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Why are my keratoconus contact lenses not working?

Keratoconus is a disorder of the cornea, the clear front […]

By Published On: 23 May 20185.8 min read

Keratoconus is a disorder of the cornea, the clear front window of the eye. Instead of being nice and smooth, the cornea becomes irregular. This leads to blurry vision.

The good news is: 95% of people with keratoconus can have excellent vision with glasses or contact lenses.

The bad news is that many people with keratoconus are given lenses that don’t fit well or are uncomfortable.

Often they are not even told about all the available options.

The struggle is real…

Many people with keratoconus complain that their lenses are uncomfortable. Or that their vision is just not clear enough.

Sometimes the contact lenses are a hassle to wear, or they keep falling out in awkward situations.

If you have keratoconus and wear contact lenses, here are 5 common reasons why you might be having a problem with them:

1. Your contact lenses have not been fitted properly

Often people with keratoconus are wearing contact lenses that are fitting incorrectly. This can cause several problems, such as:

  • Repeated rubbing / abrasion on the eye
  • Lack of oxygen to the eye
  • Irritation underneath the eyelids
  • Scarring of the eye
  • Worsening of the keratoconus

Luckily, the optometrists here at The Eye Practice have a high level of expertise with keratoconus.

Because we see so many patients with keratoconus, and we use the latest technology, we can tell you whether or not your contact lenses are fitting incorrectly.

If they are not, we can make the necessary changes to ensure that they do.

2. You are wearing the wrong type of lens

A lot of people think that the only contact lens that works for keratoconus is a small, hard lens commonly called an RGP (rigid gas permeable) contact lens.

This is not true.

In fact, this type of lens can be very irritating to wear. RGPs can also fall out easily during sport, or if the eye is accidentally rubbed.

Luckily, there are many more contact lens options available. These include: keratoconus soft contact lenses, hybrid contact lenses, and scleral contact lenses.

Unlike most optometry clinics, the optometrists at The Eye Practice see multiple patients a day with keratoconus. This is why we have one of the largest collections of keratoconus contact lenses in the country, as well as the latest contact lens fitting equipment.

In fact, we have over 50 different types of contact lens designs specifically for keratoconus in our clinic, from manufacturers located all around the world.

This means we can find a lens that will be comfortable and give great vision to our patients, no matter what their work, sport and lifestyle needs are.

Did you know that some types of hard contact lenses can be even more comfortable, durable, and stable than a regular soft contact lens?

Just ask some of our rugby player patients, who have no trouble wearing their keratoconus contact lenses in even the most challenging physical situations.

3. Your cleaning solution is not good enough

Did you know that the type of cleaning solution you use could be affecting how you feel in contact lenses?

This is a very common problem.

In some cases, people have been using a cleaning solution for years without realising the subtle damage that they are doing to their eyes over time. Eventually, this can lead to a sudden intolerance of contact lenses.

The usual culprit is the preservative that is used in the cleaning solution.

A small amount enters the eye every time the contact lens is worn. This leads to damage and inflammation on the surface of the eye and in the eyelids that builds up over time.

Thankfully, there are many cleaning solutions that contain better, new generation preservatives.

And there are some that are completely preservative-free.

4. You are using the wrong type of drops

Certain eye drops are simply not helpful for uncomfortable eyes.

In fact, they can make irritation worse!

Even anti-redness eye drops can contain harsh preservatives that can lead to long-term damage and dryness over time.

Ask your optometrist about which preservative-free eye drops are safe to use with contact lenses.

Some specialty contact lenses for keratoconus (e.g. scleral contact lenses) need to be placed on the eye filled with liquid. Using the wrong type of liquid can cause irritation, dryness and poor vision. The liquid should definitely be preservative-free.

5. Sometimes the contact lens is not the problem at all…

Sometimes a more holistic approach is needed.

It’s not all about the fit of the contact lens – there may be other underlying problems that can be easily missed.

This includes things like allergy, hayfever, infections and dry eye.

The tricky thing is, these problems can share similar symptoms, but have different treatments.

It is therefore critical that they are accurately diagnosed and treated in order to make wearing contact lenses as comfortable as possible.

It is more common for someone with keratoconus to have allergy and hayfever symptoms.

Hayfever and allergy can make the eyes itchy, dry, red and irritable. Often simple treatments, such as cool compresses and preservative-free allergy eye drops, can be very effective.

Dry eyes are also an increasingly common problem. Having dry eyes, which can be caused by a large number of things, can make wearing contact lenses very uncomfortable.

This is especially true when using a computer, phone or laptop whilst wearing contact lenses.

What should I do now?

95% of people with keratoconus can find glasses or contact lenses that are comfortable and give them clear vision.

Finding the right contact lens often means trying multiple options. One type of contact lens design might work better than another.

If you are having trouble with contact lenses, it is important to see an optometrist with lots of experience with keratoconus contact lenses.

A comprehensive eye examination and contact lens assessment for keratoconus should include:

  • Corneal imaging (e.g. topography and pachymetry of the front surface of the eye)
  • Assessment of current glasses and contact lenses
  • Assessment and treatment of any underlying problems (e.g. allergy and dry eyes)
  • A discussion about all the contact lens options, and what will work best for a patient’s lifestyle
  • A “try before you buy” contact lens fitting

At The Eye Practice, we have one of the largest collections of contact lenses in Australia.

It is almost guaranteed that our optometrists can find something to suit any patient with keratoconus.

If there are no contact lens options that are suitable (this is rare), corneal surgery can be discussed.

The optometrists at The Eye Practice have close relationships with some of Australia’s leading keratoconus ophthalmologists (eye surgeons), and can arrange a referral if required.

The future of contact lenses

In the past few decades, there have been many advances with contact lenses for keratoconus. The future is also looking bright, with new technology being developed and tested at The Eye Practice on a regular basis.

Call the friendly staff at The Eye Practice today on 02 9290 1899 or book online for a keratoconus test today.



  1. Peter J Scicluna 2 January 2021 at 8:30 pm - Reply

    Hello, I am a long term Keratoconus patient and have been wearing rigid contact lenses since I turned 18 in 1984. Almost a week ago I went to see my Opthalmologist complaining about a constant irritable burning sensation in my left eye, they diagnosed it as extreme dry eyes and suggested me to use Hylo Forte in liquid form which I have been using but this formula is not working. I am due to go back and see the Opthalmologist on Tuesday, but is there anything else I can do to soothe the irritation or could there be another underlying issue ?

    • Jim Kokkinakis 11 February 2021 at 2:32 pm - Reply

      Peter it is likely that you r contact lens is now not fitting correctly. Who prescribed these lenses? You need to see an optometrist that specialises in keratoconus and is comfortable fitting all the different contact lens modalities, especially scleral lenses. The following article explains the contact lens options:

  2. Peter J Scicluna 23 March 2021 at 1:00 am - Reply

    Sorry I took a while to get back to you, cause I lost this page and I finally retrieved it. After nearly three months on and off, I am still having the same problem, and to answer your question about if I have been seeing an Optometrist who specializes in Keratoconus, yes I have always seen an Optometrist who specializes in Keratoconus since I was diagnosed nearly 37 years ago. My Optometrist has fitted three different types of lenses in the last three months, to get the right fit, the vision is good but it’s my left that always irritates for some strange reason like it’s been scratched. I only just went to the Optometrist and had a full check up last Thursday and everything was all clear, now my left eye is sore and bloodshot. Do you have any suggestions ?

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