ABOUT KERATOCONUS - Options Available

What are the treatment options if you have just been diagnosed with keratoconus?

Spectacles
Contact Lenses
Intracorneal Rings
Cross-linking (CXL)
Corneal grafting

Spectacles

If your keratoconus is mild and/or is not progressing, then you may be happy wearing spectacles. If spectacles do not provide you with satisfactory vision other options may need to be considered.

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Contact lenses

Contact lenses are the next obvious choice as they reduce the majority of visual distortions caused by the keratoconus. In the early stages, “normal” soft lenses may give satisfactory vision however, if these cannot correct your vision, then contact lenses specifically designed to correct keratoconus are available.

Many optometrists will fit Rigid Gas Permeable lenses (RGPs) as these can mask the distortions produced by the distorted cornea. However, many keratoconics also have sensitive eyes and RGPs can be uncomfortable, especially at first.

Other contact lens options are:

Specialist soft lenses such as KeraSoft^®3 which can also correct high levels of astigmatism.

Piggy-backing – i.e. fitting an RGP over the top of a thin soft lens and Intra-limbal RGPs – larger than normal RGP lenses.

Hybrid – lenses with an RGP centre bonded to a soft “skirt”.

Scleral lenses – these are very large lenses covering the sclera (the white of the eye) as well as the cornea.

UltraVision also supply RGP lenses for Keratoconus:

McGuire™ Fitting System

This system provides lenses of differing optical zones based on cone advancement. The trial sets are categorised by the rate of flattening of the peripheral areas and the relevant diameters.

ALK™ Fitting System

This system was developed in conjunction with Alex Levit FCOptom and comprises a relatively small trial set of 24 lenses which are individually designed according to keratoconus classification. The lenses have a larger overall diameter than other conventional keratoconic designs.

Xtralens™ for Post graft fittings

The Xtralens™ Post-graft RGP lens is designed using the successful Xtralens™ standard range to vault corneal distortions using a large diameter. The lens is stabilised using positive lid attachment and good tear exchange is ensured with a transition-less ski edge.

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Intracorneal Rings

These are plastic semi circular inserts that are placed by a surgeon within the body of the cornea. They act to reshape and flatten the cornea. Often they do not give a great improvement in vision but they can significantly reduce the effect of the aberrations that cause multiple images and ghosting.

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Cross-linking (CXL)

This is a relatively new surgical procedure. It involves a one time application of riboflavin to the corneal surface (the corneal surface is sometimes scratched to allow better absorption of the drops) and then irradiation for around 30 minutes with ultraviolet light.

This procedure appears to strengthen the collagen fibres within the body of the cornea (stroma) thus increasing the cornea’s mechanical strength.

Many surgeons are now combining this procedure with intracorneal rings and the combination seems so far to be successful in reducing the progression of the condition.

Click here for further information.

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Corneal grafting

If the cornea becomes very thin and/or scarred, a corneal transplant may be the only option to restore vision. Around 10% of keratoconics go on to require such grafting.

More information on RNIB website

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