Keratoconus is a terrifying diagnosis to those that have experienced it. To compound issues, many patients complain that they had poor initial treatment due to a lack of understanding about the disease. If proper treatment is not achieved, individuals may experience a rapid deterioration in their ability to see. This leads to a reduced quality of life. You can reduce the stress related to a keratoconus diagnosis and increase the benefits of treatment by understanding your treatment options.
 

Understanding Keratoconus

Keratoconus is an eye disease that causes the cornea to thin and bulge and distort. This bulge generally takes on the appearance of a cone. As light enters the eye, it becomes scattered by the cone causing vision blurred vision and shadows. It is progressive, but usually stablizes between 20-30 years of age. 

Modern research is connecting keratoconus with an enzyme imbalance in the cornea. This imbalance leaves the eye susceptible to oxidative free radicals. Keratoconus has also been linked to UV damage, excessive eye rubbing, poorly fitting contacts, and chronic eye irritation.
 

Treatment Options

We have compiled ten of the most common treatments here.

• Corneal Cross-linking (CXL) – There are two different types of this procedure, but they both introduce riboflavin to the cornea in order to strengthen the corneal tissue and stop the bulging from progressing. This is usually not coverd by insurance.

• Custom Soft Contact Lenses – Soft contacts are generally more comfortable to wear than gas permeable lenses. Recently, some contact companies have been able to create a contact specifically to correct the issues related to mild cases of keratoconus.

• Rigid Gas Permeable Contact Lenses (RGP's) – Gas permeable lenses are smaller rigid contact lens that fit directly onto the cornea. Its smooth front surface enables to the light to be clearly focused.  RGP's may also help to slow progression. This is the most widely used treatment.  The fit is often time-consuming and may take several different lenses to achieve the proper fit.

• Piggybacking Contact Lenses – This is an older method used for individuals who needs the vision of an RGP but the comfort of a soft.  Piggybacking utilizes a soft lens placed on the eye first, and then a gas permeable lens is placed over the top. This offers the comfort of soft contacts with the rigidity and clarity of the gas permeable lenses. 

• Hybrid Contact Lenses – Hybrid contact lenses were designed specifically for keratoconus. This technology blends a rigid contact lens center with a softer edge, or skirt, of the contact

• Scleral lenses – Due recent manufacturing technolgy, these lenses are able to made from highly gas permeable materials. The are large like a soft lens and vault over the cornea resting on the sclera (white of the eye). They are very comfortable and  provide excellent vision. This modality is being prescribed more and more. 

• Intacs – These implants are surgically placed in the eye. They are a small plastic insert that is inserted into the eye, just under the surface. This option is also designed for patients who could not use other contact lens types. This helps to reduce the distortions from KC. Some patients after the procedure, can wear regular diposable lenses.

• Topography-Guided Conductive Keratoplasty – This treatment option is still being researched, but it uses the energy from radio waves and small probes to map the surface of the eye. This detailed mapping allows for an appropriate treatment plan for the patient.

• Corneal Transplant – Patients with advanced keratoconus may no longer be able to tolerate a contact lens, or the different lens types may not be correcting the issues. This surgery removes the damaged cornea and replaces it with a healthy cornea. This is extreme and seen in less than 5% of the cases.
   

There is hope for individuals with keratoconus. Properly fit contact lenses allows gives patients the freedom to have a normal quality of life. It's important to have annual evaluations as the eyes can change and adversly affect the fit of the contacts increasing the risk of damage.  If you have been diagnosed with keratoconus or are having problems with your vision, we have all the tools and experience to help you see and feel better with your contact lenses.