Have We Finally Beat Keratoconus?
Keratoconus (Care-At-Oh-Cone-us) is a condition in which the cornea becomes weaker at certain areas. This results in a continued thinning of the tissue causing an irregular, not smooth shape or curve to the cornea. The cornea is the window to the eye-all light must pass through the cornea first before the retina can process the vision information to the eye nerve. When the normal curve of the cornea becomes irregular or thin it takes on a cone like shape rather than the round smooth shape. This results in extreme scattered and un-focused light entering the eye. Because the shape of the cornea is irregular, no eyeglass prescription can allow for clear vision.
Typically Keratoconnus is genetically inherited, however some cases of keratoconus can be caused from severe friction or rubbing of the eyes. Family members should always be tested regularly so the condition can be discovered and treated early. Early diagnosis offers more treatment options.
Early stages of Keratoconnus can be helped with eyeglasses, with high-definition lenses.However, in most cases glasses simply do not help with improving eyesight because the cornea is far too distorted. In some cases glasses are prescribed simply to give patients partial vision clarity for mobility around the house or watching TV giving the eyes a rest from over wearing keratoconus lenses.
Hybrid Contact Lenses
The Synergeyes contact lens is a unique high oxygen breathing lens that combines the excellent optics of a gas permeable lens and the superior comfort a soft hydrogel contact lens. This combination is provides very high definition vision by essentially creating a ‘smooth regular’ surface on a cornea that is affected and irregular by keratoconus. There are even bifocal Keratoconus hybrid lenses available for patients.
Dr. Chander is a certified platinum Synergeyes hybrid contact lens designer and has been one of the first eye doctors in Chicago to design this type of lens for keratoconus patients. Stop in Primary Eye Care Associates for a complimentary test drive of this wonderful lens technology to improve vision in keratoconus patients.
Scleral Shell Lenses
A Scleral contact lens is a very large gas permeable contact lens that provides extreme comfort for dryness and high definition optics for clarity. Unlike a gas permeable lens this contact lens does not move when in the eye and
can act to halt the progression of keratoconus. Several lens designs are available to help optimize vision for near (bifocal contact lenses) astigmatism (toric contact lenses). The lens initially may look intimidating to insert into the eye, however even patients with normal corneas and without the need for prescription to make their vision clear, wear scleral contacts to maximize moisture and comfort for dry eye disease.
Scleral contact lenses can also be designed with astigmatism and bifocal powers for both normal and keratoconus eyes. These lenses typically last about 1 to 1 and a half years, and can be ‘deep’ cleaned about every 6 months.
Intacs are thin clear semicircular plastic ring inserts that are placed in between the clear layers of the cornea. Small “pockets” are created via femoto-laser allowing the surgeon to safely insert the rings.
Although Intacts can provide a unique alternative to contact lenses, many patients with Intact ring implants still require to wear contact lenses or glasses to see clearly. Intacts can also help to postpone the need for a corneal transplant.
The Intact Inserts are placed in the outer area of the cornea. This allows a changing curvature of cornea reducing the cone distortion from keratonoconus. This allows corneal re-shaping without removing any of the natural tissue. Intacts are designed to be permanent, but can be removed safely or replaced if the keratonoconus worsens over time. Intacts cannot be felt once placed, and they are no more visible than a contact lens. The best thing about Intacts is that they require no maintenance by the patient, but do require monitoring by your eye care professional.
Typically corneal transplants are reserved for Damaged Corneas. The cornea can be damaged from several factors including:
- Previous Injury
Corneal transplant involves removal of central cornea replaced with healthy donor cornea and is sewn into place. Medications are prescribed to avoid inflammation, infection and rejection of the donor cornea. There is a high probability that Glasses and or contacts may still need to be worn after the procedure. Rejection of the new cornea is the most severe complication, and can happen years after the initial procedure. Monitoring post operatively every 6 months is recommended to ensure the best health status of the cornea after the surgery. Stitches used to sew in the cornea can break over time, and eventually all sutures may simply just break or be removed to avoid poking the eye.