What a great question! There are many great options for patients with keratoconus.
Keratoconus is a non-inflammatory condition which results in thinning and bulging forward of the cornea (the clear part of the front of the eye). Because of this thinning, when light hits the cornea, even WITH glasses, light spreads out in irregular ways before hitting the retina (the back of the eye) to create an image.
We aren't sure why keratoconus occurs. Keratoconus
has been linked to genetics (many different genes play a part), eye rubbing, different systemic (body) diseases, and collagen and elastin-related conditions.
There are many options of contact lenses for keratoconus. But which contact lens is the best option?
Mild to moderate forms of keratoconus that do not have corneal scarring can possibly achieve good vision with special soft contact lenses for keratoconus. Regular soft contact lenses that you can purchase anywhere are generally not effective and will give you the same vision as your glasses. These soft contact lenses are made with a thick soft plastic material to try and "fill in" the irregularities on the cornea to create sharper vision.
Moderate to advanced forms of keratoconus usually benefit from a contact lens made of a rigid plastic material (rigid-gas-permeable). This means that although the material is rigid or "hard" to the touch, it allows "gas" (oxygen etc) through the lens. This means that oxygen will still nourish the cornea throughout the day!
The rigid materials are special for those with keratoconus and are probably the best material to use because they create a "new" corneal surface that takes away the irregularities that make your vision worse with keratoconus.
These rigid materials are made into contact lenses called RGP (rigid gas permeable) lenses, which are small diameter (usually 8mm to 11 mm) lenses. These lenses sit on the front of your eye and move when you blink. They are easy to insert and remove.
The rigid material can also be made into both hybrid and scleral lenses. Hybrid lenses are a rigid material in the center with a soft contact lens "skirt" surrounding this material. These lenses provide more comfort.
Scleral lenses are a large-diameter lens (around 14 to 22 mm) that is made out of a rigid gas permeable material. This is filled with a sterile saline solution prior to inserting the lens on the eye. This provides not only great sharp vision, but good comfort, and the added bonus of managing dry eye because of the saline solution prior to insertion. These are the #1 lens now recommended for advanced cases of keratoconus.
When you come for a consultation at our office we will look at high-level scans of your eye, take photographs, and discuss what would be the best option for you to both see your best and be able to wear lenses all day.