Search Results for: keratoconus

Ever wonder what modalities other independent eye care professionals are prescribing for keratoconus patients?

Or, how often keratoconus patients are experiencing annoyances with their contact lenses?

Curious about:

• How often a keratoconus patient switches contact lens brands?
• What percentage of independent eye care professionals are interested in offering products only available to independent eye care professionals?

Ten Facts about Managing Keratoconus Patients provides information from three different market research studies and shares best practices from other independent eye care professionals.

“My patient is thrilled with the improved comfort of UltraHealth. He achieves 20/25, reports no foreign body issues and is able to wear the lens 14 hours per day without days off for “irritation”. His new comfort rating is a 5!”

Susan A. Resnick, O.D., F.A.A.O.
Farkas, Kassalow, Resnick and Assoc.
New York, New York

UltraHealth Case Study

By S. Barry Eiden, OD, FAAO – For many years most practitioners promoted the concept that virtually all patients who suffered from keratoconus would require contact lens correction utilizing rigid corneal lenses. Without a doubt rigid corneal lenses provide excellent visual outcomes based on their ability to “mask” corneal irregularity in the disease. However, clinicians realize that their overall success in managing keratoconus has been limited in many cases by numerous issues, of which #1 would be poor comfort and lens wearing tolerance.

A recent study evaluated the relative performance of a keratoconic hybrid lens design and corneal rigid gas permeable (RGP) lenses. The researchers evaluated a number of performance indicators at a 2-month point following lens dispense to 40 subjects. Results indicated that there was no significant difference in visual acuity measurements between the hybrid and RGP, however a number of other key performance indicators were found to show a difference in performance. The hybrid lens design demonstrated superiority in overall vision-related quality of life based on the NEI Visual Functioning Questionnaire 25 (P<0.001), comfort (P<0.001) and foreign body sensation (P<0.013). Regarding lens tolerance, the hybrid lens demonstrated borderline superiority (P<0.085).

The purpose of this research review was not to suggest that any one particular contact lens design is superior to others in the management of keratoconus. The intent was to demonstrate that an array of lens designs is now available to address the vision needs of these patients including corneal gas permeable lenses, intralimbal lenses, scleral lenses, piggyback or tandem systems, soft keratoconic lenses and hybrid keratoconic lenses. Each design has specific and often unique attributes that can address challenges faced by our keratoconic patients. We as contact lens practitioners with special interest and experience in treating the disease need to understand when specific contact lens designs are most appropriate for an individual patient.

Hashemi E, Shaygan N, Asqari S, Rezvan F, Asqari S . ClearKone-SynergEyes or Rigid Gas Permeable Contact Lenses in Keratoconic Patients: A Clinical Decision. Eye & Contact Lens. 2014 March 40(2): 95-8.

Source: Contact Lens Spectrum-Contact Lens Today Newsletter, March 30, 2014

Keratoconus eye disease is characterized by thinning and steepening of the cornea. The cornea is the front surface of the eye and the most important focusing element of the vision system. In patients who have keratoconus their cornea is cone shaped. The name keratoconus is derived from the Greek word for cornea (‘kerato’) and cone shaped (‘conus’). Keratoconus results in visual distortion often not correctable by traditional glasses. The thinning and steepening of the cornea causes the front surface to become progressively more irregular in shape. The corneal surface irregularity is what induces the distortion and blurriness of vision experienced in keratoconus.

Keratoconus Conical Cornea

Keratoconus is found in approximately one in two thousand individuals, and as such can be considered a relatively common eye disease. New, more sensitive diagnostic techniques will likely increase the prevalence rates of keratoconus found in future studies. There is strong evidence that keratoconus has a genetic basis. Though studies have shown variable rates of keratoconus among family members of patients with the disease, it is felt that significant genetic components do exist. There is virtually no gender predilection in keratoconus with equal incidence in males and females. Typically keratoconus is initially diagnosed just after puberty and can progress through the third to fourth decade of life, however individual cases can present at any age and progress throughout life. Keratoconus most often is found in both eyes, but commonly more advanced in one versus the other. Cases of true unilateral (one eye only) keratoconus do exist, however they are the rare exception to the rule.

Commonly reported risk factors for keratoconus include: atopic allergic disease (when someone is highly sensitive to allergens), especially a history of eye allergies, and vigorous eye rubbing. The severity of the disease is quite variable. Some cases develop only to a mild stage and do not progress further. Patients with this form of the disease often can achieve adequate vision correction with the use of glasses or soft contact lenses. Other cases may progress significantly and result in dramatic distortion of vision which requires treatment with specialized contact lenses (typically rigid gas permeable, hybrid, or scleral lenses). The most advanced cases of keratoconus can develop corneal scaring and require surgical corneal transplantation. New medical technologies such as collagen corneal cross-linking with riboflavin hold promise for controlling progressive cases of keratoconus and aid in keratoconus treatment.

Author: S. Barry Eiden, OD, FAAO

President and Medical Director of North Suburban Vision Consultants, Ltd.

Website: http://www.nsvc.com

EyeVis Eye and Vision Research Institute

Immediate Past Chair of the Contact Lens and Cornea Section of the American Optometric Association