Seeing Clearly: Treating Keratoconus with Corneal Cross-Linking, Transplants, and Scleral Lenses

Keratoconus is a corneal disease that affects individuals of all ages and genders. The disease causes a progressive thinning of the cornea, resulting in blurry and distorted vision. Both genetic and environmental factors can contribute to the development of Keratoconus. However, effective treatments like corneal cross-linking and scleral lenses have made it possible to avoid surgery in most cases.

Corneal cross-linking is a procedure that has shown significant promise in stabilizing the cornea and reducing corneal thinning. During this procedure, riboflavin is activated by UV light to strengthen the tissues in the eye, preventing the cornea from continuing to bulge over time. This procedure is typically performed as an outpatient and has a recovery time of just a few days. Some discomfort and light sensitivity may be experienced, but these side effects are generally mild.

In cases where corneal cross-linking is not sufficient, a corneal transplant may be necessary. However, only 15-20% of people with Keratoconus ever require a transplant. During this surgery, a portion of the patient's cornea is replaced with a donor cornea. While the procedure is generally safe and successful, there are some risks, including eye infection, glaucoma, bleeding, retinal problems, and rejection of donor tissue.

Scleral contact lenses have emerged as a popular alternative to corneal transplant surgery. These lenses are large, hard contact lenses that are designed to bridge the entire cornea, resting on the conjunctiva. They create a crisp and clear surface for the patient's vision while providing all-day comfort. Scleral lenses are preferred over soft contact lenses and usually provide multiple rows of improved vision on the eye chart. Insurance often covers scleral lenses once a patient has been diagnosed with Keratoconus. Scleral lenses are made of breathable material and are designed to sit on the white part of your eye, which increases comfort and allows for high amounts of oxygen to reach the cornea.

The cornea is a very sensitive part of your eye, and many people find traditional contact lenses uncomfortable, especially if they have dry eyes. Scleral lenses, however, are custom-made for each individual patient to create a cushion around the cornea that can be worn for hours without discomfort.

People with a condition called Keratoconus, which causes the cornea to become thin and distorted, are particularly good candidates for scleral lenses. In the past, the only options for these patients were rigid gas-permeable (RGP) or piggyback lenses, which were often uncomfortable and limited outdoor activities. Scleral lenses provide a better option with clearer optics and increased comfort.

Scleral lenses can also benefit people with high prescriptions or high amounts of astigmatism, as well as those who experience night glare or halos after LASIK or RK surgery. If you've had trouble finding comfortable contact lenses in the past, scleral lenses may be a great option for you.

The exam process for scleral lenses typically takes several weeks or months and involves a series of appointments to ensure the perfect fit. During your initial exam, your prescription will be determined, and your eye health will be evaluated to determine if scleral lenses are the best option for you. If you have complicated corneas or advanced corneal disease, the fitting process may take longer, but the end result is often life-changing. Depending on your situation, scleral lenses may even be covered by your vision insurance policy as medically necessary contacts.

In summary, scleral contact lenses are a great option for anyone who has struggled with uncomfortable traditional contact lenses, especially those with Keratoconus. The fitting process is extensive but well worth it for the increased comfort and clarity of vision these lenses can provide.

Keratoconus is a serious eye condition that can affect a person's quality of life. Fortunately, with advancements in treatments like corneal cross-linking and scleral lenses, most cases of Keratoconus can be managed without surgery. It is essential to consult an eye doctor if you experience symptoms of Keratoconus, including blurred or distorted vision, eye strain, and sensitivity to light.