Lenses for Keratoconus and Dry Eye

Dr. DeCarlo has advanced training in fitting specialty contact lenses for Keratoconus like Scleral lenses and the NovaKone soft lens. Traditional RGP contact lenses are uncomfortable and in some cases unhealthy. The increased comfort and health benefits from Scleral lenses is greatly appreciated by Keratoconus patients.

Keratoconus is a progressive disease of the eye in which your cornea thins and gradually bulges outward into a cone shape. The cornea is the window of the eye and with keratoconus the cornea becomes irregular and cone like which distorts vision that eye glasses or traditional soft lenses can’t correct. A well fit NovaKone soft lens or Scleral RGP vaults over the cornea and offers a smooth optical surface along with excellent vision and comfort.

These lenses are more comfortable and healthier than a corneal RGP lens which can touch and rub on the apex of the corneal cone. This ‘apical touch’ of a traditional RGP lens causes discomfort, pain, scarring and decreased vision. Increase your corneal health and comfort with the NovaKone soft lens or a Scleral RGP contact lens. Scleral contact lenses are also an excellent treatment for Dry Eye.

This FAQ guide will help you understand Keratoconus.

Keratoconus  is a bilateral progressive disease of the cornea which presents with localized thinning and protrusion of corneal tissue which is referred to as a ‘cone’. Subclinical forms may be entirely symptom free and difficult to detect by traditional diagnostic methods; however, more advanced forms are commonly associated with rapid and symptomatic visual changes and prominent tissue irregularity, with end stage disease resulting in a potential need for corneal transplantation.

Keratoconus hydrops is most commonly seen in people with advanced Keratoconus. Edema can cause severe corneal opacification, which can lead to the advanced Keratoconus that causes corneal hydrops. Additionally, it mostly occurs from a break in Descemet’s membrane because of the weakened cornea. Afterward, this weakened cornea becomes a source of sudden and painful decrease in visual acuity.

Keratoconus has four stages, and its treatment on every stage is different.

  1. Early Stage: The early-stage Keratoconus can be simply treated with glasses and toric soft contact lenses.
  2. Mid Stage: Due to the irregularity of the cornea causing blurred vision specialty contact lenses need to be fit for best vision.
  3. Mid Late: Same as Mid Stage.
  4. Late Stage: The last stage, Keratoconus, is treated by replacing the affected corneal tissue with healthy donor corneal tissue, commonly referred to as a Corneal Translant.

No. Keratoconus is a progressive disease. There is a surgical procedure called Corneal Cross Linking which can stop or slow the progression of the disease but does not normalize the cornea. The irregular shape of the cornea will continue to be after Corneal Cross Linking surgery but the progression of the disease should be halted saving the patient from a possible Corneal Transplant later in life. Research continues on the possibility of laser surgery after Corneal Cross Linking to normalize the shape of the cornea.

No, Keratoconus cannot cause permanent blindness. However, without proper correction with specialty contact lenses the patient will not obtain functional vision. 

Experiencing headaches is common with Keratoconus. Keratoconus causes blur and eye strain which can cause headaches. Dry Eye can also occur since the irregularity of the cornea can prevent tears from spreading on the surface of the cornea evenly. 

The early symptoms of Keratoconus are blurry vision or progressively poor vision. This blurry vision cannot easily correct naturally, and patients sometimes remain unaware of this disease.

The following are the symptoms of Keratoconus:

  • Headache
  • Glare and halos around lights
  • Blurry night vision
  • Eye irritation
  • Increased sensitivity to bright light
  • Sudden worsening

The following may increase the risk of developing Keratoconus:

  • Genetics: The patient DNA sometimes contains the cells that activate the Keratoconus because of the family history of Keratoconus.

Similar patients have a high risk of developing Keratoconus at a younger age.

  • Chronic Eye Inflammation: Inflammation from allergies can contribute to the destruction of corneal tissue that may result in developing Keratoconus.
  • Eye Rubbing: Rubbing eye can be a cause of constant progression of Keratoconus and also associated with developing Keratoconus.
  • Age: In general, Keratoconus is discovered in the teenage years, and younger patients with advanced Keratoconus require surgical intervention to stop the progression of this disease.

An Optometrist with modern technological medical equipment is qualified to treatment and diagnose Keratoconus. After a complete medical history and performing some preliminary eye tests, your Optometrist may perform some of the following tests to diagnose Keratoconus:

  1. Corneal Topography: It is known to be the most suitable way to diagnose Keratoconus at an early stage.  A computerized image is taken that clarifies the curves of the cornea.
  2. Slit-lamp exam: The outer and middle layers of the cornea can contain some abnormalities, and the Slit-Lamp examination can help detect them.
  3. Pachymetry: Locating the thinnest areas of the cornea can be a crucial part, and this test is a great help identifying these areas.

Keratoconus has been studied for decades, and enhanced technology with state-of-the-art medical equipment helped us understand the causes of Keratoconus. It’s believed that the predisposition to develop Keratoconus is present at birth. However, the definitive cause of Keratoconus is still unknown, but a common finding in Keratoconus is the loss of collagen in the cornea. Additionally, Keratoconus may be caused by some imbalance between production and destruction of the corneal tissue by the corneal cells.

Keratoconus can also result in dry eyes. Your corneas rely on a healthy tear layer to stay hydrated and healthy themselves. The irregularity of the cornea can interfere with the even spreading of tears over the cornea leaving dry spots on the cornea. This dryness can cause additional blur, eye strain, discomfort and pain.

Corneal Cross Linking is a surgical procedure that strengthens the cornea and stops or slows the progression of Keratoconus. The irregularity of the Keratoconic Cornea will not be normalized with Corneal Cross Linking but with the progression of the disease stopped it can save the patient the need for a Corneal Transplant later in life.
Michael P. DeCarlo, O.D.
DeCarlo Optometry Placentia
1428 N Kraemer Blvd
Placentia CA 92870
Phone: (714) 996-1136
Cell: (562) 881-2454