Keratoconus is a progressive eye condition that affects the cornea, causing it to thin and bulge into a cone-like shape. This irregular shape disrupts light entering the eye, leading to distorted vision. For many individuals with keratoconus, glasses alone may no longer provide adequate vision correction. In such cases, contact lenses become an essential tool for improving clarity and comfort. But with various types of contact lenses available, it can be challenging to know which option is best suited for managing keratoconus. In this article, we’ll explore the different types of contact lenses available to individuals with keratoconus, highlighting the benefits and considerations of each option.
1. Rigid Gas Permeable (RGP) Lenses
Rigid gas permeable (RGP) lenses, also known as hard lenses, are often the first recommendation for individuals with keratoconus. These lenses are smaller in diameter than soft contact lenses, resting directly on the cornea. The smooth, rigid surface of RGP lenses helps to create a more uniform shape over the irregular cornea, improving the focusing of light on the retina.
One of the major benefits of RGP lenses is their ability to provide clear vision even in advanced stages of keratoconus. Because they maintain their shape on the cornea, they correct the irregularities caused by the disease, offering sharper vision compared to glasses or soft lenses. Additionally, RGP lenses allow for better oxygen permeability, ensuring that your eyes remain healthy and comfortable.
However, RGP lenses can take some time to adjust to, especially for individuals who are used to the softer feel of traditional contact lenses. They may initially feel more noticeable in the eye, and adapting to them can require a few weeks.
2. Scleral Lenses
Scleral lenses are a type of large-diameter RGP lens that vaults over the cornea, resting on the white part of the eye (the sclera). Scleral lenses are especially beneficial for individuals with keratoconus, as they provide superior comfort and vision correction by completely bypassing the irregularities of the cornea.
The primary advantage of scleral lenses is their ability to create a smooth surface over the cornea, allowing for optimal vision correction. These lenses are highly customizable to fit the unique shape and needs of the individual eye, which makes them an excellent option for those with advanced keratoconus. They also offer the benefit of a larger lens diameter, making them less likely to shift or move on the eye, providing more stability and comfort.
Furthermore, scleral lenses create a layer of fluid between the lens and the cornea, which helps to keep the eye hydrated and protected. This feature can be particularly beneficial for individuals with keratoconus who experience dry eye symptoms. Despite these benefits, scleral lenses tend to be more expensive and may require more maintenance than other types of lenses.
3. Hybrid Lenses
Hybrid contact lenses combine the best features of both soft and rigid gas permeable lenses. The center of a hybrid lens is made of rigid gas permeable material, which helps to correct the irregular cornea and provide clear vision. The outer skirt of the lens is made of a soft, flexible material that provides additional comfort and improves the overall fit.
For individuals with keratoconus, hybrid lenses offer a unique advantage by providing the clarity of rigid gas permeable lenses along with the comfort of soft lenses. Many people with keratoconus find hybrid lenses easier to wear than standard RGP lenses because they are less noticeable and offer a smoother feeling in the eye. The combination of rigid and soft materials also helps to reduce lens movement, enhancing stability and reducing discomfort.
However, hybrid lenses can be more challenging to fit than traditional lenses, and they require a high level of precision during the fitting process. For individuals who experience discomfort with other types of lenses, hybrid lenses can offer a viable alternative, though they may not be the best solution for every person with keratoconus.
4. Soft Lenses for Keratoconus
While soft contact lenses are typically not sufficient to correct vision in cases of keratoconus, there are specialized soft lenses designed for those with the condition. These lenses are often thicker and designed to help compensate for the irregular shape of the cornea.
Soft lenses for keratoconus do not provide the same level of vision correction as rigid lenses or scleral lenses. They are typically more comfortable and easier to adjust to, but they may not offer the sharp clarity that people with advanced keratoconus need. However, for individuals with early-stage keratoconus or those who have not yet developed severe distortion in their vision, specialized soft lenses can be an option.
5. Piggybacking (RGP with Soft Lens)
Piggybacking involves wearing a soft lens beneath a rigid gas permeable lens. The soft lens provides added comfort, while the RGP lens corrects the shape of the cornea and provides clearer vision. This combination can be particularly useful for individuals who need the clarity of RGP lenses but find them uncomfortable due to dryness or irritation.
This option is typically recommended for people with moderate to severe keratoconus, as the soft lens helps to cushion the rigid lens, offering a more comfortable fit. However, piggybacking requires careful fitting and attention to detail, as improper lens combinations can lead to discomfort or blurred vision.
6. Corneal Cross-Linking (CXL) and Lenses
Corneal cross-linking (CXL) is a treatment designed to strengthen the cornea and slow the progression of keratoconus. After undergoing CXL, some individuals may experience better tolerance to contact lenses, and their vision may improve. In such cases, the use of specialized lenses like scleral or RGP lenses may provide more effective correction, especially as the cornea becomes more stable.
CXL is not a lens option but can significantly complement the use of contact lenses in keratoconus management. For some, it may also reduce the need for more aggressive interventions, such as corneal transplants.
7. Consultation with an Eye Care Professional
Choosing the right contact lenses for keratoconus requires a professional fitting by an experienced eye care provider. Each person’s corneal shape is unique, and a thorough examination will ensure that the lenses selected are the best option for comfort, clarity, and eye health.
Your eye doctor will assess the stage of your keratoconus, the shape of your cornea, and any other contributing factors, such as dry eye or allergies. They will also help you navigate the process of adjusting to new lenses and may recommend different options if you experience discomfort with one type.
8. Considerations for Keratoconus Lens Wearers
While contact lenses are essential for managing keratoconus, it’s important to keep in mind that wearing them requires a commitment to proper lens care. Regular cleaning, maintenance, and replacement schedules are vital to ensure the lenses remain effective and comfortable. Additionally, those with keratoconus should monitor their eye health closely, as the condition can progress over time.
Maintaining regular follow-up appointments with your eye care professional is essential to track the progression of keratoconus and adjust lens prescriptions as necessary. Additionally, it’s crucial to keep in mind that not all lens options work for every individual, and it may take time to find the most suitable solution.
Conclusion
Contact lenses play a pivotal role in the management of keratoconus, offering significant improvements in vision and comfort. From rigid gas permeable and scleral lenses to hybrid and soft lens options, there are multiple choices to suit various stages of the condition and individual preferences. By consulting with an experienced eye care professional and maintaining a regular lens care routine, individuals with keratoconus can significantly enhance their quality of life, ensuring clear vision and comfort.
