Special contact lenses are usually the first keratoconus treatment of choice. Keratoconus is a disease of the eye in which the cornea (the front clear part of the eye) does not maintain its dome-like structure. This smooth and regular dome of the cornea (and the tear layer that covers it) is the first surface that light interacts with when it reaches the eye. It is crucial that this surface be regular and smooth for the light to be focused properly on the retina for good vision. The word “kerato” refers to the cornea while “conus” refers to the cone like shape made by the cornea as it ceases to maintain its smooth dome-like shape.
This disruption, or “cone,” on the corneal surface causes distortion of the vision. And, because this distortion occurs at the corneal surface, it cannot be corrected with glasses as they sit in front of the corneal surface. So, the goal in keratoconus treatment is to restore the smooth corneal surface. The most effective keratoconus treatment in most stages is specialty contact lens therapy. By using a specialty designed contact lens that vaults over the disrupted cornea and creates a new smooth surface, great improvements in vision can be obtained.
Keratoconus treatment may also include surgical treatment including corneal transplant in some advanced cases if the corneal stability has deteriorated to a point at which keratoconus treatment with contact lenses or other means is no longer possible. However, in a study by Smiddy et al in 1988 (reviewed by Worp 2010), 69 percent of patients referred for corneal surgery were found to be successfully fit with special contact lenses without surgery.
There have been a number of advances in keratoconus treatment in recent years. With the increased breathability and other design improvements to scleral contact lenses for keratoconus, wearers are more comfortable and able to wear contact lenses more hours per day than ever before. Another particularly exciting keratoconus treatment is called corneal collagen cross linking. This procedure has been used for some years overseas but is still in clinical trials in the United States (update, this corneal cross-linking for keratoconus treatment has been approved by the FDA as of August 2016). However, it has the potential to slow down or stop the rate of corneal change by using a combination of Riboflavin drops activated by UV light to stabilize the corneal structure.
Specialty Contact Lenses for Other Conditions
In addition to keratoconus treatment, contact lenses are used to treat a number of other eye conditions. These include: dry eye syndrome (often secondary to Sjogrens syndrome), corneal dystrophies and disorders such as pellucid marginal degeneration, and in cases where a corneal transplant or refractive surgery complication has caused an irregular cornea. In many cases your vision or medical insurance will cover some or all of the cost of keratoconus treatment or other medically necessary contact lens fittings. Please do not hesitate to contact our office with any questions.