, where the optometrist creates a digital map of your eye’s surface. This information is then used to customize your perfectly fitted pair of sclerals.

3. They Offer Optimal Visual Clarity and Comfort

The liquid reservoir that sits between the lens and the eye helps enhance the visual optics of the lens. Moreover, scleral lenses are made of very high-grade materials and don’t place any pressure on the cornea, delivering ultimate all-day comfort. Many patients have reported that they comfortably wear sclerals for up to 14 hours a day, which is longer than the wear time for standard soft contact lenses.

4. They Promote Eye Healing

Scleral contact lenses protect the eye by surrounding it with an oxygen-permeable, liquid-filled chamber. This hydrating environment gives the eye the moisture and oxygen it needs to stay healthy and ward off outside irritants.

This can also explain why scleral lenses promote healing of the eye’s surface, whether after a corneal transplant or when recovering from a chemical burn or other eye injury.

If you or a loved one have been diagnosed with a corneal condition that prevents you from wearing standard lenses, consider scleral lenses. To schedule an appointment or to learn more, call The Scleral Lens and Keratoconus Center at Pacific Rims Optometry in San Francisco today!

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry serves patients from San Francisco, Oakland, Berkeley, San Mateo and throughout California.

Frequently Asked Questions with Dr. Selena Chan

Q: #1: How long do a pair of scleral lenses last?

  • A: Scleral lenses can last 1-2 years before requiring replacement. Your optometrist will provide you with instructions on how to wear and care for your lenses to keep them feeling fresh and clean, day in day out.

Q: #2: Are scleral lenses expensive?

  • A: Just like any other customized product, scleral lenses tend to be more expensive than standard soft contact lenses. Although they have a higher price point, most patients who wear them will tell you that their comfort, visual clarity and stability make them worth the cost.


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Living With Keratoconus | Kenneth’s Story

Kenneth’s Story 640From the time Kenneth was 11 years old, he wore glasses to correct his quickly deteriorating vision. He was always forced to sit at the front of the classroom and felt embarrassed by it. This time in his life marked the beginning of seemingly endless visits to various eye doctors to try and figure out what was causing his vision problems.

Four years later, at the age of 15, Kenneth was diagnosed with keratoconus, a progressive eye disease that affects the shape and condition of the cornea. Kenneth was referred by his ophthalmologist to an optometrist who [specializess] in treating keratoconus.

The optometrist explained that keratoconus is a condition that causes the cornea to thin and bulge out in a cone-like shape, leading to visual impairment. The early stages of this progressive eye disease usually cause mild to moderate vision problems that can be corrected with eyeglasses. But as the cornea’s shape continues to distort, glasses are no longer suitable and rigid contact lenses must be prescribed.

The optometrist prescribed rigid gas permeable contact lenses, which significantly improved Kenneth’s vision. But Kenneth sometimes found his contacts hard to manage, and even uncomfortable at times. People would tell him to just ‘switch back to glasses’ and ‘stop wearing the lenses if they give you so much grief.’

That wasn’t possible. He simply couldn’t see without the contacts.

Thankfully, before Kenneth’s condition progressed to the point where cornea surgery was required, new technology gave him fresh hope.

At the age of 20, Kenneth was fitted for scleral contact lenses for the first time. The day of the fitting was an emotional one for him and his family, as he was truly able to see the world around him in detail—and with great comfort.

Kenneth walked out of the optometrist’s practice, looked around, and saw leaves on the trees for the first time in 5 years. Prior to this, his perception of trees were brown stumps with green shrubbery—but never leaves.

He noticed that the cars driving past him on the street looked astonishingly clean. Nothing seemed faded anymore. Colors were vivid, lines were sharp.

The detail and clarity of each object were genuinely overwhelming for him. His mom, who also suffers from keratoconus, was overcome with emotion as she watched her son visually experience his surroundings in a whole new way.

From that day forward, Kenneth’s life changed drastically. His scleral contact lenses enabled him to function normally and achieve his goals. Wearing his sclerals allows him to work, exercise, socialize and be his authentic self.

Kenneth confesses that when he doesn’t wear his sclerals, his entire personality changes. He becomes timid, quiet and apprehensive.

Having keratoconus will no longer hinder Kenneth from living his best life, and it doesn’t have to hinder you or an affected loved one.

To a person with corneal disease, scleral lenses can be truly life-changing. If you or a loved one has keratoconus or other corneal irregularities, contact The Scleral Lens and Keratoconus Center at Pacific Rims Optometry today.

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry serves patients from San Francisco, Oakland, Berkeley, and San Mateo, all throughout California.

Q&A

Q: #1: How do scleral lenses work?

  • A: Scleral contact lenses are hard lenses that have a much larger diameter than standard soft contact lenses. They vault over the entire cornea and rest on the sclera (the white of the eye) so that no part of the lens is touching the cornea itself. The lens holds a reservoir of soothing and nourishing fluid between the eye and the lens, providing the best in visual clarity and comfort.

Q: #2: What other conditions do scleral lenses help with?

  • A: Any patient with irregular corneas can benefit from scleral lenses. They’re also suitable for patients with severe dry eye syndrome, as the fluid reservoir helps maintain comfort and ocular hydration. They’re also great for patients with very high refractive errors (high myopia, hyperopia, or astigmatism). Speak to your eye doctor if you think scleral lenses may be right for you.


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A Guide to Scleral Lenses

Vision And Medicine Concept. Accessories For Contact Lenses: Con

Many people can’t wear standard contact lenses. This is especially true of patients with severe dry eye syndrome, keratoconus, irregular astigmatism, among other conditions.

That’s why eye doctors often prescribe scleral lenses to such patients. These specialized rigid, gas permeable contact lenses have a very wide diameter and extend over the entire corneal surface, making them effective and comfortable for people with irregular corneas.

At first, some patients may find scleral lenses to be difficult to insert and remove. However, after some practice, you’ll find it easy to care for your sclerals!

Safety and Hygiene for Scleral Lenses

Handling scleral lenses incorrectly can increase your risk of eye infection. Additional risk factors include improper lens cleaning, poor hygiene, and smoking. Therefore, it’s important to follow your eye doctor’s instructions on how to handle your lenses hygienically.

Before handling, inserting, or removing scleral lenses, make sure to:

  • Always wash your hands thoroughly with non-oily soap or antibacterial-based pump soap and dry them with a clean lint-free towel or paper towel.
  • Sit at a desk or table and place a lint-free cloth down to insert and remove lenses. Avoid bathrooms, as they often contain more germs than other rooms in the home.
  • Inspect your lenses for chips or cracks and protein deposits on the lens surface. If you notice any defects or are unsure whether your lenses are damaged, don’t wear them until your eye doctor has inspected them.

How to Insert Scleral Lenses

  1. Remove your scleral lenses from their storage case and rinse with them with saline. If you’re using a hydrogen peroxide solution, wait at least 6 hours from when the lenses were placed into the storage case for the solution to neutralize. Always rinse with saline before placing the lens on the eye.
  2. Either place the scleral lens between your middle, forefinger, and thumb — known as the tripod method — or secure the lens to a suction tool (plunger) supplied by your optometrist.
  3. Fill half the bowl of the lens with preservative-free saline solution to prevent air bubbles from forming between your eye and the lens. Insert the lens directly onto the center of your eye in a facedown position.
  4. Dry and wipe your lens case with a tissue and leave the case lid off to air dry.

How to Remove Scleral Lenses

There are two methods to remove scleral contact lenses: with your fingers, or with the aid of a plunger. First, to detach your scleral lenses from your eye, press firmly with your finger on your bottom eyelid just below the edge of the lens, then push upwards.

Method 1 – Manual Removal

  1. Try Scleral Lenses Thumbnail.jpg

    Insert a drop of preservative-free saline solution or artificial tears to loosen the lens.

  2. Look down onto a flat surface (a mirror or towel can be placed there).
  3. Use your middle finger to open your eyelid wider than the lens diameter.
  4. Apply pressure to the middle of the lid — as close to the lashes as you can — and push down on the eyelid to move your eyelid under the lens and lever it off the eye.

Method 2 – Suction Tool

  1. While looking at a mirror in front of you, hold your bottom lid open. Wet the tip of the suction tool to allow for better adhesion and attach it to the bottom of the lens.
  2. Using the suction tool, remove the lens by tilting the lens up and out of the eye.

How To Care for Your Scleral Lenses

The number one rule in contact lens care is always to follow the professional advice of your optometrist. If you need any clarification, always contact their office first.

Never ever use tap water in any area of lens care, whether to rinse or fill your lens case. Tap water contains a multitude of dangerous microorganisms, including acanthamoeba, that can cause a severe, painful, and sight-threatening infection. Be sure that your hands are fully dry after using a lint-free towel prior to handling your lenses.

Remove Before Going to Sleep

Most people can comfortably wear scleral contact lenses for up to 12-14 hours at a time. Approximately an hour before going to sleep is the best time to remove the lenses. If your lenses fog up in the middle of the day, it’s best to remove them and try various methods to clear up the fogginess before reinserting.

Use a Peroxide Cleaner

You can sterilize your scleral lenses by immersing them in 3% hydrogen peroxide. Over a period of 6 hours, the catalyst in the case transforms the hydrogen peroxide into water and oxygen gas. This gives your lenses a deep clean and removes the need to rub them, thus decreasing the risk of accidental breakage. Do not use the lenses until they have been immersed for 6 hours, as the un-neutralized peroxide will painfully sting your eyes. Leave the lens case to dry when not in use.

Use a Filling Solution That Is Preservative-Free

When inserting scleral lenses, use unpreserved sterile saline solution by filling the bowl of the lens upon insertion. Don’t use tap water or a preserved solution as these can lead to an eye infection.

Remove Debris Using Multi-Purpose Lens Solution

Once you’ve thoroughly washed and dried your hands, remove your scleral lenses and rub them for 2 minutes in a contact lens case filled with saline solution. This effectively removes microorganisms and deposits, lowering your risk of infection. While scleral lenses are strong, too much force or an incorrect technique can cause them to break.

After rubbing your lenses, thoroughly rinse them using the solution for 5-10 seconds. Then place them in a case filled with fresh solution and leave them to disinfect for at least 4 hours.

Routinely Clean and Replace Your Lens Case

Regularly clean and replace your lens case to prevent infection due to bacterial contamination.

It is recommended to clean the storage case on a daily basis and to replace it monthly or as advised by your eye doctor.

Your optometrist will recommend when to get a new pair of scleral lenses, and will advise you when to schedule follow-up appointments. Failure to show up for scheduled appointments can compromise the lenses’ efficacy.

At The Scleral Lens and Keratoconus Center at Pacific Rims Optometry, we can recommend the best wearing schedule for your contact lenses to ensure the highest level of comfort and visual acuity. Always follow the instructions provided by your eye care professional. Call to schedule an eye exam and a scleral lens fitting today.

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry serves patients from San Francisco, Oakland, Berkeley, and San Mateo, all throughout California.

Q&A

 

Q: Why do I need to use preservative-free solutions to fill the lens?

  • A: Long-term exposure to preservatives can cause corneal toxicity or sensitivity that results in irritation and redness.

Q: How long do my application and removal plungers last?

  • A: Plungers should be replaced every 3 months, or sooner if necessary.


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Tips For Wearing Scleral Lenses

Pretty Cheerful Woman Gesturing With Two Fingers Near Eyes. Youn

Scleral lenses are ideal for patients with corneal irregularities, dry eyes, and hard-to-fit eyes. Their uniquely large circumference offers the best in visual comfort and clarity. But wearing and caring for your scleral lenses can take some getting used to.

Below are our top 5 tips for anyone who wears scleral lenses. If you have questions about scleral lenses or any other optometric matter, The Scleral Lens and Keratoconus Center at Pacific Rims Optometry in San Francisco is here for you.

1. Lens Hygiene is Top Priority

Keeping your scleral lenses hygienic and free of buildup is key in ensuring the clearest possible vision. When you remove them from your eyes, rub them for several seconds with lens cleaner to remove surface debris and bacteria. Then, rinse them on both sides with saline solution before storing them.

Another hygiene tip: Before handling your lenses, be sure to wash your hands with soap and water, and to rinse and dry them with a lint-free cloth or paper towel. Good hygiene will significantly minimize possible complications and keep your eyes feeling fresh.

2. Manage Your Dry Eye

Many patients with dry eye syndrome (DES) choose to wear scleral lenses for their hydrating and soothing properties. While sclerals can offer substantial relief from their dry eye symptoms, patients shouldn’t forget to seek treatment for their DES.

That’s because scleral lenses help manage dry eye, but don’t actually treat it. So, it’s best to follow up with your eye doctor about any eye drops, medications, or at-home remedies to support healthy tears.

3. Use a Cotton Swab For Cleaning

Patients with long fingernails can find it challenging to thoroughly clean their scleral lenses. Rubbing the inside bowl of the lens with a cotton swab and cleaning solution can effectively remove the buildup from the lens. Then, rinse off the cleaning solution with saline to remove the cleaning solution and any lint from the cotton swab.

4. Try Different Insertion Tools

Is your current insertion method not working as smoothly as you’d like? No worries! Ask your eye doctor about different tools you can use, such as the O-ring or applicator ring.

But please only insert your lens with tools that your eye doctor recommends!

5. Follow Up With Your Eye Doctor

Because scleral lenses are customized, they often require a few visits with your optometrist to optimize their fit. Even after the fitting process is complete, follow-ups will help ensure that your lenses are still in good condition.

If your scleral lenses are giving you any trouble at all, we can help. To schedule your scleral lens consultation, call us today!

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry serves patients in San Francisco, Oakland, Berkeley, San Mateo, and throughout San Francisco.

Frequently Asked Questions with Our Scleral Lenses Expert in San Francisco, California:

Q: How do scleral lenses work?

  • A: Scleral lenses rest and vault over the entire sclera (white of the eye), encasing a hydrating reservoir in between the lens and the cornea (front surface of the eye). This allows people with irregular corneas to wear contact lenses, since the lens isn’t in direct contact with the cornea itself.

Q: How long do scleral lenses last?

  • A: Scleral lenses generally last 1-2 years, depending on how well you care for them and how your tear film reacts with them. Even so, check-ups every 6 months are recommended to ensure they still fit well and provide clear vision.


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Can I Wear Contacts If I Have Astigmatism?

brunette girl smiling 640Many people choose to wear contact lenses to correct their vision due to the freedom and convenience contacts provide. But for those with astigmatism, wearing contact lenses isn’t always simple.

At The Scleral Lens and Keratoconus Center at Pacific Rims Optometry in San Francisco we offer specialized contact lenses that provide clear and comfortable vision, even if you have moderate to severe astigmatism.

What is Astigmatism?

Astigmatism is a refractive error caused by an irregularly shaped cornea. The abnormal cornea causes light to disperse unevenly into the eye, leading to blurred or distorted vision. Other symptoms of astigmatism can include headaches, eye strain, and difficulties with reading or using digital devices.

Astigmatism may be congenital, meaning that you are born with the condition, or you can develop it later in life. People with astigmatism usually also have myopia (nearsightedness) or hyperopia (farsightedness), two of the most common refractive errors.

Which Contact Lenses Can You Wear With Astigmatism?

Although traditional soft contact lenses may not be suitable for patients with astigmatism, there are two other types of contact lenses specifically designed for those with unusually shaped corneas.

Toric Contact Lenses

Toric lenses are a popular choice for people with mild astigmatism. Patients with higher levels of astigmatism, however, generally require a higher level of expertise.

Toric lenses are designed to provide clear vision and a comfortable fit. There are two main issues with toric lenses. First, the range of corrective powers is limited, so patients with moderate to high levels of astigmatism may not be able to wear toric contacts. Second, these lenses need to rotate on the cornea to find the correct position and orientation, leading these lenses to occasionally provide unstable or varying clarity of vision.

Toric lenses are available in either soft disposable or rigid gas permeable (RGP) lens materials.

Scleral Contact Lenses

Unlike standard lenses, scleral lenses vault over the cornea and sit on the sclera (the white of the eye). These lenses do not have the issues faced by toric lenses as they are individually designed for each patient and do not sit on the cornea. By vaulting over the cornea, scleral lenses create a liquid reservoir between your cornea and the lens. This dome provides a continually hydrating environment that protects the cornea, promotes healing, and increases comfort.

Scleral lenses have become a staple therapeutic tool in the visual rehabilitation of patients with astigmatism and other corneal irregularities. They also can provide better visual acuity than standard soft lenses thanks to their rigid surface and personalized fit. Scleral lenses have proven to be an excellent solution for patients with astigmatism that appreciate sharp and comfortable vision.

How We Can Help

At The Scleral Lens and Keratoconus Center at Pacific Rims Optometry, we can provide you with customized toric or scleral contact lenses that are tailor-made for patients with astigmatism or other corneal irregularities, as well as hard-to-fit eyes. By taking precise and detailed measurements of your cornea, we will be able to ensure a secure fit and crisp, clear vision. To learn more information or to schedule your consultation, call us today.

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry serves patients from San Francisco, Oakland, Berkeley, San Mateo, and throughout California.

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5 Facts About Scleral Lenses

happy teenagers 640Scleral contact lenses are large-diameter gas permeable contact lenses that vault over the cornea and rest on the “white” of the eye (the sclera). In doing so, the lenses form a dome over the irregular cornea that provides clear and comfortable vision for individuals with keratoconus, dry eye and other ocular surface conditions.

Here are 5 facts about scleral lenses and why they are a great choice for many patients.

1- They work when nothing else will.

Patients with an irregularly shaped cornea, whether due to natural causes, an eye condition or complications following surgery, can at times develop vision problems that cannot be corrected using glasses or soft contact lenses. In such cases, scleral lenses provide a more comfortable, stable, secure fit, and improved vision.

For those with keratoconus, scleral contact lenses provide advanced care that resolves visual distortions and creates clear vision while providing a comfortable wearing experience.

In addition to helping those with keratoconus, scleral lenses are also recommended for those with an astigmatism, particularly for high astigmatism that other contacts cannot comfortably correct.

2- Scleral contacts provide relief for those who suffer from dry eye.

Unlike traditional contact lenses, scleral lenses minimize eye irritation. Since they vault over the dry, irritated cornea and sit on the sclera, they offer comfort and clear vision. Sclerals leave a space between the lens and the cornea containing a liquid reservoir of artificial tears that provides a protective cushion that soothes the eye.

This is crucial, because even blinking can irritate the eye or injure the cornea due to the mechanical friction of the eyelids on the cornea. Scleral lenses can act as a shield between a patient’s eyes and their eyelids, protecting the eyes from further irritation or damage.

3- Sclerals are long lasting lenses.

Constructed from high quality, durable materials, these rigid gas permeable contacts typically last 1-3 years. Therefore, while the initial cost of scleral lenses is higher than standard contacts, you’ll benefit from maximum value for your money.

While scleral lenses are long lasting, it is important to book follow up visits with your eye doctor to determine when it’s time to replace them with a new pair, so as not to harm your cornea.

4- Scleral contacts are worth the cost

People assume that because sclerals must be fitted and customized to fit each individual eye, they are exorbitantly expensive. In fact, the lenses are often covered by insurance and certain vision and health savings plans.

These lenses provide enough of an improvement over regular lenses — in both comfort and vision — to justify the investment.

5- Scleral lenses are very comfortable.

Some people mistakenly assume that rigid contacts aren’t comfortable. In reality, scleral contact lenses are very comfortable because they don’t touch the cornea and lubricate the eyes.

If you have irregular corneas, dry eye or hard-to-fit eyes, scleral lenses may be right for you. Find out more about scleral lenses by scheduling an eye exam at The Scleral Lens and Keratoconus Center at Pacific Rims Optometry today!

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry serves patients from San Francisco, Oakland, Berkeley and San Mateo, throughout California.

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Keratoconus and Coronavirus

Middle Aged Couple Multifocal ContactsKeratoconus refers to the thinning and elongation of the cornea, the transparent layers over the eye, into a cone-like shape. That results in blurred vision. Other symptoms include vision difficulties at night and objects appearing to have a glare or halos around them.

If you have keratoconus, several options are available.

For a mild or moderate condition, eyeglasses or soft contact lenses will help. Some people do better with rigid gas permeable (hard) contact lenses. If contact lenses hurt your cornea, scleral lenses are recommended. They vault over the cornea and rest on the sclera, the white part of the eye. For more severe cases of keratoconus, laser treatment and corneal transplants are recommended.

Hygiene for Scleral-Lens Wearers in the Coronavirus Era

As always, hygiene is paramount when you handle and wear scleral lenses, as it is with soft and hard lenses. This means thoroughly washing your hands before touching the lenses, and cleaning and rinsing the lenses with recommended solutions.

Wearing sclerals and other contact lenses during the coronavirus pandemic remains as safe as ever, but it’s even more important now to observe hygiene guidelines. In fact, you can take extra precautions to lower the risk of inadvertently transmitting the coronavirus to your eyes, from where it can enter your body.

Consider taking these additional preventative steps:

  • Use disinfectant wipes to clean the counters and other surfaces where you place the scleral-lens cases and solutions. This includes disinfecting the cases and containers of solutions before using.
  • Wash your hands before touching your eyes or removing your lenses.
  • Don’t touch the area on/near your eye and then someone else’s, or vice versa.
  • Avoid rubbing your eyes to prevent keratoconus from developing or worsening, while also reducing the risk of getting infected by coronavirus.

If you have keratoconus and are concerned about maintaining your optical health while reducing the risk of coronavirus, contact us.

 


The Scleral Lens and Keratoconus Center at Pacific Rims Optometry treats patients with keratoconus in San Francisco, Oakland, Berkeley, San Mateo, and throughout California.

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Succeeding With Sclerals

Succeeding With ScleralsHealthy corneas normally bend incoming light toward the retina so we can see clearly. However, certain corneal conditions, such as keratoconus and astigmatism, lead the light’s path to the cornea to diffuse, resulting in reduced and blurred vision.

That’s precisely what happened to three patients: Ben, Georgette, and Fred, who have irregular corneas that caused them to struggle with their vision. Thanks to scleral lenses, they and countless other patients with corneal conditions have experienced improved visual clarity, sharper focus and unparalleled comfort. But before we delve into their stories, what are scleral lenses and how exactly do they benefit those with irregular corneas?

Irregular Corneas and Scleral Lenses

Irregularly shaped corneas are most commonly caused by or associated with astigmatism, keratoconus, prior eye surgeries (such as LASIK, cataracts, corneal transplant), trauma, scarring, and pellucid marginal degeneration.

Irregular corneas cannot be corrected with eyeglasses or traditional contact lenses. An excellent non-surgical solution is scleral lenses, which provide clear vision and better comfort while keeping your eyes hydrated throughout the day.

The lenses vault over the cornea and rest on the sclera, the white part of the eye, which prevents corneal irritation. The liquid reservoir fills in the surface irregularities of the cornea, restoring vision and enabling the eye to comfortably heal. The smooth optical surface replaces the distorted corneal surface, resulting in dramatically improved vision and comfort.

Read how scleral lenses have helped address Ben’s, Georgette’s, and Fred’s irregular corneas, and enabled them to experience improved vision and a higher quality of life.

*These patient testimonials are meant to reflect actual testimonials of patients but not necessarily our patients.

Everything Is Now in Focus for Ben

Ben entered college excited for life’s newest adventure. He made friends and studied hard. But his struggle to read the content on the classroom whiteboard and in his textbooks presented the same challenges he’d experienced for much of his life.

“Here we go again,” Ben thought. Ben had astigmatism, meaning that his corneas were unevenly curved. As a result, images and texts appeared blurry. To see clearly, he resorted to squinting, which, in turn, led to frequent headaches.

Although Ben had regularly been updating his eyeglass prescription over the years, and tried wearing standard contact lenses, he still struggled with his vision. “Enough is enough,” Ben decided. “It’s time to consult a vision expert!”

That’s when Ben went to see his eye doctor, who suggested he wear scleral lenses to help see clearly with his astigmatism.

The scleral lenses worked wonders by allowing Ben’s eyes to properly focus light to the retina. Several appointments with his eye doctor ensured that the scleral lenses were fit just right. Ben can now see clearly and effortlessly, read the board and his textbooks, all of which have enabled him to graduate from college with honors.

If you or your child have astigmatism, make your life easier by following in Ben’s steps and ask Dr. Selena Chan about scleral lenses.

For Georgette, Sclerals Are the Perfect Fit

Just imagine how Georgette felt, at age 15, when she was diagnosed with keratoconus.

No one wants to hear that their cornea is thinning and gradually bulging outward into a cone shape. But that’s exactly what happened to Georgette. Because keratoconus causes blurred vision and sensitivity to light, Georgette often found herself squinting to help her see clearly.

That’s when her eye doctor suggested scleral lenses. Having never worn contact lenses, Georgette hesitated, then reconsidered. “Let’s do it,” she concluded.

Georgette left her eye doctor with her new pair of custom-fit scleral lenses, fully excited at the prospect of experiencing a great vision. Thanks to sclerals, she not only sees clearly but now finds her eyes to be significantly less sensitive to light, which allows her to enjoy the outdoors during the day.

Fred Likes What He Sees Following His Corneal Transplant

“It still hurts,” Fred complained as he looked into his eyes in the mirror.

The corneal transplant he underwent 10 months earlier effectively addressed his corneal scars following a workplace accident. Fred recovered as the operation’s physical effects receded. Post-operative medications prevented not only inflammation and infection, but also the rejection of his newly transplanted corneas. However, the standard contact lenses he began using a few months after the transplant were painful to wear, and his irregular astigmatism—far from corrected—continued to cause fluctuating vision.

Imagine Fred’s excitement at learning that scleral lenses enable clear and painless vision for keratoplasty (corneal transplant) patients like himself. He read a 2016 study published in the Eye & Contact Lens journal that found that sclerals in post-keratoplasty patients are safe and effective, with most patients attaining 20/40 vision or better.

How did things turn out? With attentive care, really well. Fortunately, Fred now experiences both comfort and excellent vision with scleral lenses.

The Scleral Lens and Keratoconus Center at Pacific Rims Optometry offers scleral lenses to patients from San Francisco, Oakland, Berkeley, San Francisco, and throughout California.

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When All Other Contacts Have Failed, Scleral Lenses May Be the Answer

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Sclerals vs. Standard Lenses

Standard contact lenses — be they soft, rigid gas permeable, or disposable — are the most popular choice for people with refractive errors who don’t want to wear glasses. But because standard lenses rest directly on the cornea, they aren’t a good fit for people with very dry eyes or irregularly shaped corneas.

Patients who have an irregular cornea find scleral lenses to be ideal. They have a larger diameter than standard lenses that allows them to vault over the cornea and rest on the sclera (the white part of the eye). Because they form a dome over the cornea, scleral lenses protect it from scratches and abrasions.

Scleral lenses also store saline solution between the back of the lens and the front of the cornea. As a result, the eye’s surface stays lubricated, maximizing comfort. Vision remains reliable, too.

Because scleral lenses are larger than standard lenses and custom-fitted to the eye, they are more stable and less likely to pop out. Scleral lenses correct astigmatism even in people with highly irregular corneal surfaces.

Sclerals are often prescribed for patients who suffer from dry eye or other complications following LASIK or other corneal surgeries.


Because scleral lenses are custom made and comfort is paramount, they might require several visits to get the fit just right. To learn if you have a corneal condition that requires scleral lenses, visit The Scleral Lens and Keratoconus Center at Pacific Rims Optometry. We help patients from San Francisco, Oakland, Berkeley, San Mateo, and throughout California.

References:

 

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