One of the biggest challenges keratoconus patients talk about is finding the right contact lens fit – one that proves comfortable. At this time, there is no cure for keratoconus and available treatment options focus on halting the progression of the disease, rather than reversing its effects.
For many diagnosed with keratoconus, the best way to correct their vision impairment is through contact lenses. While there are many contact lens designs, there isn’t one design that works for everyone. This presents a unique problem for patients when trying to find lenses that fit well and improve their vision. In addition, now that the FDA has approved corneal cross-linking to halt the progression of keratoconus, many patients also have questions about the fit of their specialty lenses post-procedure.
In a recent chat, Dr. Peter Hersh of the Cornea & Laser Eye Institute and Dr. Ken Beckman of Comprehensive Eyecare of Central Ohio answered common questions associated with corneal cross-linking, scleral lenses, and night vision.
After undergoing cross-linking, can patients still wear specialty lenses?
Dr. Hersh: Yes. We usually get patients refit with the proper specialty contact lens one month after the procedure.
If a patient undergoes corneal cross-linking, what is the recovery process like?
Dr. Beckman: Typically, the patient will have a soft contact applied immediately after the procedure as a bandage. This will stay in place until the epithelium heals, which may be between one day and one week. The eye will be scratchy and irritated for that time until the epithelium heals, but the contact reduces this significantly. The patient does not have many restrictions after the procedure. The first few days are just limited by comfort and vision. Being that the patient is not wearing their pre-op contacts for at least one week, they may have trouble due to their refractive error, unless they can see well in glasses. From an activity standpoint, they really have no restrictions.
People with keratoconus often have problems with night vision. Do you have any suggestions for coping with challenges seeing at night?
Dr. Beckman: The night driving issues are typically due to the high refractive error and distortion of the cornea. The patients need to optimize their vision in general, with glasses or contacts. Anti-reflective coating on glasses may help, as may certain tints, but this is very subjective for each patient.
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