Treatment Glasses & Contact Lenses In the early stages especially, the visual dysfunction of keratoconus can be managed with glasses and contact lenses. However, glasses and soft contact lenses are unable to correct irregular astigmatism. Beyond soft contact lenses, options include hybrid, corneal gas-permeable, and scleral lenses.20 These lenses should be fit by experienced professionals, … Continued
Risk Factors Keratoconus is a multifactorial disease. The literature has identified several important influences on its development. Genetics Keratoconus is a complex degenerative, genetically heterogeneous disorder with a sporadic distribution. Anywhere from 5-23% of keratoconus patients report a positive family history. The condition can follow an autosomal dominant or recessive inheritance pattern. In autosomal dominance, … Continued
Various-Cone-Shapes-Topography Epidemiology The most frequently cited prevalence data for keratoconus is 54.4 per 100,000; however, these numbers date back to 1935-1982. Today, studies estimate the prevalence to be 245 per 100,000. This estimated fivefold rise is likely due to the increase in corneal imaging technology now available for diagnosis. Keratoconus affects both genders; while some … Continued
Acute-Corneal-Hydrops The irregular astigmatism in keratoconus can make refraction difficult. Retinoscopy in these patients may show scissoring of the retinal reflex. Keratometry will show distorted mires and corneal steepening.4 Maximum keratometry values of 45.00 D indicate mild keratoconus. Values between 45.00-52.00 are suggestive of moderate disease and those above 52.00 D signal an advanced stage. … Continued
Apical-Corneal-Scarring
Armoring the Cone: Innovation in the Treatment of Keratoconus Keratoconus is a non-infectious, non-inflammatory disease of the cornea, causing thinning and protrusion of the stroma. The word keratoconus comes from the Greek words kerato (cornea) and conos (cone); it accurately describes the conical shape that the cornea assumes with this condition. Keratoconus is the most … Continued
Conclusion As an eye care professional, you play an important role in helping patients navigate the ever-evolving world of contact lenses. With the latest advancements in materials, fitting techniques, and lens designs, you have the tools to serve patients of all ages effectively. Asking the right questions helps you uncover what truly matters to each … Continued
Here are some general troubleshooting tips that may be helpful when different scenarios arise: Lastly, it’s important to know when to quit. Some patients are simply not able to adapt to multifocal or monovision contact lenses, or they are unwilling to put in the time and effort to fully adapt to them. A friendly but … Continued
Practical Steps A thorough consultation with the patient can help guide the contact lens fitter to the right type of lens material and design. Accurate measurements of corneal shape and pupil size will help ensure the lenses perform well. During the fitting, fine-tuning the prescription with over-refraction can help determine the best vision correction. It’s … Continued
Truncation This stabilization technique involves cutting off a part of the lens, typically between 0.75 and 1.5 mm. The amount removed depends on the lens size, with larger lenses requiring more truncation than smaller ones. Trimming off the lower part of the lens allows it to rest against the lower eyelid, preventing rotation and providing … Continued
Segment Designs (Translating or Alternating Image) Segment design contact lenses, also commonly referred to as translating designs or alternating image designs, somewhat mimic the way traditional bifocal glasses work. These lenses have two distinct zones, one for distance vision at the top and one for near vision at the bottom. As the wearer shifts their … Continued
Simultaneous Vision Contact lenses for the correction of presbyopia can be categorized under two main designs: simultaneous and segmented. Simultaneous vision is designed to provide both near and distance vision at the same time by allowing light from both distances to enter the eye simultaneously. The brain then sorts through these multiple focal points, deciding … Continued
Generation Z (Born 1997 – 2012) Gen Z’s, all aged 25 or younger, have never known a world without the internet, smartphones, and social media. They’re tech-savvy, socially conscious, and have an entrepreneurial spirit. This generation’s healthcare perspective is thought to be heavily influenced by the COVID-19 pandemic since this occurred while this group was … Continued
Baby Boomers (Born 1946 – 1964) Baby Boomers, the generation that grew up in the post-war era as the American economy was “booming,” make up a significant portion of today’s presbyopic population. Having driven many societal and cultural changes throughout their lives, Boomers are known for being hard-workers, economically prosperous, and introducing new digital technology … Continued
Cataract Cataracts are a natural part of aging for many people, as the eye’s lens becomes cloudy over time, making it blurry or dull. While cataract surgery is the most common and effective way to restore clear vision, many patients with early-stage cataracts may still wear contact lenses for as long as possible before deciding … Continued
Tear Film Dry eyes are more prevalent in older adults, with reports of tear dysfunction increasing particularly from age 40 to age 80. Patients over 40 with tear dysfunction commonly have an unstable tear film (de Paiva 2017). As we age, the tear film becomes less stable, mainly because of changes in the oily layer … Continued
Corneal Sensitivity Studies show the cornea becomes less sensitive to touch in older adults (Nosch 2023). The inner layer of the cornea called the endothelium, controls the hydration of the corneal tissue and facilitates the exchange of nutrients and waste with the fluid inside the eye. The average corneal endothelial cell population decreases from approximately … Continued