Scleral Lenses for Irregular Corneas: Managing Conditions Like Keratoconus and Astigmatism

Your cornea is the clear, dome-shaped front part of your eye that helps focus light. In a healthy eye, the cornea has a smooth, regular shape. However, some people develop irregularities in the corneal curvature, leading to vision problems.
 

Common Eye Conditions

Irregular corneas can be caused by a variety of eye conditions, including:

• Keratoconus: This progressive condition causes the cornea to thin and bulge into a cone-like shape, resulting in significant astigmatism and blurred vision.
• Corneal Scarring: Scarring on the cornea, often due to injury or infection, can disrupt its smooth surface and cause irregular astigmatism.
• Pellucid Marginal Degeneration: This rare condition causes the lower portion of the cornea to thin, leading to irregular astigmatism and distorted vision.
• Post-LASIK Ectasia: In some cases, LASIK eye surgery can weaken the cornea, causing it to bulge and become irregularly shaped.

Dealing with irregular corneas can be challenging, but advancements in scleral lens technology have provided a solution for many individuals.
 

What are Scleral Lenses and How Do They Work?

Scleral lenses are a type of rigid gas-permeable (RGP) contact lens that are designed to cover the entire cornea and extend onto the white part of the eye, known as the sclera. Unlike traditional contact lenses that rest on the cornea, scleral lenses create a liquid-filled space between the lens and the eye, providing a smooth, uniform surface for light to pass through. Here's how scleral lenses work to correct vision problems caused by irregular corneas:
 

• Vaulting the Cornea: Scleral lenses are designed to "vault" over the irregular corneal surface, creating a smooth, uniform optical surface that corrects vision.
• Fluid-Filled Lens-Cornea Relationship: The space between the scleral lens and the cornea is filled with saline solution, which helps to neutralize the corneal irregularities and provide clear, comfortable vision.
• Stable Lens Positioning: Scleral lenses are larger in diameter than the cornea, resting on the sclera and providing a stable, secure fit that helps maintain the desired optical correction.

By addressing the unique challenges posed by irregular corneas, scleral lenses have become an increasingly popular and effective solution for managing various eye conditions.
 

Managing Keratoconus with Scleral Lenses

Keratoconus is one of the most common eye conditions that can benefit from scleral lens treatment. As the cornea thins and bulges into a cone-like shape, traditional contact lenses often become uncomfortable and ineffective. Scleral lenses are designed to vault over the irregular cornea, providing a smooth, uniform surface for light to pass through. This helps to correct the significant astigmatism and distortion caused by keratoconus, resulting in clearer, more comfortable vision.
 

In addition to improving visual acuity, scleral lenses can also help protect the cornea in individuals with keratoconus. By resting on the sclera and avoiding direct contact with the cornea, scleral lenses can help prevent further corneal damage and progression of the condition.
 

Treating Astigmatism with Scleral Lenses

Astigmatism is a common refractive error that can be caused by an irregularly shaped cornea. Traditional contact lenses and eyeglasses may struggle to effectively correct astigmatism, particularly in cases where the corneal irregularity is more pronounced. Scleral lenses, however, are uniquely suited to address astigmatism by providing a smooth, uniform optical surface. The fluid-filled space between the scleral lens and the cornea helps to neutralize the corneal irregularities, resulting in clear, undistorted vision.
 

In addition to correcting astigmatism, scleral lenses can also help to stabilize the position of the lens on the eye, ensuring that the desired optical correction is maintained throughout the day. This can be particularly beneficial for individuals with high degrees of astigmatism, who may experience significant fluctuations in their vision with other lens types.
 

By addressing the root cause of the astigmatism, scleral lenses can provide a highly effective and long-lasting solution for individuals struggling with this common vision problem.
 

The Fitting Process for Scleral Lenses

Fitting scleral lenses requires a specialized approach and expertise from your eye care provider. The process typically involves the following steps:

• Comprehensive Eye Examination: Your eye doctor will perform a thorough examination of your eyes, including measurements of the corneal curvature, eye shape, and tear film quality.
• Scleral Lens Evaluation: Your eye doctor will use specialized equipment, such as corneal topography and optical coherence tomography (OCT), to precisely map the contours of your eye and determine the optimal scleral lens design.
• Lens Selection and Customization: Based on the information gathered during the evaluation, your eye doctor will select the appropriate scleral lens parameters and customize the lens to fit your unique eye shape and vision needs.
• Lens Fitting and Adjustment: During the initial fitting, your eye doctor will carefully place the scleral lens on your eye and make any necessary adjustments to ensure a comfortable, stable, and effective fit.
• Wear and Follow-up: You'll be instructed on how to properly insert, remove, and care for your scleral lenses, and you'll have regular follow-up appointments to monitor your progress and make any necessary adjustments.

The scleral lens fitting process may require multiple visits and adjustments to achieve the optimal fit and vision correction. However, with the expertise of a qualified eye care provider, you can expect a comfortable, customized solution that addresses your unique vision needs.
 

Are Scleral Lenses Right for You?

Whether you're struggling with the effects of keratoconus, dealing with the aftermath of corneal surgery, or simply have high degrees of astigmatism, scleral lenses may be the answer you've been searching for. By working with your optometrist, you can explore the benefits of scleral lens technology and take the first step towards regaining control of your vision.
 

If you're ready to explore the life-changing benefits of scleral lenses, schedule a consultation with Evolutionary Eye Care. We are dedicated to providing personalized, cutting-edge solutions for even the most complex vision challenges. Visit our office in Webster, Texas, or call (346) 486-6700 to take the first step towards clearer, more comfortable vision and a higher quality of life today.