Keratoconus Patient Fit Into Custom Scleral Lens

Keratoconus is a progressive eye condition that causes the cornea to thin and bulge into a cone-like shape, leading to distorted and blurred vision. Finding the right contact lens can be challenging, especially as the condition advances. At Insight Vision Optometry in Las Vegas, our specialty lens team works with keratoconus patients at every stage to find contact lens solutions that provide clear, comfortable vision.

What Are Hybrid Contact Lenses for Keratoconus?

Hybrid contact lenses combine a rigid gas permeable center with a soft lens skirt around the edges. The firm center provides crisp optics similar to a gas permeable lens, while the soft outer portion offers comfort similar to a standard soft contact lens. Hybrid lenses are one of several options available for keratoconus patients. While many patients do well with hybrids, some find that as their keratoconus progresses, hybrid lenses no longer provide an adequate fit or sufficient comfort.

When Is It Time to Switch to Scleral Lenses?

As keratoconus advances, the cornea becomes more irregular, making it harder for smaller lenses to fit properly. In these cases, scleral lenses are often the next step. Scleral lenses are large-diameter gas permeable lenses that vault completely over the cornea and rest on the sclera. Because they do not touch the corneal surface, scleral lenses are especially well-suited for patients with moderate to severe keratoconus.

Even when standard scleral lenses have been fitted successfully, changes in the corneal shape over time may require a new lens design. Patients with advanced keratoconus sometimes develop corneal scarring when the lens clearance is not adequate, and central corneal scars can cause significant vision loss. In severe cases, a corneal transplant may eventually be needed. This is why regular follow-up care and timely lens adjustments are essential.

How Custom Scleral Lenses Are Designed

For complex keratoconus cases, custom-designed scleral lenses offer the best combination of fit, comfort, and vision. The process begins with advanced 3D imaging of the eye’s surface, which captures the precise contours of both the cornea and sclera. This detailed map is then used by the laboratory to design and fabricate a lens that matches the patient’s unique eye shape.

Custom scleral lenses provide several advantages over standard designs for advanced keratoconus, including better centration on the eye, safer clearance over the cone, and improved overall comfort.

What Results Can Keratoconus Patients Expect?

One of our keratoconus patients had been wearing scleral lenses for several years after transitioning from hybrid lenses. As his condition progressed, his existing lenses were no longer fitting properly, and he began developing corneal scarring. His referring optometrist sent him to our practice promptly to address the issue and prevent further corneal damage.

After evaluating his eyes and discussing the available options, we proceeded with custom scleral lenses designed from 3D imaging. During the diagnostic fitting, he achieved 20/20 vision in each eye. This case highlights how timely intervention and advanced lens technology can help preserve both vision and corneal health in keratoconus patients.

Key Takeaways for Keratoconus Patients

• Keratoconus is a progressive condition, and your contact lens needs may change over time as the cornea changes shape.
• If your current lenses are uncomfortable or your vision has declined, it may be time for a new fitting rather than continuing with a suboptimal lens.
• Custom scleral lenses designed from 3D imaging can provide excellent vision and comfort even in advanced keratoconus.
• Regular follow-up appointments help detect changes early and prevent complications such as corneal scarring.
• If you notice sudden vision loss, severe eye pain, or significant worsening of your vision, seek immediate eye care.

Schedule a Keratoconus Consultation in Las Vegas

If you have keratoconus and are struggling with your current contact lenses, Insight Vision Optometry can help. Dr. Stephanie Woo, OD, FAAO, FSLS, Dr. Nathan Schramm, OD, FSLS, FBCLA, and Dr. Thanh Mai, OD, FSLS have extensive experience fitting scleral lenses for keratoconus patients with complex needs. Call 702-747-4070 or visit www.insightvisionlv.com to book your consultation.