Keratoconus and Contact Lenses: What You Need to Know

Keratoconus is a progressive condition that changes the shape of the cornea – the clear front surface of the eye. Instead of remaining round and dome-like, the cornea thins and bulges into a cone shape, which distorts vision.

For those affected, common symptoms include blurred vision, sensitivity to light, ghosting or double images, and frequent changes in eyeglass prescriptions.

The condition often begins in the teenage years and can progress into early adulthood.

While it may stabilise by the mid-30s, advanced keratoconus can lead to corneal scarring, significant vision loss, and in severe cases, the need for a corneal transplant.

Early detection and proper management are key to maintaining optimal vision.

Why Contact Lenses Are Important for Keratoconus

Glasses can correct simple refractive errors, but they cannot address the irregular surface caused by keratoconus. Specialty contact lenses are usually the most effective solution because they provide a smooth optical surface over the cornea. This allows light to focus more accurately on the retina, resulting in clearer and more stable vision.

Custom fitting is essential. Every cornea affected by keratoconus is unique, so lenses must be tailored to the individual. A well-fitted lens not only improves vision but also helps protect the cornea from further damage, making it a cornerstone of effective keratoconus management.

Types of Contact Lenses for Keratoconus

Several types of lenses are available, each suited to different stages of keratoconus:

• Rigid Gas Permeable (RGP) lenses: Often recommended for mild to moderate keratoconus. These small, firm lenses maintain their shape on the eye, providing a smooth surface to correct vision. They may feel uncomfortable at first, and some patients require a short adaptation period.
• Large-diameter RGP lenses: Cover a greater portion of the cornea, offering improved stability and reducing lens movement. Useful for patients with more advanced keratoconus.
• Hybrid lenses: Combine a rigid centre for clear vision with a soft outer ring for comfort. Ideal for active lifestyles or sports, although they tend to be more expensive.
• Scleral lenses: Vault over the entire cornea and rest on the sclera (the white of the eye), avoiding direct contact with the sensitive cornea. These are comfortable and effective for severe keratoconus, but require a more complex fitting process and ongoing maintenance.

The choice of lens depends on the severity of the condition, lifestyle needs, and comfort preferences. 

The Fitting Process: What to Expect

Proper fitting is critical. Poorly fitted lenses can lead to corneal scarring, discomfort, or even accelerate disease progression.

A typical fitting process includes:

• Comprehensive eye assessment – including visual acuity checks and detailed corneal measurements.
• Corneal imaging – topography maps the curvature and shape of the cornea, allowing precise lens selection.
• Trial lenses – patients try different lens types and sizes to find the best balance of vision and comfort.
• Patient training – instructions on inserting, removing, and caring for lenses.
• Follow-up appointments – monitor progress and adjust lenses as needed.
• Working with an experienced optometrist ensures that lenses fit correctly, maximize vision improvement, and minimise complications.

Managing Keratoconus and Eye Health

Caring for your eyes goes beyond wearing the right lenses. Effective management includes:

• Regular check-ups: Frequent exams allow early detection of changes, which may prevent severe complications.
• Lens hygiene: Daily cleaning and proper storage prevent infections and irritation.
• Consistency: Wearing lenses as recommended helps maintain stable vision and slows disease progression.

Neglecting these steps can compromise both lens performance and corneal health, potentially leading to discomfort, dry eyes, or infection.

Lifestyle Considerations

Contact lenses for keratoconus can help patients participate in sports without worrying about glasses breaking or shifting, perform screen-heavy work without ghosting or blurred vision interfering, and drive with improved clarity at night.

Patients should discuss lifestyle needs with their optometrist to select lenses that fit their daily routines and visual demands.

When to See An Optometrist

Keratoconus can progress differently for each individual. Signs you should consult an optometrist include:

• Rapid changes in vision or prescription.
• Increased glare, halos, or ghosting.
• Discomfort or poor fit with current lenses.
• Redness, pain, or signs of infection.
• Early consultation allows timely intervention, preserving vision and potentially avoiding invasive procedures.

Keratoconus can be challenging, but with the right contact lenses and professional care, most people achieve clear, comfortable vision.

If you’ve noticed changes in your vision or have been diagnosed with keratoconus, the team at Optometrist Parramatta can provide comprehensive eye tests to detect keratoconus, custom lens fittings, and ongoing support to help you manage your eye health.

Book an appointment with us today to find out more.