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Custom Scleral Contact Lenses

How Can I Find a Keratoconus Specialist?

If you’ve just been diagnosed with keratoconus or have a family history, you’ll want to find the best keratoconus specialist near you for your ongoing treatment.

Keratoconus Develops Rapidly

One of the differences between keratoconus and other eye diseases is how quickly it can progress. With an eye disease that changes often, it is important to find an eye doctor you feel comfortable with. Keratoconus requires an ongoing relationship with frequent appointments for best management.

An optometrist that specializes in diagnosing keratoconus and the treatment of keratoconus will often have special equipment allowing them to recognize keratoconus sooner than other optometry clinics.

Sometimes Develops in Families

While it is not known exactly what causes keratoconus, one factor is that it can sometimes be hereditary. If your family has a history of keratoconus, it is recommended to find an eye doctor near you that specializes in keratoconus for early detection. Keratoconus can start developing during the teenage years.

Treating Keratoconus

Treatment options for keratoconus may include eyeglasses or contact lenses, custom scleral contact lenses or custom rigid gas permeable lenses, Intacs, corneal collagen cross linking, and eye surgery or a cornea transplant.

In the early stages, patients are often fitted for glasses or contact lenses. The prescription may change often as the disease progresses.

Custom scleral contact lenses are often prescribed as they can be more comfortable for patients with keratoconus as they vault over the cornea of the eye. Patients with keratoconus have a cone-shaped cornea which may make it difficult to wear soft contact lenses. It can be helpful if the optometrist managing your keratoconus is also able to fit you for custom scleral contact lenses. Many patients that suffer from corneal eye diseases will find custom scleral contact lenses a good option.

If Intacs, corneal crosslinking, and/or cornea surgery or corneal transplants is recommended, your eye doctor will refer you to an ophthalmologist who specializes in the surgical treatment of keratoconus. Together, both eye doctors will develop an individualized treatment plan before and after the surgery and will co-manage the treatment of your keratoconus.

Keratoconus Specialists Stay Informed

Having a cornea eye specialist managing your keratoconus means they stay informed of the latest treatments and best practices for managing keratoconus.

When looking for a keratoconus specialist to treat your eye disease, find an eye doctor near you that:

  • You feel comfortable with,
  • Has the necessary equipment for early detection of keratoconus,
  • Can fit you with custom scleral contact lenses,
  • Works with an ophthalmologist specializing in keratoconus surgical options if your corneal disease progresses and requires surgery,
  • Regularly works with other keratoconus patients and specializes in the treatment of keratoconus.

Albuquerque Optometrists that Specialize in Keratoconus

The optometrists at Eyes of New Mexico Family Optometry and Contact Lenses in Albuquerque are specialists in treating keratoconus. If you or your family has a keratoconus diagnosis or you’d like to find out, book an appointment at our Albuquerque clinic. We’ll get started with an eye exam to see where we can improve vision and increase the comfort of your eyes.

7 Tips for Using Scleral Contact Lenses

Scleral contact lenses are larger diameter Rigid Gas Permeable (RGP) lenses. The larger size of scleral contact lenses fits vaults over the cornea of the eye.

They are often a good option for patients with corneal diseases like keratoconus and pellucid degeneration.

Scleral contact lenses can be customized for each individual patient providing a more comfortable fit. Other benefits of scleral contact lenses are clear vision and improved dryness. 

Be patient as you learn to adjust to wearing scleral contact lenses. It will take a bit of practice. 

1. Not the Same as Other Lenses

Scleral Contact Lenses are inserted and removed differently than regular contact lenses. This can take some time to adjust to. This video provides some tips on inserting and removing scleral contact lenses as well as caring for them, we also have a video here. You may need to try several insertion and removal methods before finding the one that works well for you.

2. Cleaning Regularly

Like any contact lens wearers, regular cleaning is essential. Make sure you’re washing your hands thoroughly before inserting scleral lenses and for lens removal.

Use only recommended products to keep lenses and your eyes in the best condition. Follow instructions from your eye doctor on proper lens care and cleaning methods.

Regularly clean your contact lens case as well.

Good hygiene will prevent eye infections.

3. Removing Scleral Contact Lenses

A drop or two of preservative-free artificial tears or saline into the eye before removing and a gentle massage can help to loosen the lens. For most wearers, it is best to remove their lenses about one hour before going to bed. 

4. UV Protection

We recommend wearing sunglasses with your custom scleral contact lenses to protect your eyes from UV rays. 

5. When Wearing Makeup

For those that would like to wear makeup while wearing scleral lenses, there are a few minor adjustments.

Put your custom scleral contact lenses in before applying your makeup. Choose cream rather than powders and eye-friendly, hypoallergenic products. Don’t use eyeliner on the inside rims of the eyes.

Remove lenses before cleaning off makeup. 

6. Facial Moisturizer

Avoid oil-based moisturizers on the eyelids.

7. Avoid Wearing Lenses on a Plane

For anyone wearing contact lenses, wear your glasses when flying if you are able to. The air in aircraft cabins is very low causing your eyes to become dry and uncomfortable. Put them in as soon as you land when you are able to do so. 

There are many benefits to custom scleral contact lenses for patients. With a bit of time and practice, scleral contact lenses will become part of your routine. A scleral lens fitting may take more time but patients often find them more comfortable.

They will help to keep the cornea healthy and with their wider diameter are often more comfortable for better patient vision and comfort. Fitting scleral lenses properly can also help with dry eyes as the scleral lens design is to vault over the eye, protecting the cornea underneath. Follow all of the recommendations provided to you by our optometrists

Contact our Albuquerque office if you are having any issues or to book an appointment for a custom scleral contact lenses consultation and fitting.

Photo by Nataliya Vaitkevich from Pexels

Differences between Keratoconus and Pellucid Marginal Degeneration

Keratoconus and Pellucid Marginal Degeneration (PMD) are both considered to be cornea ectatic disorders or corneal thinning disorders. While they may have similar topographic features, they have slightly different cornea abnormalities. They can often be misdiagnosed. It is possible for a person to have both eye conditions but this is quite rare.

There is some discussion of whether PMD is a form of keratoconus or its own eye disease entirely. Treating and managing these eye disorders is different so it is important to have a keratoconus or PMD specialist working with you to get the proper diagnosis.

Cornea Abnormalities

PMD shows severe inferior crescent-shaped thinning of the cornea. This shows as the thinning of the corneal band with the cornea protruding above the thinning. It is sometimes referred to as a “beer belly” configuration when you view it from the side. The cornea of a patient with keratoconus is cone-shaped rather than the dome shape of a healthy eye.

In PMD, cornea thinning extends 1–2 mm away from the inferior limbus while in keratoconus, the thinning usually occurs in the paracentral region. If the cone shape is away from the cornea, a patient with keratoconus can often be confused to have PMD.

Hereditary

There is no known hereditary link for those with PMD. It is a bit more complicated with Keratoconus. There is often no hereditary link, but if you have a first-degree relative with keratoconus, you are at higher risk than the general population of developing this eye disease.

Keratoconus is quite a rare disorder and PMD is an even more rare eye disorder. About 3% of cases with corneal ectasia resulted in a PMD diagnosis with the other 97% having keratoconus.

Keratoconus is more likely to occur in men. Some studies have found that PMD might be more apparent in women.

Many patients will have had a history of allergies, hayfever, asthma, or eczema, possibly due to excessive rubbing of the eyes.

Age of Diagnosis

Symptoms of Keratoconus are often diagnosed in the teenage years. PMD symptoms will typically start to show after age 30. Keratoconus will start to plateau after around age 40 but PMD will continue to progress.

Patients with keratoconus are often diagnosed sooner as vision starts to deteriorate earlier. The first signs are often a minor blurring of their vision.

Symptoms of Keratoconus and Pellucid Marginal Degeneration

With both diseases, eyesight deterioration progresses. Both may have astigmatism (eyesight problem of blurriness) present with keratoconus patients also sometimes experiencing myopia. Keratoconus causes astigmatism reducing visual acuity.

Neither eye condition usually causes pain. Keratoconus will typically show scarring while with PMD typically there is usually no scarring present.

Treatments for Keratoconus and Pellucid Marginal Degeneration

Corneal Cross-linking

Corneal cross-linking is a treatment that can halt the progression of both keratoconus and PMD. It is a minimally invasive procedure that uses special eyedrops of Riboflavin (Vitamin B12) and a UV light.

Rigid Gas Permeable Contact Lenses and Custom Scleral Contact Lenses

Rigid Gas Permeable (RGP) contact lenses are often used to treat both eye diseases. Custom scleral contact lenses may feel the most comfortable for those with keratoconus as they are wider and a scleral lens can vault over the dome of the eye.

Glasses or Soft Contact Lenses

Often this is the first treatment for mild cases. Lenses can be custom fit so the patient has a more comfortable experience.

Surgery or Cornea Transplant

In a small number of cases, a patient may need to have surgery or a corneal transplant.

How We Can Help

Having an eye doctor near you that understands the differences between diagnosing and treating keratoconus and pellucid marginal corneal degeneration is essential. Visit our comfortable office in Albuquerque to speak with our eye doctors that have experience treating these eye disorders.

10 Advantages of Scleral Contact Lenses

 

A scleral contact lens is a specialty hard contact lens. They are Rigid Gas Permeable (RGP) contact lenses that are larger in diameter. Their large diameter allows them to vault over the cornea of the eye providing a more comfortable fit for some patients.

Patients with some eye disorders can find them particularly comfortable. Any patient with an irregular corneal surface can also enjoy scleral lenses. Each custom scleral contact lens patient is provided a custom fit at our clinic to deliver exceptional comfort.

10 Benefits of Custom Scleral Contact Lenses

  1. Due to the vaulting of the lens over the cornea, there is space between the back of the lens and the front of the cornea to hold saline solution to keep the eye moist. This promotes a healing environment for the eye.
  2. RGP lenses, including scleral contact lenses are made from a durable material that will last significantly longer than regular contact lenses.
  3. The larger diameter of the lens creates a firm and stable area reducing the lens from moving around. This maintains consistent steady vision for the wearer.
  4. A wider lens supports contact over a broader area distributing the weight for a more comfortable fit.
  5. Lenses are composed of highly breathable gas permeable material allowing much needed oxygen to reach the eye.
  6. The lens protects the wearer from debris and dust. This is also an ideal solution for those that suffer from allergies.
  7. The wider lens provides increased peripheral vision and reduces glare and sensitivity to light.
  8. Scleral lenses often work when other lenses fail for the patient. Due to their size and custom fit they provide a comfortable option with a healing environment for some eye conditions.
  9. They will hold firmly when patients are playing sports or during other activities so wearers don’t have to worry about them falling out.
  10. Custom scleral contact lenses typically last 2-5 years or longer.

Who Wears Scleral Contact Lenses?

Due to their wide diameter, vaulting over the cornea, and customization, scleral contacts are particularly suited for certain eye conditions:

  • Keratoconus patients can experience clear vision and a comfortable fit due to the vaulting over the cornea that is created with custom scleral contact lenses.
  • People with astigmatism or irregular astigmatism can benefit greatly from wearing scleral lenses. Wearing the lenses can delay or eliminate the need for corneal transplant surgery.
  • Those with Dry Eye Syndrome will find that the ability to hold liquid between the back of the lens and the front of the cornea of notable benefit.
  • Chemical or burn injury patients will find comfort in a completely custom fit for irregular ocular surfaces.
  • After a corneal transplant, patients can continue to see improvement of visual acuity while wearing scleral contact lenses. Scleral contact lenses are ideal after a corneal transplant as the lens won’t touch the surface of the cornea, but rather, will vault over it.
  • Following Lasik surgery or refractive surgery, some patients can use lenses to improve their vision.
  • Anyone with hard to fit eyes or irregular corneas will appreciate that lenses can be custom fit for irregularities and can help with vision correction.

Scleral Contact Lenses Cost

Scleral contact lenses are a custom fit for each patient. This may require a higher upfront cost and more visits to the office to get the fit right. The longevity of the lenses and the comfortable fit will outweigh the cost for most patients as they will not need replacement as often, unless the eye condition changes.

Conclusion

Although most patients find custom scleral contact lenses comfortable, there is an adjustment period to get used to wearing them. Once adjusted, most patients find their lenses to be quite comfortable. The eye care routine is not that different from soft contact lenses.

If you want to find out if you’re a good candidate for custom scleral contact lenses, contact our office to book an appointment. One of our eye doctors that specializes in fitting custom scleral contact lenses will discuss your eye health with you and provide a recommendation.