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Everything You Need To Know About Keratoconus

Everything You Need To Know About Keratoconus 640×350If you’ve been diagnosed with keratoconus, our Temecula eye doctors understand your challenge and are here to help you see clearly and comfortably.

Below are some of the most commonly asked questions to help you gain a better understanding of what keratoconus is and how it can be treated.

What is Keratoconus?

Keratoconus affects about 1 in every 2,000 people. This progressive eye disease impacts the shape of the cornea, weakening it and causing it to thin and bulge outward into a cone shape.

The cornea is the clear, dome-shaped outer covering of the eye. It’s responsible for focusing incoming light onto the retina at the back of the eye to enable clear vision. So, when keratoconus develops, the change in the cornea’s shape directly impacts the way light is focused.

Keratoconus often results in nearsightedness and high levels of astigmatism — two refractive errors that cause blurry and distorted vision.

If left untreated, keratoconus can lead to permanent corneal damage and even loss of vision.

What Typically Causes Keratoconus?

Keratoconus develops when the collagen fibers that support the cornea begin to weaken. While having a family member with the disease is a significant risk factor, the following conditions can also lead to keratoconus:

  • Eye trauma
  • Eye allergies
  • Excessive eye rubbing
  • Certain eye diseases
  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Down syndrome
  • Osteogenesis imperfecta
  • Addison’s disease
  • Leber’s congenital amaurosis

The Signs & Symptoms of Keratoconus

The symptoms of keratoconus include:

  • Blurry vision
  • Distorted vision, with straight lines appearing bent or wavy
  • Sensitivity to bright light and glare
  • Red and irritated eyes
  • Increasing difficulty wearing standard contact lenses

Keratoconus tends to be initially detected in teens or young adults in their 20s, but symptoms can develop at any age.

Keratoconus symptoms usually start out mild but grow progressively worse over time — often over a decade or two — until the condition plateaus.

Both eyes are usually affected, and it’s common to have a difference in optical prescriptions between each eye.

Can Keratoconus Cause Vision Loss?

Keratoconus progression causes nearsightedness, astigmatism and visual distortions to worsen.

Eventually, corneal swelling can lead to scarring of the corneal tissue, which diminishes its transparency and increases your risk of vision loss.

Early detection and treatment of this condition are therefore critical for preventing permanent vision loss.

Can Keratoconus Be Corrected?

Initially, blurry and distorted vision can be corrected with custom-fit soft contact lenses or eyeglasses. However, as the condition progresses and your cornea becomes increasingly cone-shaped, these standard methods of vision correction become less effective.

At this point, many patients with mild to moderate keratoconus opt for scleral lenses, an effective, non-surgical method of achieving clear vision.

Severe keratoconus may require a corneal transplant procedure to replace your damaged cornea with a healthy donor cornea.

Scleral Lenses for Keratoconus

Custom designed scleral lenses help patients with corneal irregularities achieve dramatic improvements in visual acuity and comfort. Scleral lenses vault over the cornea and rest on the sclera while avoiding the diseased cornea. This creates a new optical surface instead of the damaged cornea and prevents discomfort by resting on the sclera of the eye. Moreover, the reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a liquid environment – making it optimal for healing.

Don’t let keratoconus impact your quality of life. We can help you achieve clear, comfortable vision with scleral contact lenses.

If you or a loved one has been diagnosed with keratoconus, call Temecula Valley Optometry Scleral Lens and Keratoconus Center today to schedule a scleral lens consultation.

Our practice serves patients from Temecula, Murrieta, Elsinore, and Menifee, California and surrounding communities.

 

Frequently Asked Questions with Dr. Winkelstein

Q: How long does it take to get used to scleral lenses?

A: While scleral lenses are easy to handle and care for, it can take a few days to feel comfortable inserting and removing them from your eyes. The more you [practice] the easier it will become. Once the lenses are settled in your eyes, you’ll benefit from the crisp and comfortable vision they provide.

Q: Are scleral lenses covered by insurance?

A: When it comes to scleral lenses, every insurance company is different. We recommend contacting us or checking with your insurance provider to find out if scleral lenses are covered under your plan.

4 Facts You Should Know About Scleral Lenses

Woman wearing Scleral Lenses scenic viewDo you have keratoconus or another type of corneal irregularity due to a medical condition or post-surgical complications? Are you considering giving up conventional contacts due to dry eye syndrome?

Consider scleral contact lenses! Contact Temecula Valley Optometry in Temecula to learn more and to discover a new sense of freedom with sclerals!

What Are Scleral Contact Lenses?

Sclerals are customized rigid gas permeable lenses that are wider than conventional lenses. Their name reflects the fact that they vault over the cornea and rest on the sclera, the white part of the eye.

Scleral contact lenses are 14-24 mm in diameter, while regular contacts are 9mm. This gives sclerals room to accommodate irregularly shaped corneas and provides a reservoir of moisture to soothe dry eyes.

4 Essential Facts About Scleral Contact Lenses

1. Sclerals Are the Right Fit for Irregularly Shaped Corneas

Keratoconus, astigmatism and complications from eye surgery can all result in an irregular-shaped cornea, and wearing contact lenses when your eyes are hard to fit can be challenging. Because sclerals are larger than regular contacts and don’t sit on the sensitive cornea, they provide lots of space and a comfortable fit.

2. Scleral Contact Lenses Can Reduce Dry Eye Symptoms

If you have dry eye syndrome, you may be tempted to give up on wearing contacts altogether. Scleral lenses are ideal for people with dry, itchy and irritated eyes. A lubricating pool of saline solution inside each scleral lens can reduce or even eliminate dry eye discomfort.

3. Sclerals Create a Wider Field of Vision

The width of sclerals not only makes them more comfortable but can extend your field of vision. Their diameter can expand your optic zone and make your peripheral vision sharper and clearer.

4. Sclerals Are Durable and Long-Lasting

Rigid gas permeable contact lenses, including scleral lenses, last longer than conventional soft contacts. Their durable materials are designed to resist wear and tear, which is also why scleral lenses don’t require frequent replacements.

Enjoy the convenience and clear vision scleral lenses by scheduling an appointment with Temecula Valley Optometry Scleral Lens and Keratoconus Center and discover whether scleral lenses are the right choice for you.

Our practice serves patients from Temecula, Murrieta, Elsinore, and Menifee, California and surrounding communities.

 

Frequently Asked Questions with Dr. Winkelstein

Q: Can I exercise with scleral lenses?

  • A: Scleral lenses are ideal for people who lead active lives—whether you’re a professional athlete or just like to pass a ball around with friends at the park. Thanks to their greater width, scleral lenses stay in place on the eye more than standard lenses while simultaneously providing clear crisp vision. That said, scleral lenses aren’t recommended for martial arts and other sports with a higher-than-usual rate of facial injuries.

Q: If I have keratoconus, can I avoid corneal surgery with scleral lenses?

  • A: A study published in the Journal of Ophthalmology (2018) that examined 51 patients with advanced keratoconus found that 40 of them didn’t need surgery after wearing scleral lenses. In fact, wearing them reduced the need for corneal transplant or keratoplasty by half during a 5-year period.

Regular Contact Lenses Not Working for You? Consider Scleral Lenses

Woman wearing scleral lensesIf you have dry eye syndrome, a corneal transplant, keratoconus or who simply find conventional contacts uncomfortable to wear, you may want to try scleral contact lenses. Scleral lenses are larger than standard lenses and vault over the entire surface of the cornea. Because the lens sits firmly on the eye, it offers more comfortable and stable vision than traditional lenses.

Eye Problems That Can Make Contact Lens Wearing Difficult

If your cornea is irregularly sized or shaped, standard contact lenses may not fit you properly or may move when you blink. Furthermore, standard contacts can also cause or exacerbate dry eye symptoms, such as red, irritated, itchy or dry eyes.

Below are common eye conditions that can make contact lens wearing a struggle:

  • Keratoconus
  • Dry eye syndrome
  • Astigmatism
  • Corneal transplant
  • Post-refractive surgery (i.e. LASIK)

Why are Scleral Lenses a Comfortable Alternative?

These oversized lenses provide relief, clear vision, and visual rehabilitation for dry eye, keratoconus, corneal degeneration, eyelid abnormalities, and corneal ectasia, among other conditions. That’s because the custom-designed scleral lenses are fitted to your unique eye shape, providing a superior level of comfort.

Moreover, a fluid reservoir between the lens and the cornea optically neutralizes any corneal irregularities and hydrates the ocular surface, providing a moist and comfortable environment between the eye and the lens.

How Large are Scleral Lenses?

The average size of regular contact lenses is 9mm, which is smaller than the cornea, whereas scleral lenses measure between 14.5mm to 24mm in diameter. This allows the scleral lens to form a dome over the cornea, creating a cushion of tears between the lens and the eye.

What Happens During a Scleral Lens Fitting?

Scleral lenses are custom-fit to each person’s unique eye shape, corneal curves, and contours, providing unparalleled comfort. Their size and shape also ensure stability.

To design the lenses, your Temecula Valley Optometry Scleral Lens and Keratoconus Center eye doctor in Temecula will take exact measurements of your cornea through a process called corneal topography. This process ensures that your personal pair of scleral lenses allows the right amount of light in and sits stably on the eye, thus offering superior vision, all-day ocular hydration, and increased comfort.

Schedule an appointment with Alan M. Winkelstein, OD, FCOVD and talk to us about getting fitted with scleral lenses.

Our practice serves patients from Temecula, Murrieta, Elsinore, and Menifee, California and surrounding communities.

 

Frequently Asked Questions with Dr. Winkelstein

 

Q: Can Scleral Lenses Treat or Cure Keratoconus?

  • A: While scleral lenses aren’t a cure for keratoconus, they are highly effective at correcting vision if you have irregular-shaped corneas or cone-shaped corneas.Because those with keratoconus have irregular, cone-shaped corneas, glasses and standard contact lenses cannot conform to the shape of the eyes and thus cannot adequately correct the patients’ vision. The best solution, therefore, is scleral contact lenses, since they sit on the sclera without touching the cornea and deliver maximal clarity while being perfectly comfortable in most cases.

Q: Can Scleral Lenses Help Improve Vision Following Corneal Transplants?

  • A: Though corneal transplants have a high rate of success, it can take more than a year for the eye to recover from surgery. This is because the eye needs time to adapt to the new cornea, during which time nearsightedness or astigmatism may develop. For this reason, scleral lenses are the ideal choice for clear and comfortable vision following a corneal graft.

 

Stay Active and See Better With Scleral Lenses

Stay Active and See Better With Scleral Lenses 640×350Scleral contact lenses have long been the way to provide clear and comfortable vision to people with keratoconus, severe dry eye syndrome, irregularly shaped corners and patients recovering from corneal transplants and refractive surgeries.

But did you know that scleral lenses are also a great option for active people who need their lenses to sit securely and not pop out? Many people find that traditional contact lenses don’t provide the stable and clear vision required for their active lifestyle. This is especially true for athletes with high astigmatism who want to achieve a greater level of clarity comparable to LASIK surgery.

Whether you like to run marathons, go skiing or play sports that require sharp vision, scleral lenses can provide the vision correction and peace of mind you’ve been seeking.

What Makes Scleral Lenses Different?

Scleral lenses are hard, gas-permeable contact lenses that settle on the eye in a more stable position than regular soft or hard contacts. That’s because scleral lenses have a larger diameter than standard lenses, so they’re less prone to falling out or moving on the eye.

In addition, these lenses vault over the cornea to rest on the sclera, the whites of the eyes, on a cushion of fluid, providing additional comfort. Your eyes stay hydrated when exposed to harsh winds during winter sports or in hot and dry conditions.

These features make sclerals a good option for active people and athletes.

What Else Are Scleral Lenses Used For?

Scleral lenses are the go-to lenses if you have an irregularly shaped cornea or keratoconus, which causes the lens to thin, bulge and develop a cone-like shape. As keratoconus progresses, patients often can’t achieve clear vision from eyeglasses or regular contact lenses.

The fact that scleral lenses are custom-designed to fit a patient’s eyes can make them the best option for people who can’t wear traditional hard or soft lenses.

Who Is a Good Candidate for Scleral Lenses?

The following people may find a particular benefit from scleral lenses:

  • Active people and athletes who need clear vision and want contacts that will stay firmly in place
  • People with irregular corneas, such as keratoconus
  • Those with dry eye syndrome
  • Post-corneal transplant patients
  • Those who have poor vision due to complications after eye surgery.

Can You Play Sports with Scleral Lenses?

Thanks to their greater width, scleral lenses stay in place on the eye more than standard lenses while simultaneously providing clear crisp vision. Many wearers also find them more comfortable than other contact lenses. This makes sclerals ideal for most sports, including baseball, basketball, cycling and skiing.

There are, however, some direct contact sports, such as karate, boxing and wrestling, where sclerals aren’t recommended due to the risk of eye injury if the lens is damaged.

Do Scleral Lenses Treat Keratoconus?

Scleral lenses aren’t a cure. However, sclerals are highly effective at correcting vision if you have irregular-shaped corneas because the lenses vault over the cornea and rest on the sclera, compensating for the misshapen cornea.

If you love sports, live an active lifestyle, have an irregularly shaped cornea or dry eyes, consult with Alan M. Winkelstein, OD, FCOVD at Temecula Valley Optometry Scleral Lens and Keratoconus Center to see whether scleral lenses are the right solution for you.

Our practice serves patients from Temecula, Murrieta, Elsinore, and Menifee, California and surrounding communities.

Frequently Asked Questions with Dr. Winkelstein

Q: How Can Scleral Lenses Improve An Athlete’s Vision?

  • A: Athletes are typically exposed to challenging environmental conditions, such as dust, chalk, sand and wind. These can all interfere with the comfort of wearing soft contact lenses. Because scleral lenses provide a seal over the eye’s surface, the eyes are better protected from the elements, allowing athletes more stable, clear, crisp vision.

Q: Do Scleral Lenses Cure Keratoconus?

  • A: No. Custom-designed scleral lenses help patients with corneal irregularities, like astigmatism and keratoconus, achieve dramatic improvements in visual acuity and comfort. These lenses vault over the cornea and rest on the sclera, thus creating a new optical surface. Moreover, the reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a liquid environment, ensuring optimal vision and comfort for those with keratoconus.

8 Benefits of Wearing Scleral Lenses

8 Benefits of Wearing Scleral Lenses 640×350Scleral contact lenses have an extra-wide diameter and are rigid gas permeable. Unlike standard contact lenses, they vault over the sensitive cornea and rest on the whites of the eyes.

Our eye doctors at Temecula Valley Optometry are experts at fitting scleral lenses. We offer expert vision correction for a variety of difficult-to-fit eye conditions, including keratoconus and irregular corneas. When other forms of contacts don’t perform well for astigmatism, we prescribe scleral lenses.

Here are 8 reasons why scleral contact lenses may be beneficial for you:

1. Keratoconus causes blurred vision

Keratoconus causes the cornea to thin and bulge, leading to significant vision problems and, eventually, the inability to wear standard lenses. Scleral lenses correct the visual distortions caused by keratoconus while ensuring a smooth and comfortable wearing experience.

2. Scleral Lenses for Astigmatism

In addition to prescribing scleral lenses for keratoconus, we also propose cutting-edge scleral lenses for astigmatism, especially for extreme astigmatism that other contacts aren’t able to correct.

3. Comfortable for Dry Eyes

Scleral lenses form a pocket that fills with artificial tears as they vault over your cornea. This lubricating cushion provides an extremely comfortable wearing experience as well as improved eye health. Additionally, because sclerals don’t touch your corneal surface, they lower the risk of corneal abrasions.

4. Stable Vision

Even if your cornea is exceedingly irregular, scleral lenses will provide you with continuously clear vision. Their extra-large diameter keeps them centered and steady on your eye. Even if you play sports or have an extremely busy lifestyle, their size prevents sclerals from easily popping out.

5. Wide Visual Field and Reduced Glare

Scleral contact lenses have extra-wide optic zones that provide wider, more precise peripheral vision. They also reduce glare and light sensitivity.

6. Sclerals are Safe

Scleral contact lenses have an excellent safety record.

7. Long-Lasting Lenses

These rigid gas permeable contacts, which are made of high-quality, long-lasting materials, last about a year in most cases. Refer to your eye doctor for guidance and when it’s time to replace your lenses.

8. Cost-effective

Scleral lenses are custom-fit, which necessitates additional professional training for your eye doctor as well as several appointments to achieve the ideal fit. For these reasons, sclerals cost more than conventional contacts. However, their life span is greater, and because they are a medical necessity, your insurance plan may cover the cost.

Ready to Try Sclerals? Come in For a Fitting!

Our eye doctors are well trained and experienced in the fitting of scleral lenses. To find out if you’re a good candidate for these specialty lenses, schedule an appointment with one of our Manhattan Beach or Redondo Beach optometrists. We take exact measurements of your cornea to fit scleral lenses that are tailored to each patient’s eyes and specific ocular condition.

Temecula Valley Optometry Scleral Lens and Keratoconus Center provides scleral lenses to patients from Temecula, Murrieta, Elsinore, and Menifee, California and surrounding communities.

6 Things To Know About Keratoconus

6 Things To Know About Keratoconus 640×350Keratoconus is an eye disease that causes the cornea, the clear dome-shaped front surface of the eye, to become misshapen and bulge. This progressive disease usually occurs in both eyes and affects approximately 50-200 in every 100,000 individuals.

People who have keratoconus often experience problems like blurred vision, distorted vision, night blindness and sensitivity to light. Clear vision correction for keratoconus can be challenging to achieve because the irregular corneal shape makes it difficult or impossible for standard eyeglasses or contact lenses to provide you with sharp vision.

Thankfully, there are ways for people with keratoconus to achieve clear and comfortable vision, something we explore below, along with several other key points about keratoconus.

1. Everyone has different risk factors for developing keratoconus

Some risk factors for developing keratoconus include:

  • Hereditary predisposition
  • Eye rubbing
  • Other medical conditions like Down syndrome, allergic dermatitis and connective tissue disorders
  • Eye inflammation

2. Keratoconus can develop at any age

Although most cases of keratoconus are first diagnosed in adolescence or young adulthood, it can appear during any stage of life. That’s why regular eye exams are crucial, even if your vision seems clear and your eyes appear to be healthy.

3. Early diagnosis is key

This rings true for almost every eye disease, especially keratoconus. Catching it early in its tracks can allow the eye doctor to implement various treatments to slow down its progression during the initial stages, when this condition tends to worsen more rapidly.

4. Keratoconus progresses at different rates throughout life

Keratoconus progression varies from person to person, and one person can experience varying degrees of progression in each eye. Some patients live with mild keratoconus their entire lives, while other patients develop severe keratoconus early on.

Often, optometrists will recommend that patients undergo certain procedures to strengthen the cornea and prevent or slow down further progression.

5. Keratoconus can be treated with surgery or scleral contact lenses

Corneal cross-linking surgery is an effective option to provide enhanced strength to the cornea and is the only FDA approved method of stopping or slowing keratoconus progression. However, if the condition develops into severe keratoconus, a corneal transplant may be the best option for treating the condition and restoring clear vision.

Scleral contact lenses offer another option to surgery. They are ideal for patients with early or moderate levels of keratoconus because they safely and effectively correct vision without irritating the misshapen cornea. In fact, studies have shown that patients with keratoconus who wear scleral contact lenses greatly reduce their risk of needing keratoplasty (corneal transplant surgery).

The large diameter of scleral contact lenses allows them to vault over the sensitive corneal tissue and then also coat the cornea in a nourishing reservoir of fluid for optimal comfort and visual clarity. Because eye rubbing and corneal irritation are significant risk factors for the progression of keratoconus, the protective qualities of scleral lenses can help to minimize keratoconus progression.

6. You can live a normal life with keratoconus

With the proper care and treatment from your optometrist, keratoconus shouldn’t stop you from living your life to the fullest. Although it can be discouraging to experience vision problems that can’t be resolved with standard lenses or glasses, know that there are other options available.

At Temecula Valley Optometry Scleral Lens and Keratoconus Center, we help patients with keratoconus and other corneal abnormalities achieve crisp and comfortable vision using scleral contact lenses and other specialty lenses.

If you or a loved one have been diagnosed with keratoconus, call Temecula Valley Optometry Scleral Lens and Keratoconus Center in Temecula to schedule a consultation today!

Temecula Valley Optometry Scleral Lens and Keratoconus Center provides scleral lenses to patients from Temecula, Murrieta, Elsinore, and Menifee, California and surrounding communities.

Frequently Asked Questions with Dr. Winkelstein

Q: Who else can benefit from wearing scleral contact lenses?

  • A: Scleral contact lenses are ideal for patients with any of the following conditions: corneal abnormalities, severe dry eye syndrome, post-LASIK or corneal transplant, eye allergies, high refractive error or corneal trauma. Speak with your optometrist to find out if scleral lenses are right for you.

Q: Do all optometrists fit specialty contact lenses like sclerals?

  • A: No. If you are interested in scleral contact lenses, be sure to choose an optometric practice that has years of experience fitting specialty lenses. At Temecula Valley Optometry Scleral Lens and Keratoconus Center, we have the knowledge, skill and experience necessary to provide you with the best lenses for your eyes. Call us to learn more or schedule your scleral lens fitting.

6 Tips For Adjusting To Wearing Scleral Lenses

6 Tips For Adjusting To Wearing Scleral Lenses 640×350Congratulations on your new pair of customized scleral contact lenses! As with most new things, there can be a learning curve when getting your scleral contacts to feel and fit just right.

Whether you’ve been prescribed sclerals for keratoconus, dry eye syndrome, corneal abnormalities or other conditions, it can take up to two weeks for you to feel completely comfortable in your new contacts.

Here are some tips to help shorten the adjustment period on your scleral lens journey:

1. Stick to proper hygiene protocol

Even the most perfectly fitted scleral lenses won’t feel right if they aren’t cleaned and cared for properly. Carefully follow the hygiene guidelines prescribed by your optometrist without cutting any corners. Although it may seem tedious at first, your efforts will be well worth the results.

2. Practice makes progress

The only way to make inserting and removing your lenses second nature is to wear them. Don’t be discouraged if it takes a bit more time to insert them than you’d anticipated. Wearing your sclerals daily will give you the opportunity to practice wearing and caring for your lenses.

3. Try out different insertion tools and techniques

At your initial fitting or follow-up consultation, your eye doctor will show you ways to safely and comfortably insert your lenses. Some patients prefer using a large plunger, while others prefer the scleral ring or O-ring. If neither of these recommended techniques are working for you, seek advice from your eye doctor.

4. Overfill the lens

A common problem that many patients encounter when they begin wearing scleral contact lenses is how to get rid of tiny air bubbles that get trapped in the lens’ bowl. Try filling up the lens with the recommended solution until it is almost overflowing. That way, you’ll have enough fluid left in the lens even if some spills out when you bring it up to your eye.

5. Give it time

If your scleral lenses feel slightly uncomfortable upon insertion — don’t worry. It’s recommended to wait 20-30 minutes to allow them to settle on the eye’s surface before attempting to readjust or remove them. Of course, remove them immediately and try again if you feel significant discomfort.

6. Follow up with your optometrist

Even once you leave your optometrist’s office, we encourage you to remain in touch with your eye doctor if something doesn’t feel right or if you have any questions regarding your scleral lenses.

To learn more or to schedule a scleral lens consultation, call Temecula Valley Optometry Scleral Lens and Keratoconus Center today!

Temecula Valley Optometry Scleral Lens and Keratoconus Center provides scleral lenses to patients from Temecula, Murrieta, Elsinore, and Menifee, California and surrounding communities.

Frequently Asked Questions with Dr. Winkelstein

Q: What are scleral contact lenses?

  • A: Scleral contact lenses are rigid gas permeable lenses with a uniquely large diameter. They rest on the sclera (whites of the eyes) instead of the cornea, making them a more comfortable and stable option for people with corneal irregularities or dry eye syndrome. Scleral contacts hold a reservoir of nourishing fluid between the eye’s surface and the inside of the lens, providing the patient with crisp and comfortable vision.

Q: Who is an ideal candidate for wearing sclerals?

  • A: Patients with keratoconus, corneal abnormalities, ocular surface disease (dry eye syndrome) and very high refractive errors can all benefit from scleral lenses. Moreover, those with delicate corneas due to disease or after surgery find scleral lenses to be comfortable and therapeutic, as the lenses don’t place any pressure on the sensitive corneal tissue.