Keratoconus

photo of keratoconic corneaKeratoconus is a progressive condition where the cornea at the front of the eye stretches into a distorted cone shape, causing blurred vision due to irregular astigmatism. Keratoconus often first appears in the teens or twenties. It often progresses for 10-20 years and then stabilises, although everyone is different. The cause is not fully understood but it does appear to be associated with allergies and excessive eye-rubbing, and also there is likely to be a genetic (hereditary) component.

In early keratoconus, vision changes may be mistaken for regular astigmatism, and glasses or soft contact lenses may still provide good vision. A surgical procedure called corneal cross-linking (CXL), using riboflavin, may be used to slow down progression. However if keratoconus progresses the best way to provide clear vision is with a custom made Rigid Gas Permeable (RGP) contact lens, designed especially for keratoconus.

graft300Ultimately a corneal graft (transplant) may need to be considered but this is usually a last resort. Many keratoconus patients achieve good vision for many years using custom RGP contact lenses, without ever needing a corneal graft.  Anyone who has been diagnosed with keratoconus should strictly avoid eye rubbing.

If you’ve been diagnosed with keratoconus it’s natural to feel concerned but you don’t have to be fearful of ‘going blind’. Even though there is no “cure” for keratoconus, the right eyecare and expertise can usually provide you with a lifetime of good useful vision.

At Custom Eyecare (formerly known as Marketown Optical) in Newcastle NSW, we use the Medmont E300 corneal topographer – the most accurate model on the market today – which provides a very detailed “contour map” of the cornea necessary for accurate customised keratoconus RGP contact lens fitting. This allows us to select the most appropriate type of lens for your eyes, meaning the best possible vision and wearing comfort. This also applies to RGP contact lens fittings for other reasons besides keratoconus, for example astigmatism, pellucid marginal degeneration (PMD), dry eye, or corneal scarring.

Keratoconus contact lens fitting at Custom Eyecare involves an initial baseline eye examination in our Darby Street practice where we check the overall health of your eyes, measure your vision, and give you a recommendation of your best vision correction option (glasses, soft lenses, or custom rigid lenses).

If you proceed to rigid lens (RGP) fitting then we go on to take more detailed measurements specially for this. We often assess several pairs of ‘trial’ lenses on your eyes before ordering your own custom made rigid lenses. Commonly, even your custom made lenses need to be modified or ‘tweaked’ after trying them out, and this is covered by your lens warranty. It’s normal for keratoconus lens fitting to involve a number of visits in order to achieve a good lens fit, and this is covered by your contact lens fitting fees, which are payable at the time of ordering your lenses.

Types of contact lenses used for keratoconus fitting include designs such as: Rose K, Rose K2, Capricornia KBA, Capricornia Epicon, ACL Kera, Gelflex Keracon, Synergeyes ClearKone & UltimateHealth, Capricornia ICD (KATT), Gelfex Mini-scleral, and various others. The best type of lens for an individual patient depends on how advanced the keratoconus is, and on the shape and type of cone in each eye.

In 2014, new research showed that if you have keratoconus, up to 50% of your close family members may also have suspicious corneal changes, detectable by topography. Early detection & awareness of keratoconus in family members means better, more customised eyecare and better outcomes.

At Custom Eyecare we also offer mini-scleral contact lenses, probably the most comfortable type of rigid lenses available in the world, for keratoconus and as also a ‘troubleshooter’ lens for other eye conditions. Mini-sclerals can also be used for people with irregular corneas due to failed LASIK eye surgery, scarring, pellucid marginal degeneration (PMD), corneal grafts etc, and even for treatment of severe dry eye. They’re not cheap, but if you’re looking for a very comfortable lens or a more stable fit, a miniscleral contact lens fitting could be the answer.

A lovely patient of ours, Janna Seysener, wrote a poem describing her own first-hand experience with keratoconus and she has kindly allowed us to share it here.

If you know, or even suspect, that you have keratoconus or a related condition we are happy to welcome you to our practice for an initial consultation and a discussion of your various options.

Contact us to arrange your keratoconus assessment and comprehensive eye & vision check.

For more information on keratoconus, or to read about the latest treatment options and developments, take a look at http://www.keratoconusaustralia.com.au/