If you've been diagnosed with keratoconus, you may have noticed that your glasses or regular contact lenses no longer provide the clear vision they once did. You might experience blurry vision, ghosting, halos around lights, or frequent changes in your prescription.
The good news is that keratoconus doesn't necessarily mean you have to live with poor vision. Specialty contact lenses can often provide significant improvements in clarity and comfort, even when traditional glasses and soft contact lenses are no longer effective.
At Weston Contact Lens Institute, Dr. Elise Kramer specializes in fitting customized contact lenses for patients with keratoconus, including those with advanced or complex corneal conditions.
There are several types of contact lenses available, and the best option depends on the shape of your cornea, the severity of your keratoconus, your visual needs, and your comfort.
Let's explore the different options.
What Is Keratoconus?
Keratoconus is an eye condition in which the cornea, the clear front surface of your eye, gradually becomes thinner and develops an irregular, cone-like shape. Normally, the cornea has a smooth, rounded surface that helps focus light properly.
With keratoconus, the irregular shape causes light to scatter rather than focus clearly, resulting in distorted vision.
Common symptoms include:
- Blurry or distorted vision
- Ghosting or seeing multiple outlines around objects
- Increased sensitivity to light
- Halos and glare, especially at night
- Frequent changes in glasses prescriptions
- Difficulty achieving clear vision with regular contact lenses
Keratoconus often begins during adolescence or early adulthood and may progress over time. It commonly affects both eyes, although one eye may be more affected than the other.
Why Don't Regular Contact Lenses Work as Well?
Traditional soft contact lenses are designed to follow the shape of the cornea. When the cornea becomes irregular, these lenses may not adequately correct the resulting visual distortion.
Specialty contact lenses are designed to create a smoother optical surface, allowing light to focus more accurately and often providing significantly clearer vision.
What Are the Best Contact Lens Options for Keratoconus?
There are five main specialty contact lens options for patients with keratoconus:
1. Scleral Lenses
Scleral lenses are among the most versatile options for managing keratoconus, particularly when the cornea is highly irregular. Unlike traditional contact lenses that rest directly on the cornea, scleral lenses are larger lenses that vault over the cornea and rest on the sclera, the white part of your eye. Before insertion, the lens is filled with sterile, preservative-free saline, creating a fluid reservoir between the lens and the corneal surface.
This design offers several advantages:
- Clearer vision: The rigid optical surface helps correct irregular astigmatism and visual distortion.
- Improved comfort: The lens rests on the less-sensitive sclera rather than directly on the cornea.
- Stable vision: The larger design helps keep the lens centered and minimizes movement.
- Ocular surface protection: The fluid reservoir can be particularly beneficial for patients who also experience dry eye symptoms.
Scleral lenses can be effective for mild, moderate, and advanced keratoconus. Because they are larger than traditional contact lenses, insertion and removal require some practice. However, most patients become comfortable with the process after proper training.
For patients with especially complex eye shapes or those who have difficulty achieving an adequate fit with conventional scleral lenses, highly customized options such as EyePrintPRO may be considered. Learn more about scleral lenses.
2. Rigid Gas Permeable (RGP) Lenses
Rigid gas permeable lenses, also called RGP or corneal GP lenses, are smaller, firm contact lenses that rest directly on the cornea. Unlike traditional soft lenses, RGP lenses maintain their shape rather than conforming to the irregular corneal surface. This creates a smoother optical surface that can significantly improve vision in patients with keratoconus.
Benefits of RGP lenses include:
- Excellent visual clarity
- Effective correction of irregular astigmatism
- Smaller lens size
- Durable lens materials
However, because these lenses rest directly on the cornea, some patients experience initial discomfort or increased lens awareness. Patients with more advanced or highly irregular keratoconus may also experience lens instability or difficulty achieving a comfortable fit.
RGP lenses are often a good option for patients with mild to moderate keratoconus, although they can also be successfully fitted in selected more advanced cases. Specialized designs, such as Rose K lenses, are specifically developed for irregular corneas.
3. Hybrid Contact Lenses
Hybrid lenses combine features of both rigid and soft contact lenses. They have a rigid gas-permeable center surrounded by a soft outer skirt. The rigid center provides clear vision by correcting irregular astigmatism, while the soft outer portion helps improve comfort and lens stability.
Hybrid lenses may be a good option if:
- You need the visual clarity of an RGP lens.
- You find traditional RGP lenses uncomfortable.
- You prefer a lens that moves less on the eye.
- Your corneal shape is suitable for a hybrid design.
Hybrid lenses can work well for many patients with mild to moderate keratoconus and selected patients with more advanced disease. However, they require specialized fitting and careful handling.
At Weston Contact Lens Institute, we offer customized SynergEyes hybrid lenses, including designs developed for irregular corneas.
4. Piggyback Contact Lens Systems
A piggyback lens system involves wearing two contact lenses on the same eye. First, a soft contact lens is placed on the cornea. Then, a rigid gas-permeable lens is worn over it. The soft lens acts as a cushion, helping improve comfort while the rigid lens provides the optical correction needed for clearer vision.
This approach may be particularly helpful for patients who achieve excellent vision with RGP lenses but have difficulty tolerating them directly on the cornea.
Advantages include:
- Improved comfort for some RGP wearers
- Excellent visual correction from the rigid lens
- An alternative when other lens designs are not suitable
The main disadvantage is that patients must handle and care for two lenses per eye, which can make the daily routine more involved. Piggyback systems may also require additional monitoring to ensure adequate oxygen reaches the cornea. Although they are not usually the first option considered, they can be very effective for selected patients.
5. Custom Soft Contact Lenses
Not everyone with keratoconus needs a rigid contact lens.
For patients with early or mild keratoconus, specially designed soft contact lenses may provide a comfortable alternative. Unlike standard disposable soft lenses, custom soft lenses for keratoconus can be manufactured with specialized thickness profiles, optical designs, and parameters to accommodate irregular corneal shapes.
Potential benefits include:
- Familiar soft-lens comfort
- Easier insertion and removal
- Customized prescription options
- Improved vision compared with standard soft lenses in selected patients
However, because soft lenses still conform to the corneal surface to some degree, they may not correct significant irregular astigmatism as effectively as rigid or scleral lenses. Custom soft lenses are generally most appropriate for patients with mild keratoconus or those whose corneal irregularity this design can adequately correct.
Which Contact Lens Is Best for Your Keratoconus?
There is no single contact lens that is best for every patient with keratoconus. The ideal lens depends on several factors, including:
- The shape and steepness of your cornea
- The severity of your keratoconus
- Your prescription and visual needs
- Whether you also have dry eye or ocular surface disease
- Your comfort with different lens designs
- Your lifestyle and daily wearing requirements
The goal is to find a lens that provides the best possible combination of vision, comfort, stability, and long-term eye health.
Comparing Contact Lens Options for Keratoconus
These are general guidelines. The best lens is determined through a comprehensive specialty contact lens evaluation.
What Happens During a Keratoconus Contact Lens Fitting?
Fitting contact lenses for keratoconus is different from fitting traditional soft contact lenses.
Because every keratoconic cornea has a unique shape, specialty lenses require more detailed measurements and customization. At Weston Contact Lens Institute, your evaluation may include:
Corneal Topography
This technology creates a detailed map of the cornea, allowing us to evaluate its shape, curvature, and irregularities.
Advanced Ocular Surface Measurements
Additional imaging and measurement technologies may be used to evaluate the shape of the eye and guide the design of customized lenses.
Trial Lens Evaluation
Different lens designs may be evaluated to determine which provides the best combination of vision, comfort, and fit.
Customized Lens Adjustments
Specialty lenses can be modified to accommodate your unique eye shape. Adjustments may be needed to optimize the lens fit, vision, and comfort.
Insertion, Removal, and Care Training
Our team provides hands-on instruction to help you become confident handling and caring for your lenses at home.
Depending on the complexity of your eyes, achieving the ideal fit may require more than one visit or lens adjustment.
Can Contact Lenses Stop Keratoconus From Progressing?
This is an important distinction.
Contact lenses improve vision, but they do not stop keratoconus from progressing. Specialty lenses compensate for the irregular shape of the cornea, helping you see more clearly. However, if keratoconus is progressing, your eye care provider may recommend corneal collagen cross-linking.
Cross-linking is a procedure designed to strengthen the cornea and slow or halt further progression. Even after successful cross-linking, many patients continue to benefit from specialty contact lenses to achieve their best possible vision.
Regular monitoring is essential, especially in younger patients and those with documented progression.
Specialty Keratoconus Contact Lens Fittings at Weston Contact Lens Institute
A keratoconus diagnosis doesn't mean you have to settle for blurry or distorted vision. With advances in specialty contact lens technology, many patients can achieve significant improvements in visual clarity, comfort, and quality of life.
At Weston Contact Lens Institute, Dr. Elise Kramer specializes in fitting complex corneas using customized scleral lenses, EyePrintPRO, rigid gas-permeable lenses, hybrid lenses, and custom soft contact lenses. Our approach focuses on understanding your unique corneal shape and finding the lens design that best meets your visual and lifestyle needs.
We proudly welcome patients from across the United States and around the world who travel to our Weston and Miami locations for specialized keratoconus and complex contact lens care. If you're struggling with your current contact lenses or have recently been diagnosed with keratoconus, our team is here to help.
Schedule a keratoconus contact lens consultation at Weston Contact Lens Institute, or visit our Miami location.
