When Scleral Lenses are Better than Other Contact Lenses for Keratoconus

The contact lens type most utilized by people with keratoconus is the Rigid Gas Permeable (RGP) lens. Due to the usual astigmatism in conjunction with nearsightedness caused by keratoconus, “soft” contact lenses are not sufficient to correct vision. According to the National Keratoconus Foundation, around one in every 2,000 people has keratoconus, but the prevalence is far higher in certain global regions. Since keratoconus as a cornea disorder can also cause cornea pain and persistent “dry eyes”, not everyone who needs corrective eyewear can utilize RGP contact lenses.

Reasons to utilize scleral contact lenses instead of eyeglasses or RGP contact lenses are described below, as well as keratoconus-afflicted people for whom scleral lenses are contraindicated. The staff of the Precision Keratoconus Center can aid you in learning about your corrective lens (and surgical) options as a person diagnosed with keratoconus.

What is the Difference Between RGP Contact Lenses and Scleral Contact Lenses?

Both “soft” contact lenses and RGP (“hard”) contact lenses rest on the cornea of your eye. For this reason, the learning curve to insert them correctly in the eye is relatively short for most adults. However, cornea pain can preclude wearing RGP contact lenses for more than a brief time period (and this can interfere with performing your job duties as a keratoconus-afflicted adult with distorted eyesight).

In contrast to RGP contact lenses, scleral contact lenses rest on the white (sclera) of the eye. Therefore, scleral contact lenses can be worn by many keratoconus-afflicted people with cornea pain. Eyeglasses are an alternative option for corrective eyewear, but scleral contact lenses also are recognized as helpful for keratoconus-afflicted people with persistent “dry eyes”. This is because scleral contact lenses have liquid reservoirs that minimizes “dry eye” symptoms, as described in an article in 2019 in Optometry Times.

A research article in Clinical Optometry in 2018 reported scleral contact lens prescriptions linked to specific eye disorders at the following percentages:

  • Cornea irregularity (74 percent of all prescriptions);
  • Ocular surface disease (16 percent of all prescriptions);
  • Uncomplicated refractive error (10 percent of all prescriptions)

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Benefits of Utilizing RGP Contact Lenses

Adolescence and young adulthood are the developmental periods when keratoconus is typically diagnosed. Since progressively worsening vision until age 40 often occurs in people with keratoconus, wearing either eyeglasses or contact lenses is usually necessary. Preparing to graduate from college and begin a professional career can necessitate attention to overall interview appearance. In turn, wearing contact lenses (such as RGP contact lenses) can increase the confidence in professional appearance of a young adult with keratoconus on a job interview – as compared to wearing the larger scleral contact lenses.

Can Young Adults Utilize RGP Contact Lenses or Scleral Contact Lenses Safely?

If you are the parent of a 20-25 year-old offspring with worsening vision and keratoconus, you probably know if your son or daughter is capable of caring for contact lenses in a way that does not promote infection. For anyone who does not adhere to proper storage and cleaning of contact lenses (RGP contact lenses or any other type), developing an infection in the eye is a risk.

Engaging in athletic activities (such as playing volleyball with friends) may make wearing eyeglasses less desirable to a college student or young adult. Therefore, RGP contact lenses may be preferable during the athletic activity. However, ensuring that the RGP contact lenses do not fall out (or the eyes injured) is imperative for a keratoconus-afflicted person engaged in recreational athletic activities. This is equally the case for the utilization of scleral contact lenses.

An infection in the eye can lead to corneal scarring, and this can lead to cornea pain (or worsen cornea pain) in a person with keratoconus. Therefore, it is extremely important for any keratoconus-afflicted person to avoid enabling an eye infection to occur through improper care of contact lenses. Avoidance of eye-rubbing is also advisable in people living with keratoconus, as this can damage corneal tissue and result in – or increase – cornea pain (per the American Academy of Ophthalmology). Scheduling an appointment at the Precision Keratoconus Center is a good idea if either you or your offspring have been diagnosed with keratoconus.

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