A diagnosis of keratoconus can be a major shock to the system, but so can the discussion around the cost of treatment.
This post explores the breakdown of costs for managing this condition and will give you realistic expectations about the out-of-pocket expense of your keratoconus treatment.
This condition is not as rare as we once thought, with recent studies showing the prevalence of all forms of keratoconus at 1 in 375. The reason for this apparent increase is related to the more sensitive screening technology available to diagnose milder forms of the disease rather than a genuine increase in prevalence.
It is important to understand that many of these mild cases require no treatment at all! But if you have a family history of the disease and / or experience the classic symptoms of keratoconus, it is best to see a practitioner who specialises in this condition for an accurate and timely diagnosis.
The initial consultation
A comprehensive initial consultation for this condition could set you back up to $500. At our practice, this includes an individual assessment of risk of progression as well as a long discussion on treatment options. You can expect to be at the practice for up to 2 hours for this initial visit.
Diagnostic tests include Optical Coherence Tomography, or OCT, which rules out disease at the back of the eye – something easily overlooked in this condition when all the attention is on the front of the eye.
We perform a number of tests to measure and baseline your corneal shape and thickness. One of the things we excel at is finding your best possible glasses prescription. This is particularly complex, but if done correctly, glasses can be a very viable treatment option.
Other tests include:
- Corneal topography
- Global corneal pachymetry
- S-map scleral topographer (1 of only 2 in the country)
- Contact lens trial fitting.
The contact lens fitting involves determining the best contact lens modality – (Soft, RGP, Scleral etc) and trialing a number of lenses from our extensive range of over 100 different fitting sets.
Most keratoconus cases are managed with special RGP contact lenses. Critically, these lenses need to be fitted by an experienced practitioner with access to a wide range of lens designs. Someone who sees this eye condition in their practice once or twice a year (or who has access to a couple of fitting sets), is very unlikely to develop expertise or achieve a successful fit. In many cases, these practitioners can do more harm than good.
One of the main reasons for requiring a corneal transplant is scarring caused by inappropriately-fitting contact lenses. While these may provide clear vision at first, the constant rubbing on the delicate central cornea eventually causes permanent thinning and scarring, resulting in permanent vision loss.
It is not uncommon for patients we see to have had up to 10 different pairs of unsuccessful contact lenses before they arrive at our practice. They may be paying for their third or fourth consultation. Save your money and choose an expert to start with.
A pair of RGP contact lenses for keratoconus (i.e. the mainstay of treatment) costs anywhere from $800 to $1300. Alternatively, in some cases, specialist glasses can be a viable option.
(Some of this may be rebatable through your health fund, depending on your level of cover. Most funds cover up to about $200 per year towards contact lenses or glasses, although some can contribute more).
The delivery and handling instructions for your new contact lenses are, in most cases, largely covered by Medicare. You will be instructed in insertion, removal and cleaning of your lenses and you will need to return for follow up a couple of times to ensure the lens is fitting properly. The cost of the lenses includes two exchanges under warranty, in case the lens needs to be altered to achieve the perfect fit.
Find out more about contact lenses for keratoconus in our FREE Guide. Download here.
Once the successful contact lens fit has been achieved and everything has settled down, you will still need regular review. This condition is a progressive disease during the teens and twenties, and new lenses will be needed on average every 18 months.
(If you have progressive disease, your keratoconus contact lens specialist may refer you to a surgeon to discuss the possibility of having a procedure called corneal collagen cross linking to stabilise your condition).
Allow approximately $1, 000 per year for contact lenses and consultation. Another way to look at it is this: $2 per day is not a lot of money for ongoing expert care of your progressive eye disease.
Keratoconus management needn’t break the bank. The most important thing is to manage the disease successfully and avoid the need for a corneal transplant. This means you can live a full, productive life with no loss of earnings. A keratoconus specialist can make living with this disease a lot more straightforward than you might have thought.