What is keratoconus?
Keratoconus is a condition that causes the cornea, which is the front portion of the eye, to take on a cone-like shape, causing distortion that will make seeing much more difficult as the patient gets older. Typically conventional eyeglasses or contact lenses do not work because soft contact lenses will typically not fit the misshapen cornea correctly and glasses don’t address the severe problem with the shape of the cornea.
Is keratoconus caused by genetics?
Keratoconus is considered genetic, with the Latin population and Askenazi Jews being especially vulnerable. So, there is a genetic basis to it. On the other hand, people that rub their eyes with their knuckles can accelerate the thinning and warping of the cornea, potentially causing keratoconus. It usually starts at around age 18 to 20 years old, and progresses further as a person ages, usually halting at around age 40 to 45 years old. It tends to affect males more than females.
What benefits do scleral lenses have over standard contacts?
Certainly scleral lenses work much more efficiently than regular soft contact lenses for keratoconus. Soft lenses typically wrap around the cornea, so if the cornea is warped, the soft contact lens will become warped. In contrast, scleral lenses vault over the distorted cornea, bypassing its warped shape. This gives much better vision, as we like to say, “high definition vision.”
Can scleral lenses help anyone besides those with keratoconus?
Scleral lenses are very helpful for keratoconus patients, but they can also help individuals who have a high amount of astigmatism. It will also help the patient who has dry eye; Anybody with arthritis, Sjogren’s disease, any medical conditions that cause dry eye.
When wearing a scleral lens, you actually fill the lens with pure saline and as a result, it keeps the eye nice and moist.
Do you have any specialty lenses or technology in-office? Any certifications?
I’m certified by the AAOMC, the American Academy of Optometry & Myopia Control.
As for types of lenses, Zen lens by Bausch and Lomb and SynergEyes are the main scleral lenses that we use at the office.
The special equipment we use in our office would be a corneal topographer, which is an instrument that basically gives us an individualized “fingerprint” of your cornea, which will allow us to make a better custom design scleral lens for you. In addition, we have optical coherence. Tomography, or OCT. This takes an image of the contact lens on the eye, allowing us to further customize the lens once the lens is placed upon the patient’s eye.
What got you interested in fitting specialty lenses?
Early in my career, there were certain patients that had a much harder time because they couldn’t see well. Regular contact lenses and glasses didn’t work for them.
I did some research to help these patients, and found that treating them with certain specialty design lenses, such as scleral lenses, made a life-changing difference for them. They could see considerably better. Before, they weren’t able to drive, had difficulty reading or working on computers. Now they can do all that and more. It gave them a much better quality of life, and that was very rewarding personally to me.
Do you have any memorable stories of how you were able to help a patient with keratoconus?
We actually had a patient in the office just yesterday. Four or five years ago, her vision was horrible. She couldn’t wear glasses or contact lenses. And as a result, she could only get a job where she could walk or take the bus because her vision was so bad she couldn’t drive.
Over the last five years, we’ve treated her with scleral lenses, and she’s now the manager at a bank, driving to work every day. And her quality of life? She sees much better, and she’s able to be much more visually independent. All thanks to scleral lenses!
Any advice for a patient who’s looking for an eye doctor for scleral lenses?
Yes. A scleral lens consultation is a very intimate type of exam, which creates a very special type of bond between doctor and patient. During your consultation, you should look for a doctor who’s been working with these lenses, scleral lenses, for many years and who has access to different types of lenses.
Your doctor should understand your concerns, needs, wants and expectations. It’s very important that your personality as a patient and the doctor’s personality blend well because many of these patients become lifelong patients and you want to make sure you trust the doctor.