Keratoconus 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 Cornea and Contact Institute of Minnesota, we help patients with keratoconus and other corneal abnormalities achieve crisp and comfortable vision using scleral contact lenses and other specialty lenses.

Our practice provides scleral lenses to patients from Edina, Maple Grove, Wayzata, and Excelsior, Minnesota and surrounding communities.

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 Cornea and Contact Institute of Minnesota, 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.

World Keratoconus Day is dedicated to raising awareness about keratoconus (KC), as well as educating and advocating for those living with keratoconus and ectatic corneal disorders.

Keratoconus, or KC, is a degenerative non-inflammatory eye condition affecting the cornea. In KC, the cornea, which is normally dome-shaped, gradually becomes thinner and bulges out as it begins to assume a cone shape.

Keratoconus tends to develop during the early teens, with mild symptoms. As the disease progresses, the cornea’s shape changes to a point where wearing regular contact lenses is no longer an option and eyeglasses cannot fully correct one’s vision.

Fortunately, with the right contact lenses, those with keratoconus can once again see the world clearly and comfortably.

Keratoconus and Contact Lenses

In its early stages, people with keratoconus can usually wear glasses or standard soft contact lenses to correct resulting astigmatism and improve clarity. As the condition progresses, however, your eye doctor will prescribe the most suitable contact lens to accommodate a cone-shaped cornea to provide you with the clearest vision possible.

There are a variety of contact lens options for keratoconus, all of which depend on the severity of the condition.

1. Soft Toric Lenses

Astigmatism can be corrected with soft toric lenses, a comfortable and effective solution during the early stages of KC. However, this may not be a good treatment option as the condition worsens.

2. Custom Soft Contact Lenses

Custom soft contacts are an improvement over soft toric lenses since they are designed to match the exact contour of your cornea. Soft contact lenses can be custom-made for KC patients and may eliminate the need for glasses by fully correcting astigmatism.

3. Gas Permeable Contact Lenses

Gas permeable contact lenses (hard lenses) allow more oxygen into the eye than standard soft lenses. A gas permeable lens has a somewhat different shape than soft contact lens alternatives, as it rests on the cornea, and because the lens is hard, it creates a new optical surface. These lenses are suitable for people with moderate KC.

4. Hybrid Contact Lenses

These lenses are a cross between hard and soft lenses. The hard center provides a flat surface, which helps alleviate the issues associated with a misshapen KC cornea. The lens is rendered more comfortable by the soft outer ring. Hybrids combine the convenience and comfort of soft lenses with the crisp, clear vision of rigid gas permeable contacts.

5. Scleral Lenses

Scleral lenses are larger than standard hybrid, gas permeable or custom soft contact lenses. They vault over the cornea and rest on the sclera, the white of the eye. The advantage of scleral lenses is that they do not sit on the cornea, which removes any rubbing and irritation on the corneal bulge. This reduces the risk of corneal injury from the contact lens.

Furthermore, as the scleral lens vaults above the cornea, the reservoir of pure saline solution between the underside of the lens and the front of the cornea keeps the eye in a liquid environment at all times. This enables the eye to receive an abundance of oxygen.

While both rigid gas permeable (GP) and scleral lenses deliver enough oxygen to the eyes, scleral lenses provide more comfort and better stability than regular GP lenses. For this reason, scleral contact lenses are a very successful option for people with keratoconus and irregularly shaped corneas.

Treatment for Keratoconus

We offer treatment for keratoconus that is tailored to each patient based on the severity and progression of the condition, as well as the patient’s lifestyle.

Contact Cornea and Contact Institute of Minnesota to learn more about scleral lenses and to discover ways we can help you manage your keratoconus.

Q: For how many hours can scleral lenses safely be worn in a day?

• A: Scleral lenses can be worn for 12-14 hours per day. To preserve the greatest possible vision and comfort, some patients may need to remove the lenses, clean them, and reapply fresh saline several times a day.

Q: Can scleral lenses completely correct my vision?

• A: Scleral lenses hide abnormalities on the eye’s surface and may improve vision over other types of correction. However, you’ll probably need to wear glasses over the lenses to see clearly at all distances, particularly if you’re over 40 and require reading glasses for close work.

Cornea and Contact Institute of Minnesota provides scleral lenses to patients from Edina, Maple Grove, Wayzata, and Excelsior, Minnesota and surrounding communities.

If you wear glasses or contact lenses, you probably have some degree of astigmatism. But how much do you really know about this all-too-common refractive error?

Below, we answer some of the most frequently asked questions about astigmatism and explain why scleral contact lenses are often prescribed to astigmatic patients.

1. What is Astigmatism?

Astigmatism is a common refractive error caused by a cornea that isn’t perfectly spherical. The cornea is the outer front covering of the eye and is partially responsible for refracting light onto the retina. When the cornea is misshapen, it refracts light incorrectly, creating two focus points of light entering the eye. Since the light is no longer focused on the retina, it results in blurred vision at all distances.

2. What are the Symptoms of Astigmatism?

The main symptom of astigmatism is blurred vision, but it can also cause symptoms like:

• Objects appearing wavy or distorted
• Squinting
• Headaches
• Poor night vision
• Frequent eye strain

3. How Common is Astigmatism?

Astigmatism affects approximately 1 in 3 individuals around the world. Most people with myopia (nearsightedness) or hyperopia (farsightedness) also have some level of astigmatism.

4. What’s the Difference Between Astigmatism, Nearsightedness and Farsightedness?

Although all 3 of these refractive errors negatively affect visual clarity, they are caused by different mechanisms.

Astigmatism is a result of a non-spherical cornea, which causes two focal points and blurry vision. Myopia occurs when the corneal focusing power is too high and the light focuses in front of, instead of directly, on the retina. Hyperopia occurs when the corneal power is too weak, so the light rays focus behind the retina, not on it. Both myopia and hyperopia can occur with a spherical cornea.

5. How is Astigmatism Corrected?

In cases of mild to moderate astigmatism, the blurred vision can be easily corrected with prescription glasses or contact lenses. But for patients with high levels of astigmatism, standard contact lenses may not be an option. Toric contact lenses are a popular choice for patients with mild or moderate astigmatism due to their unique focusing features and oblong shape. Scleral contact lenses are suitable for moderate to severe astigmatism.

Refractive surgery is also an option, but comes with the risk of surgical complications.

6. Why Can’t Individuals With High Astigmatism Wear Standard Contact Lenses?

A highly astigmatic cornea has an irregularly shaped surface that isn’t compatible with standard soft contact lenses. Standard soft lenses are limited in the amount of astigmatism they can correct, as these lenses move around on the cornea due to the cornea’s irregular shape. This, in turn, reduces visual clarity and comfort.

Regular hard lenses can often correct astigmatism better than soft lenses, but they, too, have limitations: these lenses are smaller and may also move around too much.

7. Why are Scleral Lenses Ideal For Astigmatism?

Scleral contact lenses are customized to each patient. They have a larger diameter than standard lenses, and thus cover the entire front surface of the eye. These specialized rigid lenses gently rest on the white part of the eye (sclera) and don’t place any pressure on the sensitive cornea, making them suitable for even highly astigmatic eyes.

Furthermore, scleral contact lenses contain a nourishing reservoir of fluid that sits between the eye and the inside of the lens, providing the cornea with oxygen and hydration all day long. In fact, patients typically report that sclerals provide sharper vision than other types of contact lenses.

Have Astigmatism? We Can Help

If you’ve been told that you have astigmatism and that your current contacts or glasses just aren’t cutting it, ask your optometrist whether scleral contact lenses are right for you.

At Cornea and Contact Institute of Minnesota, we provide a wide range of eye care services, including custom scleral lens fittings and consultations. Our goal is to help all patients achieve crisp and comfortable vision, no matter their level of astigmatism or corneal shape.

To schedule your appointment or learn more about what we offer, call Cornea and Contact Institute of Minnesota today!

Cornea and Contact Institute of Minnesota serves patients from Edina, Maple Grove, Wayzata, and Excelsior, Minnesota and surrounding communities.

Q: Can a person outgrow astigmatism?

• A: About 20% of all babies are born with mild astigmatism, but only 1 of those 5 babies with astigmatism still have it by the age of 5 or 6, at which point it is unlikely to diminish or disappear. Astigmatism can continue to change and even progress as the child grows, but tends to stabilize at around age 25.

Q: Can eye surgery cause astigmatism?

• A: Yes. For example, cataract surgery may cause or worsen astigmatism as the surgeon makes a tiny incision in the cornea to replace the lens. During the healing process, the cornea may change its shape and lead astigmatism to develop.