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Frequently Asked Questions About Keratoconus

Welcome to our FAQ page, where we delve into some of the most frequently asked questions about keratoconus, shedding light on treatments such as Corneal Cross-Linking (CXL), corneal transplants, Scleral lenses, PROSE, EyePrint Pro, and more. This resource is designed to provide clarity and insight into various aspects of keratoconus treatments, helping you navigate your journey with informed confidence.

Keratoconus Specialists of Maryland, where we have been dedicated to providing expert care for individuals with keratoconus for over 40 years. Our practice is at the forefront of keratoconus treatment, offering a comprehensive range of services tailored to meet the unique needs of each patient.

With a deep understanding of the challenges faced by those with keratoconus, our team is committed to delivering the highest quality of care. We pride ourselves on our ability to restore hope and improve the vision of many patients who had previously felt hopeless about their condition. Our personalized approach ensures that every patient receives the best possible treatment, empowering them to achieve better vision and an enhanced quality of life.

We are proud to serve patients from across Maryland, including the cities of Annapolis, Baltimore, Bethesda, Columbia, Frederick, Glen Burnie, Hunt Valley, Owings Mills, Pikesville, Rockville, and Towson. We also welcome many patients traveling from Virginia, including Alexandria, Fairfax, Reston, Tysons, and Vienna, as well as from Pennsylvania, including Harrisburg, Hershey, Lancaster, and York.

FAQs about Keratoconus

What is Keratoconus?

Keratoconus is a progressive eye condition in which the normally round cornea thins and begins to bulge into a cone-like shape. This distortion causes vision to become blurry and distorted, as the irregularly shaped cornea prevents light from focusing correctly on the retina.

What are the symptoms of Keratoconus?

Symptoms of keratoconus typically include blurred vision, increased sensitivity to light and glare, eye redness or swelling, and frequent changes in eyeglass or contact lens prescriptions. As the condition progresses, vision may become increasingly distorted and blurry.

How is Keratoconus diagnosed?

Keratoconus is usually diagnosed through a comprehensive eye exam that includes a visual acuity test, slit-lamp examination, and corneal topography. Corneal topography maps the surface of the cornea, helping to detect the early signs of keratoconus.

What are the treatment options for Keratoconus?

Treatment for keratoconus varies depending on the severity of the condition. In the early stages, eyeglasses or soft contact lenses may be sufficient. As the condition progresses, treatments may include rigid gas permeable contact lenses, scleral lenses, corneal cross-linking (CXL), PROSE, EyePrint Pro, or in severe cases, corneal transplant surgery.

Can Keratoconus lead to blindness?

While keratoconus can significantly impact vision, it is rare for the condition to lead to complete blindness. However, without proper management and treatment, keratoconus can lead to severe visual impairment. Regular follow-ups with an eye care professional are crucial for monitoring the condition and maintaining optimal vision.

If I have keratoconus, can I wear contact lenses?

Yes! There are many types of contact lenses for keratoconus, including hard lenses, hybrid lenses, soft lenses, custom-soft lenses, scleral lenses, custom scleral lenses, EyePrint Pro, and PVR PROSE lenses. A proper evaluation is necessary to determine the best option for each individual.

Can you obtain 20/20 vision with keratoconus?

Yes, 20/20 vision is possible even with keratoconus with the right treatment and lenses.

Higher Order Aberrations (HOAs) and Keratoconus

What are Higher Order Aberrations (HOAs) in the context of Keratoconus?

Higher Order Aberrations (HOAs) are complex visual distortions that occur when light rays entering the eye are not focused properly. In keratoconus, the irregular shape of the cornea can cause significant HOAs, leading to symptoms such as glare, halos, starbursts, and blurred vision.

How do HOAs affect vision in individuals with Keratoconus?

HOAs can significantly impact the quality of vision in individuals with keratoconus. They can cause difficulties with night vision, reduce contrast sensitivity, and create visual disturbances that cannot be corrected with standard glasses or contact lenses.

Can HOAs be treated or minimized in patients with Keratoconus?

Yes, HOAs can be treated or minimized in patients with keratoconus through the use of specialty lenses such as scleral lenses, hybrid lenses, custom soft lenses, PVR PROSE, and EyePrint Pro. These lenses are designed to correct the irregular corneal shape and reduce the effects of HOAs, improving visual clarity and comfort.

How do specialty lenses help in reducing HOAs in Keratoconus?

Specialty lenses for keratoconus, such as scleral and hybrid lenses, provide a smooth refractive surface over the irregular cornea, effectively reducing the impact of HOAs. They create a tear-filled vault over the cornea, which neutralizes the irregularities and minimizes the higher-order aberrations, leading to clearer and more stable vision.

How are HOAs measured in patients with Keratoconus?

HOAs in patients with keratoconus are typically measured using wavefront aberrometry. This advanced diagnostic tool creates a detailed map of the eye’s optical system, capturing both lower-order aberrations (such as nearsightedness and astigmatism) and higher-order aberrations. The wavefront map helps eye care professionals understand the specific aberrations present and guides the customization of specialty lenses for optimal vision correction.

FAQs on Corneal Crosslinking (CXL) and Keratoconus

What is Corneal Cross-Linking (CXL)?

Corneal Cross-Linking (CXL) is a minimally invasive procedure used to strengthen the cornea in patients with keratoconus. The treatment involves applying riboflavin (vitamin B2) eye drops to the cornea and then exposing it to ultraviolet (UV) light. This process increases the collagen cross-linking within the cornea, making it more stable and less likely to continue bulging.

Who is a candidate for CXL?

Candidates for CXL are typically individuals with progressive keratoconus or those with corneal ectasia following refractive surgery. The ideal candidate is someone whose condition is worsening, as evidenced by changes in vision or corneal shape. An eye care professional can determine candidacy through a comprehensive eye exam and corneal imaging.

What are the benefits of CXL?

The primary benefit of CXL is its ability to halt the progression of keratoconus, reducing the likelihood of further vision loss. In some cases, CXL may also lead to a mild flattening of the cornea, which can improve vision and make contact lens fitting easier.

What is the recovery process like after CXL?

Recovery from CXL varies among individuals. Patients may experience mild discomfort, light sensitivity, and blurred vision for the first few days post-procedure. It’s important to follow the post-operative care instructions provided by your eye care professional, including the use of prescribed eye drops and avoiding rubbing the eyes. Vision may fluctuate for several weeks to months as the cornea heals.

Are there any risks associated with CXL?

As with any medical procedure, CXL carries some risks, though they are relatively rare. Potential risks include infection, corneal haze, and temporary or permanent changes in vision. It’s crucial to discuss the risks and benefits of CXL with your eye care professional to make an informed decision.

Does CXL Cross-linking cure keratoconus?

CXL Cross-linking does not cure keratoconus; it stops the progression of the condition. Many people still need treatments like scleral lenses or PVR PROSE after CXL Cross-linking.

Will I need lenses after CXL Cross-linking?

In many cases, lenses are needed after CXL Cross-linking to correct vision.

FAQs on Corneal Transplant and Keratoconus

What is a corneal transplant, and when is it considered for keratoconus?

A corneal transplant, also known as keratoplasty, is a surgical procedure that replaces part of the cornea with corneal tissue from a donor. For keratoconus, a corneal transplant should only be considered if there is a medical concern of the cornea rupturing. It should not be viewed as a means to achieve better vision. Before considering a major eye surgery, patients should consult with a specialist who is experienced in fitting scleral lenses, PROSE, and EyePrint Pro. A corneal transplant is a last resort for addressing medical needs, not for improving vision.

Do I need to get a corneal transplant for keratoconus?

Most often, no. A corneal transplant is usually only necessary when there’s a critical medical need, which is often not the case for keratoconus. Many patients can manage their condition effectively with other treatments, such as scleral lenses.

Are there different types of corneal transplants for keratoconus?

Yes, there are different types of corneal transplants, including penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK). PK involves replacing the entire thickness of the cornea, while DALK replaces only the front layers, preserving the patient’s own endothelium. The choice of procedure depends on the extent of corneal damage and the surgeon’s assessment.

What can I expect after a corneal transplant for keratoconus?

After a corneal transplant, patients can expect a recovery period that may last several months. Vision may initially be blurry and gradually improve over time. Regular follow-up visits with the surgeon are essential to monitor the healing process and to adjust any medications. It’s important to understand that a corneal transplant does not guarantee perfect vision, and many patients still require glasses or contact lenses for optimal vision.

What are the risks associated with corneal transplants for keratoconus?

As with any surgical procedure, corneal transplants carry risks, including rejection of the donor cornea, infection, glaucoma, cataracts, and issues with sutures. These risks are generally manageable with appropriate post-operative care and monitoring. Patients should discuss the potential risks and benefits with their surgeon before proceeding with the surgery.

Can I wear contact lenses after a corneal transplant for keratoconus?

Yes, many patients may still need to wear contact lenses after a corneal transplant to achieve the best possible vision. The type of lens and the fitting process may vary depending on the individual’s needs and the shape of the transplanted cornea. It’s important to work closely with an eye care professional experienced in fitting contact lenses post-transplant.

FAQs on Scleral Lenses and Keratoconus

What are scleral lenses and how do they work for keratoconus?

Scleral lenses are large, gas permeable contact lenses that rest on the white part of the eye (sclera) and vault over the cornea. They are custom-made to fit the unique shape of each individual’s eye and can improve visual acuity and comfort by providing a stable, even surface over the cornea. Scleral lenses help to correct visual distortions caused by keratoconus by refracting light onto the retina.

How do scleral lenses compare to traditional contact lenses or eyeglasses for people with keratoconus?

Scleral lenses are typically used to correct vision in people with irregular corneas, such as those with keratoconus. They provide more stable and comfortable vision than traditional contact lenses or eyeglasses by covering more of the eye and offering a custom fit.

Are scleral lenses comfortable to wear, and can they be worn for long periods of time?

Scleral lenses are generally considered to be comfortable to wear, especially when compared to traditional contact lenses. They are larger and cover more of the eye, which can make them more comfortable for people with certain types of eye conditions. However, comfort can vary from person to person.

How long do scleral lenses last and how often do they need to be replaced?

Scleral lenses typically last for about one to two years before they need to be replaced. The exact lifespan depends on how well they are cared for and the specific type of lens. Regular check-ups are important to ensure the lenses are still in good condition.

Can scleral lenses correct vision in both eyes at the same time?

Yes, scleral lenses are designed to correct vision in both eyes simultaneously. They cover the entire cornea and part of the sclera, allowing them to correct vision in both eyes.

FAQs on EyePrint Pro and Keratoconus

What is EyePrint Pro and how does it benefit those with Keratoconus?

EyePrint Pro is a highly specialized contact lens that is custom-molded to the exact shape of the wearer’s cornea and sclera. This customization provides an unparalleled fit, making it an excellent option for individuals with keratoconus. The precise fit can significantly improve comfort and vision by correcting irregularities in the corneal shape caused by keratoconus.

How is EyePrint Pro different from standard contact lenses?

Unlike standard contact lenses that come in a range of preset sizes and curvatures, EyePrint Pro lenses are designed from a precise impression of the individual’s eye. This method ensures that the lens mirrors the exact surface area of the eye, offering a unique fit that standard lenses cannot achieve, especially in cases of irregular corneas like those seen in keratoconus.

Who is a good candidate for EyePrint Pro lenses?

Individuals with keratoconus who have difficulty achieving adequate vision or comfort with traditional contact lenses may be excellent candidates for EyePrint Pro. This includes patients with highly irregular corneal surfaces or those who have not found success with other types of specialty lenses.

What is the process for getting fitted with EyePrint Pro lenses?

The fitting process for EyePrint Pro involves taking a detailed impression of the ocular surface, which is then used to create a 3D model of the eye. This model is utilized to manufacture a lens that matches the exact contours of the individual’s eye, ensuring a precise fit. The process is highly specialized and requires a practitioner trained in the EyePrint Pro system.

How do EyePrint Pro lenses improve vision for individuals with Keratoconus?

EyePrint Pro lenses improve vision by providing a smooth optical surface over the irregular cornea, allowing light to be focused more accurately on the retina. The custom fit also minimizes fluctuations in vision and discomfort, common issues with standard lenses in keratoconus patients, thereby offering potentially superior visual acuity and overall satisfaction.

FAQs on PROSE Lenses and Keratoconus

What are PROSE lenses and how do they work for Keratoconus?

PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) lenses are custom-designed scleral lenses that create a new, smooth optical surface over the irregular cornea characteristic of keratoconus. They work by vaulting over the cornea and resting on the sclera, filled with a saline solution that continuously bathes the eye, helping to improve vision and comfort.

How are PROSE lenses different from other contact lenses?

PROSE lenses are larger than standard contact lenses and are specifically designed to manage complex corneal conditions like keratoconus. They provide a unique combination of vision correction, protection, and healing of the ocular surface by creating a liquid reservoir that constantly hydrates the eye.

Who is a good candidate for PROSE lenses?

Good candidates for PROSE lenses are individuals with keratoconus who have not achieved satisfactory results with traditional contact lenses or glasses. PROSE lenses are particularly beneficial for those with severe corneal irregularities or those who experience discomfort with other types of lenses.

What is the fitting process for PROSE lenses?

The fitting process for PROSE lenses involves a comprehensive evaluation by a specially trained eye care professional. It includes detailed corneal mapping and imaging to design a lens that fits the unique contours of the patient’s eye. The process may require multiple visits to ensure the best possible fit and comfort.

What are the benefits of PROSE lenses for individuals with Keratoconus?

PROSE lenses offer several benefits for individuals with keratoconus, including improved visual acuity, reduced glare and light sensitivity, enhanced comfort, and protection of the cornea. They can also help to stabilize vision and slow the progression of the disease by providing a supportive environment for the eye.