Keratoconus and Contact Lenses: What You Need to Know

Are you concerned that your keratoconus is progressing, but unsure of the best way to manage it? Do you know how the right contact lenses could dramatically improve your vision?

As the owner and principal optometrist at Optometrist Parramatta, I’ve spent years helping patients navigate the challenges of keratoconus. I’m Dr. Nick Papadopolous, and I understand how frustrating and concerning vision changes can be, especially when conventional solutions fall short. Whether you’re exploring contact lens options for the first time or seeking better results, I’m here to guide you through every step with care and expertise.

3 Key Takeaways

There are several types of contact lenses available that can provide both comfort and clear vision, even in advanced cases of keratoconus.
Proper contact lens fitting is crucial for managing the condition effectively and preventing further damage to your cornea.
Regular eye exams and timely intervention are essential to slow the progression of keratoconus and maintain your quality of life.

Understanding Keratoconus and Its Impact on Vision

What is Keratoconus?

Have you ever wondered what happens when the cornea, the clear front surface of your eye, begins to change shape? This is precisely what occurs in a condition known as keratoconus. It is a progressive eye disease where the normally round, dome-shaped cornea gradually thins and takes on a cone-like shape. This alteration distorts vision, making it difficult to focus clearly.

For those living with keratoconus, the most common symptoms include blurred vision, an increased sensitivity to light, and frequent changes in their eyeglass prescription. It often starts in the teenage years and can progress over time, leading to significant visual impairment if not properly managed.

How Keratoconus Progresses

Keratoconus typically advances in stages, starting from mild symptoms and potentially leading to more severe complications. In younger patients, the condition can progress faster, with the cornea becoming increasingly cone-shaped. By the time most patients reach their mid-30s, the disease often stabilises, though the extent of vision loss varies.

Advanced stages of keratoconus can lead to corneal scarring, significant vision loss, and, in severe cases, the need for a corneal transplant. Early detection and appropriate management are key to maintaining the best possible vision.

The Role of Contact Lenses in Managing Keratoconus

Custom Contact Lenses

Due to the irregular shape of the cornea in keratoconus, glasses can’t fully correct the distortion in the way that contact lenses can. Contact lenses are crucial because they sit directly on the eye, helping to reshape the cornea and focus light more accurately onto the retina. This results in clearer, more stable vision compared to what glasses can provide.

The key lies in custom fitting. Because every cornea affected by keratoconus is unique, a one-size-fits-all approach simply doesn’t work. Custom fitting ensures that the lenses provide the best possible correction while also being comfortable to wear, which is essential for long-term success in managing the condition.

Types of Contact Lenses for Keratoconus

There are various types of contact lenses available for keratoconus, each suited to different stages and severities of the condition.

Small diameter rigid gas permeable (RGP) lenses are often the first choice for early to moderate keratoconus. These lenses provide sharp vision by maintaining their shape on the eye, offering a smooth surface that corrects the irregularities of the cornea. However, they can be uncomfortable initially, and some patients may struggle with the adaptation period.

For those who need more stability and comfort, larger diameter RGP lenses might be more suitable. These lenses cover a greater portion of the cornea, providing better centration and reducing the likelihood of the lens moving out of place. This can be particularly beneficial for patients whose keratoconus is more advanced.

Hybrid lenses combine the best of both worlds: the clarity of RGP lenses and the comfort of soft lenses. These lenses have a rigid center to correct vision and a soft outer ring to enhance comfort, making them ideal for individuals with moderate keratoconus who engage in physical activities or sports. However, they come with limitations, such as higher costs, which may not make them the right choice for everyone.

When keratoconus has progressed to a more severe stage, we often recommend scleral lenses. These large-diameter lenses vault over the entire cornea and rest on the sclera, the white part of the eye. Because they don’t touch the cornea directly, scleral lenses offer unparalleled comfort and are suitable for patients with significant corneal irregularities. However, they require a more complex fitting process and can be more expensive and time-consuming to maintain.

If you’d like to know more about why scleral contact lenses can be a game changer for managing keratoconus, watch the following video by Dr Joseph Allen from the Doctor Eye Health YouTube channel.

No matter which type of lens we help you choose, the ultimate goal is to achieve a comfortable fit that provides clear vision and supports the health of the eye.

Achieving the Perfect Contact Lens Fit for Keratoconus

A successful contact lens fitting can make the difference between managing the condition effectively or experiencing further complications. Poorly fitting lenses can lead to issues like corneal scarring, discomfort, and even accelerate the progression of keratoconus. That’s why it’s essential to work with an optometrist who has experience in working with lenses specifically for keratoconus.

The patient journey involves several steps, starting with a thorough examination of your cornea using advanced imaging techniques like corneal topography. This provides a detailed map of your cornea’s surface, allowing for a precise fit. From there, we offer trial lenses to ensure that the selected lens type not only provides clear vision but also feels comfortable throughout the day.

Maintaining Eye Health

Frequent check-ups are essential, as they allow your optometrist to monitor the progression of the condition and make necessary adjustments to your treatment plan. If we can detect any changes early, that may prevent more severe complications down the line, such as the need for invasive procedures like corneal transplants.

Caring for your contact lenses properly is just as important as attending regular eye exams. Daily cleaning and proper storage are non-negotiable. Neglecting these routines can lead to eye infections, dry eyes, and discomfort, which can further complicate the management of keratoconus. Maintaining good lens hygiene, not only extends the life of your lenses but also safeguards your eye health.

Taking these simple steps—regular exams and diligent lens care—can help you keep keratoconus under control and maintain the best possible vision.

CONCLUSION

This blog post explores the different types of contact lenses available for keratoconus and why a proper fit is necessary for effective treatment. Custom-fit contact lenses, like RGPs, hybrids, and sclerals, can significantly improve your vision and comfort. But failing to get properly fitted contact lenses can cause your eye condition to progress more rapidly, making it harder to manage.

Your vision is too important to delay—book a consultation today and start managing your keratoconus effectively.

To make an appointment, give us a call at 02 9891 2020 or click the “Book Online” button on our website.

Dr Nick Papadopoulos – Owner and Optometrist

B.Optom (UNSW), CertOcTher (ACO) Therapeutically Endorsed Optometrist

Member of the Cornea & Contact Lens Society of Australia & the Orthokeratology Society of Oceania