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Scleral Lenses for Astigmatism

Scleral lenses are a great nonsurgical solution that provides exceptional vision correction in patients with astigmatism, whether by birth, due to post-refractive surgery, or other corneal procedures. Astigmatism is a refractive error caused by irregular corneal curvature, resulting in blurred and distorted vision. Scleral lenses allow astigmatic patients to experience improved visual acuity and comfort while keeping eyes hydrated all day.

If you have been told that your astigmatism is too severe to wear contacts, ask our optometric team about scleral contact lenses. At the The Scleral Lens and Keratoconus Center at Loudoun Eye Associates in Ashburn, we work hard to give each patient a superior contact lens fit and know that these lenses can truly make a difference in our patients’ lives.

What is Astigmatism

Histoplasmosis Retinopathy ThumbnailAstigmatism is a common type of refractive error caused by an irregularly shaped cornea. The abnormal cornea causes light to enter unequally onto the retina, which results in blurred or distorted vision, eye strain, headaches, squinting and eye irritation. People are either born with this condition or can develop it later in life.

This condition typically occurs with myopia (nearsightedness) or hyperopia (farsightedness) and can be easily diagnosed using a simple eye exam.

Astigmatism falls into three categories:

  • Myopic (nearsighted) astigmatism: For the myopic, light rays focus in front of the retina, leading objects in the distance to appear blurred. Myopic people who have astigmatism experience further blurring and vision distortion due to the refractive error caused by mismatched curvatures of the cornea or lens.
  • Hyperopic (farsighted) astigmatism: For the farsighted, light focuses beyond the retina. Individuals with hyperopia and astigmatism experience blurred and distorted vision and have difficulty focusing on objects that are up close.
  • Mixed astigmatism: In people with mixed astigmatism, one curvature of the cornea or lens focuses light to the front of the retina while the other focuses light to the back of the retina.

Astigmatism falls into the regular or irregular camp:

Most cases of astigmatism are regular, meaning that the front surface of the eye is oval-shaped. Irregular astigmatism is often caused by scarring of the cornea, keratoconus or from certain types of eye surgeries.

Can People With Astigmatism Wear Contact Lenses?

In cases of moderate to severe astigmatism, sometimes the distortion is too severe to be compensated for properly by soft contact lenses, which simply conform to the irregular shape of the cornea. Scleral lenses, on the other hand, sit on the sclera – not the cornea. They are rigid and maintain their shape regardless of the corneal dimensions. This allows the eye to properly focus light and thus ensures the sharp vision and exceptional comfort. The liquid reservoir that gets trapped underneath the scleral lens masks corneal astigmatism and ensures a stable fit.

What are Scleral Lenses?

Scleral lenses get their name from the way they fit on the eye. The sclera is the white part of the eye, and these lenses rest on the sclera while the lens itself vaults over the cornea.

Scleral lenses have become an important therapeutic strategy in the visual rehabilitation of patients with irregular corneas, such as astigmatism. The liquid reservoir between the lens and the cornea neutralizes astigmatism and provides a continuous moist environment that protects the cornea from exposure to air and friction from blinking.

Scleral lenses offer better comfort, breathability and improved visual acuity due to their rigid optical surface and a shape designed specifically for each patient’s eye. We have found that for our patients with astigmatism, scleral lenses have proven to be the best solution in providing sharp and comfortable vision all day long.

eye doctor, scleral lens on the finger

Are Scleral Lenses for Astigmatism Expensive?

Scleral lenses are custom-fit to each eye, and though the fees for fitting scleral and the cost of the lenses are higher than traditional lenses, their life span and benefits offset the costs.

Coverage rates and restrictions vary among providers, and if considered a medical necessity, many insurance companies will cover the cost of scleral lenses. That said, every country and state has its own restrictions and regulations. Consult with our eye care team at the The Scleral Lens and Keratoconus Center at Loudoun Eye Associates to discuss your specific payment options and cost of scleral lenses.

Specialized optometrists, such as our optometric team, are trained in fitting scleral lenses for excellent, effective vision correction, and help patients with astigmatism and other corneal irregularities enjoy great vision and comfort with specialty lenses.

TESTIMONIAL:

“ I went to the The Scleral Lens and Keratoconus Center at Loudoun Eye Associates for my astigmatism, and I’m so grateful to the staff and doctors for their thorough care! They meticulously fitted me for scleral lenses, and now I can not only see well, but I tend to forget I’m wearing lenses. They’re so very comfortable! “

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Specialty Contact Lenses For Presbyopia

As we get older our vision starts to change. Between the ages of 40 and 50, almost all people develop presbyopia (age-related farsightedness), which makes nearby objects appear blurry.

Reading glasses used to be the only option for contact lens wearers with presbyopia who wanted to perform tasks that require good near vision such as reading a book or menu.

Nowadays, several specialty contact lenses offer patients with presbyopia clear near and distance vision for ultimate visual comfort and convenience.

Contact Lenses for the Farsighted

Monovision

This is a vision correction technique in which the contact lens in one eye corrects for distance vision and the other eye for near vision. Basically, each lens has a different prescription.

Scleral Lenses

Scleral contacts are large-diameter gas-permeable contact lenses that vault over the entire corneal surface and rest on the white part of the eye (sclera) instead of the cornea.

Scleral contacts can also be designed as multifocal contacts for presbyopic patients to correct both farsightedness and nearsightedness. When compared to regular multifocal lenses, scleral lenses are firmly positioned on the eye, offering substantially better stability and comfort.

Multifocal

Patients who wear multifocal contact lenses are able to see at all distances without sacrificing depth perception. Those who participate in outdoor activities, use the computer regularly or don’t like using reading glasses to view their smartphone, tablet, or newspaper might consider multifocal contact lenses.

There are two basic types of multifocal contact lenses: simultaneous vision design and segmented vision design.

1. Simultaneous vision design – Concentric rings of distant and near powers encircle a primary viewing zone in the lens’s center. The central viewing zone is typically used to view distant things, although there are also center-near designs. Under other circumstances, the dominant eye is fitted with a center-distance design, whereas the non-dominant eye is fitted with a center-near design. These multifocal contacts are similar to concentric multifocal lenses, but instead of discrete rings of distance and near power encircling the lens’s center, the multifocal lens power gradually changes from distance to near (or near to distant) from the lens’s center to the periphery. Aspheric multifocal contact lenses are similar to progressive eyeglass lenses in this way.

2. Segmented vision designs – Bifocal and trifocal eyeglass lenses have a similar design to segmented multifocal contact lenses. The upper and center zones of the lens feature a zone for distant vision, while the lower half of the lens has a zone for near vision. A noticeable line in the lenses separates the distant and near zones.

These contact lenses are made of rigid gas permeable (GP) contact lens material. These lenses have a smaller diameter than soft contact lenses and rest above the edge of the lower eyelid on a layer of tears. A segmented multifocal contact lens stays in place as your look shifts downward for reading or seeing close objects, allowing you to see through the lower, near-correction part of the lens.

Rigid gas-permeable (RGP)

RGP contact lenses are composed of rigid silicone polymers that allow oxygen to pass through the cornea. Unlike soft contact lenses, they hold their shape and can often provide clearer vision than soft lenses.

Orthokeratology

Orthokeratology, also called ‘ortho-k’ lenses, are lenses that are worn overnight to reshape the cornea. Ortho-k can be used to correct both eyes for distance vision and be used as monovision and multifocal vision.

If you have presbyopia and are looking into your contact lens options, contact The Scleral Lens and Keratoconus Center at Loudoun Eye Associates to learn more about which specialty contact lenses are right for you.

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Treating Ocular Surface Disease with Scleral Lenses

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Treating Ocular Surface Disease with Scleral Lenses

Ocular surface disease (OSD) is not a single disease. It is a group of eye disorders that affect the surface of the eye. It can significantly affect your eyesight and quality of life. Many cases of ocular surface disease are misdiagnosed a simply ‘dry eyes’, so this condition can go undiagnosed and therefore untreated.

Fortunately, scleral lenses, which are custom-fit and lubricate the eye’s surface, can provide the relief and comfort people with OSD seek.

What are the Causes and Symptoms of Ocular Surface Disease?

Your tear film is controlled by various tissues and glands around the surface of your eyes. If there is a problem with those glands or tissues, it can cause your tear film to become unstable, resulting in dry eye syndrome or other types of ocular surface disorders.

A stable tear film keeps eyes moist, protects them against infection and cleans the surface of your cornea.

When your tear film is unstable, symptoms can include:

  • Redness
  • Watery eyes
  • Blurry vision
  • Gritty or scratchy feeling in the eye
  • Itching
  • Pain

Ocular surface disease symptoms are usually worse in the evening. They can also be exacerbated by windy conditions or a dry climate.

Types of Ocular Surface Disease

Some of the most common types of ocular surface disease include:

  • Dry eye syndrome
  • Blepharitis
  • Meibomian gland dysfunction
  • Allergies
  • Keratitis
  • Conjunctivitis
  • Immunological conditions (e.g. Sjogren’s syndrome)
  • Chemical or thermal burns

Treatment With Scleral Lenses

Depending on the type of condition, treatment can range from artificial tears (dry eye) to antihistamines (allergies), but many people continue to experience dry, itchy, irritated eyes. Eventually, many patients with ocular surface disease seek out more durable methods of treatment.

In recent years, scleral lenses have become a preferred treatment option for patients with ocular surface problems.

While they are generally used to treat refractive errors and corneal irregularities, scleral lenses can also provide immense relief to patients with ocular surface disease.

Scleral lenses do three things simultaneously: they protect the eye, they provide vision correction, and they serve a therapeutic purpose by lubricating the eye. Scleral lenses decrease discomfort, pain, itchiness and eye redness while providing sharp, clear vision.

These customized lenses form a dome over the cornea and rest on the sclera (the white part of the eye). The zone between the lens and the cornea provides a continuous moist environment that protects the cornea and provides relief for those with ocular surface disease.

At The Scleral Lens and Keratoconus Center at Loudoun Eye Associates, we regularly diagnose, treat and manage the different types of ocular surface disease to help patients experience clear, healthy vision again. Our our optometric team has the experience and proven treatment options you need to find relief from OSD.

If you have OSD and are interested in scleral lenses, The Scleral Lens and Keratoconus Center at Loudoun Eye Associates can help. our optometric team is specialized in fitting scleral lenses for dry eyes and other corneal conditions.

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Scleral Lenses for Athletes

Clear and comfortable vision is vital in sports—it can make a huge difference to optimizing your game-time performance. Fortunately, scleral lenses offer a way for athletes who need corrective eyewear to achieve their goals, even in contact sports like basketball, football and hockey.

Scleral lenses are custom-fit contact lenses for people with corneal irregularities, hard-to-fit eyes and severe dry eye syndrome, among other conditions. They provide comfort and offer sharp vision on and off the playing field.

Scleral lenses are extremely stable on the eye, as they vault over the cornea and rest on the sclera. Moreover, the reservoir of saline solution between the back surface of the lens and the front of the cornea ensures that the eye remains moist all day long. Furthermore, the lenses’ highly breathable gas permeable material ensures that plenty of oxygen reaches the front of the eye.

What Kind Of Athletes Wear Scleral Lenses?

Scleral lenses benefit athletes who find wearing traditional contact lenses challenging or impossible, and/or who have any of the following eye conditions:

  • Astigmatism
  • Dry eye syndrome
  • Presbyopia
  • Keratoconus
  • Post-refractive surgery (i.e. LASIK, PRK)
  • Giant papillary conjunctivitis (GPC)

Scleral Lenses for Athletes with Keratoconus

Keratoconus is an eye condition in which the cornea thins and weakens over time. This causes a cone-like bulge to develop and an irregular-shaped cornea. Keratoconus can result in increased sensitivity to light, distorted vision, slightly blurred vision and even significant vision loss. Professional athletes diagnosed with keratoconus often worry that the condition could end their career.

Scleral lenses are a long-term solution that helps athletes with keratoconus to continue to perform at their peak with amazing vision. Just ask professional athletes Brandon Williams from the Baltimore Ravens, Steph Curry from the Golden State Warriors, or Diamond DeShields from the Chicago Sky. These star athletes all wear scleral contact lenses and can now show off their true sporting prowess due to their sharp vision.

Do Scleral Lenses Work For All Sports?

When fitted correctly, the edges of these customized lenses fit comfortably under the eyelids, which prevents them from easily falling out. Moreover, because of their stability and extreme comfort, they offer an added advantage for athletes who engage in contact or extreme sports or those with rapid movements, such as in:

  • Basketball
  • Baseball
  • Football
  • Gymnastics
  • Hiking
  • Hockey
  • Rock Climbing
  • Soccer
  • Skiing
  • Tennis

However, scleral lenses are not advised for wrestling, karate, or boxing, other martial arts or any sports where facial injuries are common.

How Can Scleral Lenses Improve An Athlete’s Vision?

Athletes are often exposed to challenging environmental conditions, such as dust, chalk, sand and wind, all of which can lead to discomfort with soft contact lenses. As scleral lenses provide a seal over the eye’s surface, their eyes are much more protected from the elements. Because athletes have demanding visual needs, stable, clear, crisp vision is essential for optimal athletic performance.

To learn more, contact The Scleral Lens and Keratoconus Center at Loudoun Eye Associates today.

Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 703-724-0330

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Scleral Lenses for Keratoconus

Keratoconus (keh-rah-toe-cone-us) is a non-inflammatory eye disorder in which the round dome-shaped cornea progressively thins causing a cone-like bulge to develop.

Hence the name keratoconus, from the Greek word ‘kerato’ (cornea) and ‘conus’ (cone-shaped).

Because those with keratoconus have irregular, cone-shaped corneas, glasses cannot conform to the shape of the eyes and thus cannot adequately correct the patients’ vision. The best solution, therefore, is scleral contact lenses, since they sit on the sclera without touching the cornea and deliver maximal clarity while being perfectly comfortable in most cases.

What are Scleral Lenses?

what are scleral lensesCustom designed scleral lenses help patients with corneal irregularities achieve dramatic improvements in visual acuity and comfort. Scleral lenses vault over the cornea and rest on the sclera while avoiding the diseased cornea. This creates a new optical surface instead of the damaged cornea and prevents discomfort by resting on the sclera of the eye. Moreover, the reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a liquid environment – making it optimal for healing.

Both rigid gas permeable (GP) lenses and scleral lenses provide the eyes with sufficient oxygen. However, scleral lenses provide more comfort and stable vision than traditional GP lenses. In most cases, scleral contact lenses are the optimal choice of treatment for patients with keratoconus and irregularly-shaped corneas.

If you have Keratoconus and are interested in scleral lenses, our optometric team at The Scleral Lens and Keratoconus Center at Loudoun Eye Associates can help. We serve patients from all over Ashburn, Broadlands, Brambleton and Ryan, Virginia and provides the highest level of care.

Two Major Benefits of Scleral Lenses for Keratoconus

1) Scleral Lenses Provide More Comfort

Our patients report comfort as the most prominent feature of the scleral lens. Throughout the fitting process, we survey our patients on how the lenses feel, and not surprisingly, the usual response we get is “fine” or “I can’t feel them at all”.

The size of a scleral lens is one of the reasons it is more comfortable than a traditional gas permeable contact lens. A traditional contact lens is much smaller, typically 9 -10 mm in diameter. With each blink, this contact lens moves a bit over the cornea and the lid tends to roll over the edge of the lens as well. Many patients report being unable to wear them for more than a few hours at a time due to discomfort.

The scleral lens, on the other hand, is larger in diameter and spreads its weight over a much greater, less sensitive area so that when you blink, the eyelid doesn’t catch the edge of the lens. Moreover, because the lens vaults over the bulging cornea, it protects the cornea from any abrasion caused by blinking or external irritants. Furthermore, the scleral lens is made up of highly oxygen permeable materials and provides a soothing bath of artificial tears that refresh the ocular surface.

2) Scleral Lenses Offer Improved Vision

Patients with keratoconus have a clearer vision with scleral lenses than with glasses. With glasses, patients usually see 20/200, whereas with scleral lenses their vision typically improves to 20/30 or even 20/20. Furthermore, because the lenses sit firmly on the eye, they offer more stable vision than traditional lenses. The scleral lens not only offers comfort but also improves vision acuity.

What Changes Will I Notice with Scleral Lenses?

Once you have been properly fitted for scleral lenses, you can expect to gradually see improvements in clarity, color and detailed contrast between multiple images and objects within your visual field. The comfort you’ll experience will enable you to wear your custom-made scleral lenses all day long so that you can keep doing all the things you enjoy – but with better vision.

Should I See An Eye Doctor Experienced in Fitting Keratoconus Patients with Scleral Lenses?

improved vision with scleral lensesIf you are interested in seeing whether scleral lenses are right for you, make sure that the eye doctor you visit has the knowledge and experience required to correctly fit the lenses on patients with keratoconus. Scleral lenses require precise customization, and every patient’s case of keratoconus varies in degrees of severity and corneal measurements.

To check if you are a good candidate for scleral lenses, contact us at The The Scleral Lens and Keratoconus Center at Loudoun Eye Associates. Our staff has the expertise in fitting specialty contact lenses. Call or book online and regain your quality of life.

“I loved my visit from start to finish. The The Scleral Lens and Keratoconus Center at Loudoun Eye Associates staff is friendly, caring and knowledgeable. The eye exam that I had for keratoconus was incredibly thorough and our optometric team explained all the results very clearly. He fitted me for scleral lenses, and now my eyes feel so comfortable that I frequently forget that I’m wearing contact lenses.“

REFERENCES:

Ariela Gordon‐Shaag, Michel Millodot, Igor Kaiserman, Tzahi Sela, Guy Barnett Itzhaki, Yaffa Zerbib, Efrat Matityahu, Shira Shkedi, Svetlana Miroshnichenko and Einat Shneor, Risk factors for keratoconus in Israel: a case–control study, Ophthalmic and Physiological Optics, 35, 6, (673-681), (2015).

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Scleral Contact Lenses For Post Corneal Graft

Patients may be concerned that achieving a clear and comfortable vision will be nearly impossible following corneal transplant surgery. Although corneal transplants have a high success rate, they do not entirely cure the eye of disease. Patients will certainly notice dramatic improvements, but their vision will still need to be corrected.

It can take more than a year for the eye to recover from a corneal transplant, as it needs time to adapt to the new cornea. Because this adjustment is unpredictable, nearsightedness or astigmatism may develop. Even after complete recovery, prescription glasses or lenses may still be required. For this and other reasons (explained below), scleral lenses are the optimal choice for vision correction.

Here at The Scleral Lens and Keratoconus Center at Loudoun Eye Associates, we aim to provide the best possible vision for our patients who’ve had a corneal transplant. If you’ve undergone this procedure, speak with our optometric team to determine whether scleral contact lenses are the best choice for you.

Understanding Corneal Transplants

There are two common types of corneal transplants:

Penetrating keratoplasty, also called “full-thickness corneal transplant”, is when the full thickness of the cornea (the clear front surface of the eye) is replaced with healthy donor tissue.

Endothelial keratoplasty replaces only the diseased corneal tissue, leaving healthy tissue behind.

woried old manWhy Would Someone Need a Corneal Transplant?

A corneal transplant is generally recommended in the following cases:

  • For those with vision problems caused by the thinning of the cornea (generally due to keratoconus) and only after less invasive treatments have been proven ineffective
  • Scarred cornea caused by severe injuries or infections
  • Vision loss caused by cloudiness of the cornea, typically due to Fuchs dystrophy

Scleral Lenses & Post-Corneal Transplant Surgery

Corneal transplants don’t cure irregular corneas, as the transplant doesn’t fully adapt to the eye. Some eye doctors may recommend rigid gas permeable lenses (RGP’s), hybrid contact lenses, or scleral lenses for clear and comfortable vision.

Of all the options, scleral lenses are the optimal choice. The fully customized contact lens vaults entirely over the cornea without adding any pressure to it, while allowing the cornea to remain hydrated for ultimate healing and comfort. Furthermore, because they are larger in size than any other contact lens, they are less likely to shift and move around on the eyes, thus reducing the risk of irritation or abrasion.

We Fit Scleral Lenses and Other Specialty Contact Lenses

Getting fitted for scleral lenses after a corneal graft can be life-changing. It can allow you to comfortably and safely drive at night or resume playing a sport that you thought you’d have to give up.

If you’ve had a corneal transplant or plan to do so in the near future, know that clear and comfortable vision after the surgery is possible. Don’t miss out on incredible life experiences because of poor vision — call The Scleral Lens and Keratoconus Center at Loudoun Eye Associates today.

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Can Scleral Lenses Help You? Find Out! 703-724-0330

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