Terry, in my left eye I wear a simple disposable contact. That eye has super easy slight correction and no kerataconus or stigmatism. My right eye is a hot mess with both stigmatized and kerataconus that I have been told takes the lenses as Maddog2020 describes to fix. I went to the skirted lense two years ago thinking that was going to be a great opportunity for more comfort and still correcting vision over my gas permeable versions. I think the sclera lense Maddog describes us newer technology and I will discuss with my optometrist about. As far as extended wear I’ve never used them and don’t know if they are an option that would work for my right eye (and I do a lot of computer work that tends to create less blinking and dries out lenses).
The bottom line is I’m going to discuss all the above at my appointment this Monday and try to get the best/most comfortable vision I can for 2020 (every pun intended!!
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This is kind of long, but this is to give folks an understanding of what these guys are dealing with:
Not a lot of doctors fit scleral lenses, it’s kind of a specialty thing. Just wanted to warn you.
The really frustrating thing about Keratoconus is that when the cornea gets to the “hot mess” stage, glasses just aren’t that useful and getting a good prescription is sort of a process after contacts are fit.
For those that don’t have it, keratoconus is a progressive disease of the cornea where there is an isolated area of thinning which causes the pressure behind the cornea to push that area out (like pushing a balloon with your finger from the inside) with the result being an elevated “cone” on the front of the eye that both distorts the vision, creates some irregular astigmatism AND makes glasses largely useless.
The process is that you do the eye exam which gets you a ballpark prescription (sometimes it‘a a tee ball size park, sometimes it’s Wrigley Field) and the curvature of the eye. Someone equipped to manage it will utilize a corneal topographer that makes a detailed elevation map of the front of the eye that measures all of the irregularity and most importantly, the elevation of the “cone” that keratoconus causes and then a lab custom designs a lens based on that map.
After the lens comes in, it’s put on the eye and evaluated for how it fits (if it pushes too much on that cone, it’ll actually make it worse) and then you do another prescription with the contact on which might be totally different and you then add those numbers to the original contact lens! You generally go through a few lenses as you refine the fit and prescription.
How the lenses work (and why soft ones don’t work) is that the rigid lens sits making very light contact with the tip of the cone “vaulting” the rest of the cornea. Tears fill in that space between the lens and the cornea creating a much more regular optical surface and allows the image that usually hits the cornea and just scatters to focus more precisely and therefore correctable.
Most middle aged or older keratoconus patients wear both those expensive contacts AND glasses over them because once you make the eye correctable, you then have to deal with the normal “over 40’s” issue of not being able to read close any longer. Most of the time, I’ll end up with those custom lenses AND a pair of progressive lenses. It’s an expensive proposition no matter how you slice it, but damn it, a man HAS to be able to see!
Really everything involved in the process is a hot mess. The cornea, the vision, the process, the cost involved...the works.
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Topic: UPDATE PG. 3 Eye glass wearers/bifocal/single script lens question (Read 3207 times)
