Keratoconus: How Scleral Lenses Can Help You Avoid Surgery
Typically, keratoconus begins in the late teens or early twenties and can progress over the next 10 to 20 years before slowing or stabilizing. It usually affects both eyes but often impacts each eye differently.
If you have Keratoconus and are exploring treatment options, Manhattan Vision Associates in New York City offers practical ways to manage it at every stage. Here’s what you need to know.
What is Keratoconus?
Keratoconus (keh-rah-toe-cone-us) is a progressive eye condition in which the cornea—the clear, dome-shaped front surface of the eye—gradually weakens, thins, and bulges outward into a cone-like shape.
This cone-shaped cornea causes light entering the eye to scatter or focus improperly, leading to blurred, distorted, or double vision, as well as increased sensitivity to light, halos, and streaks around lights, and frequent changes in vision prescriptions.
A comprehensive eye exam is necessary for diagnosis. At Manhattan Vision Associates, Dr. Arkady Selenow evaluates the shape and thickness of your cornea to identify early signs of keratoconus.
The Causes of Keratoconus
Your cornea is held in place by tiny collagen fibers. When they are weakened, they cannot preserve the spherical dome-like shape of your cornea. The exact cause of keratoconus, however, is still unknown.
Weakened corneal tissue tends to occur in individuals with a genetic predisposition, which is why keratoconus may affect multiple family members. It has been linked to risk factors like:
- Excessive eye rubbing
- Genetics and family history
- Eye rubbing
- Oxidative damage
- Underlying health conditions
- Excessive exposure to UV rays
- Difficulty wearing contact lenses
- Certain eye injuries
- Retinitis pigmentosa
- Marfan syndrome
- Ehlers-Danlos syndrome
Keratoconus Symptoms
As the shape of your cornea begins to bulge, it affects your eyesight. Your normally smooth corneal surface becomes wavy and expands. This causes astigmatism or myopia. The condition typically starts in one eye and later develops in the other eye as well.
Early-stage symptoms may include:
- Mild blurred vision
- Slightly distorted vision (straight lines appear bent or wavy)
- Some sensitivity to light and glare
- Red-eye and/or swelling
- Chronically irritated eyes
In later stages, symptoms may worsen and include:
- Increased blurred and distorted vision
- Nearsightedness or irregular astigmatism
- Inability to wear regular contact lenses
As keratoconus progresses, vision prescriptions may change frequently. If lenses are not properly fitted, they can rub against the weakened cornea, leading to scarring and exacerbating symptoms.
Keratoconus Treatments in New York City
Managing keratoconus depends on the stage and severity of the condition. While eyeglasses or soft contact lenses may be enough in the early stages, many patients eventually need more advanced solutions to maintain visual clarity. Below are the primary treatment options for keratoconus:
Eyeglasses & Standard Soft Contact Lenses
Eyeglasses or soft contact lenses may work in mild cases by correcting basic refractive errors. However, as the cornea becomes more irregular, these options often no longer provide clear vision.
Specialized Contact Lens Solutions
As the condition progresses, specialized contact lenses help with vision correction by creating a smoother surface for light to focus properly. Options include:
- Rigid Gas Permeable (RGP) Lenses: These maintain a firm shape to correct vision and visual distortion.
- Scleral Contact Lenses: These lenses vault over the cornea and sit on the sclera, providing a fluid-filled barrier for enhanced comfort and clarity.
- Custom Soft Contact Lenses: Designed for mild to moderate cases to enhance comfort and vision.
- Piggyback Contact Lenses: A soft lens is placed under a rigid lens for better comfort.
- Hybrid Contact Lenses: These lenses feature a rigid center and a soft outer ring, offering both clarity and comfort.
Surgical & Medical Interventions
When keratoconus progresses beyond what special contact lenses can manage, surgery or medical treatments may be necessary. These treatments help protect vision and stabilize the cornea. They aim to strengthen the cornea, improve its shape, or replace it completely. The choice depends on the severity of the condition.
- Corneal Collagen Cross-Linking (CXL): A non-surgical method that uses UV light and vitamin B2 drops to strengthen the cornea and prevent further bulging.
- Intracorneal Ring Segments (ICRS or Intacs): Small implants inserted into the cornea to flatten its shape and improve vision.
- Corneal Transplant Surgery (Keratoplasty): In severe cases, a cornea transplant may replace the damaged cornea with healthy donor tissue. After surgery, glasses or contact lenses may still be necessary.
How Scleral Lenses at Manhattan Vision Associates Help Keratoconus Patients
Scleral lenses have become a trusted option for people with keratoconus who wish to avoid surgery and enhance their day-to-day vision.
Comfort, Clarity, and Corneal Protection
Scleral lenses are large-diameter lenses that rest on the sclera and arch over the cornea without touching it. This creates a stable, smooth surface and protects the sensitive cornea from friction and external irritants. A fluid reservoir located between the lens and cornea helps keep the eye hydrated and reduces inflammation.
Patients who find traditional lenses uncomfortable often report that scleral lenses feel natural and easy to wear for long periods. Their stable position also reduces daily fluctuations in vision.
Reducing the Need for Surgery
A study of patients with severe keratoconus found that over 75% avoided corneal transplant surgery simply by wearing scleral lenses. These lenses reduce scar formation and irritation by eliminating contact with the cornea, providing a practical and non-invasive approach to managing advanced cases.
Expert Fitting Makes the Difference
Fitting scleral lenses requires skill and attention to detail. At Manhattan Vision Associates, our eye doctors carefully map the unique shape of each patient’s eye. This ensures a secure and comfortable fit that provides the best vision improvement.
Find Relief from Keratoconus with Personalized Eye Care in New York City
Living with keratoconus doesn’t mean you have to settle for constant discomfort or unpredictable vision. At Manhattan Vision Associates, we provide real solutions. Our expertly fitted scleral lenses can help you regain your vision without the need for surgery.
Whether your condition is just beginning or you’re navigating more advanced keratoconus symptoms, our team is here to guide you through your treatment options. We’re proud to serve individuals and families throughout New York City with thorough care and one-on-one support.
