When a patient is diagnosed with keratoconus, their immediate reaction is fear, thinking that they will go blind. This vision impairment may be very intimidating, especially when the doctor explains that it is progressive.
However, in the hands of an experienced practitioner, there are many solutions to this eye ailment.
In a nutshell, the main reason why this eye disease leads to visual impairment is because it causes the cornea to become thinner and bulge out in an irregular way. It becomes conic in shape. This causes distortion in the vision. In some cases, there may be scarring which further damages vision.
The type of cure which will be suggested by the optometrist or cornea specialist will depend on the severity of the problem. Once glasses can no longer correct your eyesight adequately, there are two options to consider. First, is to have contact lenses fitted, which can mask the shape of the cornea and help in having clearer vision. Second, is to undergo a surgical procedure.
Types of Lenses for Keratoconus
It is important to have the perfectly fitted lens for people who have distorted cornea. Among the popular types of contact lens for this eye ailment are:
- Custom Soft Contact Lens. This is applicable only for patients who have mild disease. The vision may be a little better than what is possible with glasses.
- Rigid Gas Permeable Contact Lens. This is a rigid type of lens which should be used by patients who have more severe eye disease. The lens vaults over the cornea and provides a regular surface, so that vision can be improved.
- Piggybacking Contact Lenses. When the cornea is already irregularly shaped, fitting the contact lens can be quite problematic. Poor comfort is a big factor in giving up on contact lenses. In such cases, your practitioner may prescribe the use of soft lenses underneath your hard contact lenses. This is a little more time consuming for the patient but can really help to keep the lenses comfortable.
- Hybrid Contact lenses. These have a hard centre portion and a soft skirt for improved comfort.
- Scleral Contact Lenses. In more advanced disease, it might not be possible to have one of the above options work. This is where scleral lenses come into play. They are larger in diameter and are more successful in not irritating the cornea, whilst providing excellent vision.
All of the above contact lenses need to be fitted by an experienced contact lens practitioner, who understands the nuances of keratoconus.
When keratoconus is still in the progressive stage (getting worse), an excellent treatment option is a surgical procedure called corneal collagen cross linking. Usually, this procedure can halt the progression of the disease in its tracks. It doesn’t provide clearer vision (and in fact vision may be worse for a while due to to corneal haze) but it does stop the disease from getting worse and is usually recommended in the teens and twenties.
In some cases, when contact lenses cannot be successfully worn, replacement of the entire central portion of the cornea is required. This means that the damaged tissue will be carefully removed by a corneal specialist surgeon and it will be replaced by a new one. The new cornea will come from a compatible donor.
It has to be noted though that opting for surgery does not solely depend on what the patient wants. This is a decision which will depend on the recommendation of an ophthalmologist. Patients should undergo several tests which determine the extent of the corneal damage to be able to identify if surgery would be the most fitting solution.