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Posts Tagged ‘keratoconus contact lenses’

Christian’s Keratoconus Story – “ClearKone Changed the Way I See Life”

Thursday, June 23rd, 2011

My vision challenges began in junior high school when I started to wear glasses. Although my vision was fine at that time, things started to change when I entered high school. I began to notice that I wasn’t able to read the chalkboard. Even though I sat in the front row, I found it difficult and frustrating to read the teachers’ notes. I went back to my optometrist, who gave me another pair of glasses with a stronger prescription. Unfortunately, the new glasses only helped for a period of time. By the time I was in my junior year, my vision was a problem again. The new glasses no longer corrected my vision. I decided it was time to see a new optometrist. 

In my senior year of high school my new optometrist, Dr. Barry Leonard, diagnosed me with keratoconus. While I was glad to have found out the cause of my vision problems and learn that contact lenses could improve my eyesight, I could never have imagined the contradictions that came with contact lens wear. My doctor fit me in RGP lenses, which did improve my vision, but the lenses were so uncomfortable. My eyes were often irritated, so I would try to function without wearing the lenses. Unfortunately, my vision was so poor without them that I could not drive, see faces of friends at a distance, or read a book with small font. Keratoconus was truly affecting my daily activities!

Dr. Leonard then recommended that I try the ClearKone lens from SynergEyes. He explained that the rigid center would give me the visual acuity I needed, while the soft skirt would keep my eyes comfortable throughout the day. It sounded like a great option! As we began the fitting process, it was difficult for my lids to open wide enough for the lenses to be inserted. My eyes were so sensitive that my lids would close whenever the lens got near my eye. Thankfully, Dr. Leonard was very patient with me, and after many attempts, was able to insert the lenses.

Once I began wearing the lenses, I was amazed. My vision was clear and crisp, and the lenses were so comfortable that I could wear them all day long without irritation. It really was the best of both worlds!

I have now been wearing the lenses for several months, and my life has changed in so many ways. I can distinguish faces from a distance and see their expressions, which is so wonderful! I am also able to drive, use the computer, and read books with small font. I feel like I now have a normal life without the frustrations of poor vision. ClearKone lenses have truly changed the way I see life!

Melanie’s Keratoconus Story – “Life Inside an Impressionist Painting”

Tuesday, December 21st, 2010


ClearKone Sharing Vision Grant Recipient

Melanie's Keratoconus Story

I live inside an impressionist painting, where colors smear across the canvas and ghost images hover around any large object I can actually identify. At night, my world is ablaze with eight-pointed stars that spring from every source of light – headlights, streetlamps, neon signs and even candles on the altar at church. When I try to focus on your face, I see a double image of your features; your eyes and nose and mouth run together like melting wax. Like a blind person, I focus on your voice, your height and weight, and the way you move. I miss seeing you smile and roll your eyes and grimace – all the nuances that nurture communication. Because I can’t see you clearly, I often misunderstand. I’m a writer and graphic designer, but I can’t read the words on the monitor as I type them. I can’t read a letter or take legible notes when I talk on the phone. The more I enlarge the letters on my monitor, the more they smear. I squint. I turn my head, and try to capture a pinpoint of light that will fall on my retina at just the right angle and reflect a clear impression of what’s before me.


I’ve lived for 39 years as a classic myope, “seeing” new places and people and experiences through my enormous collection of novels, reference and business books, textbooks, biographies, and books on art, psychology and spirituality. At one time, I could take out my contact lenses before I went to bed, put on a pair of bottle-bottom glasses, and settle under my down comforter to read myself to sleep. Since having RK surgery some 17 years ago, however, there’s not a lens in the world that can filter light through my damaged corneas and hit the sweet spot on my retinas. If I want to read these days, I must wear both contact lenses and reading glasses, and maintain a powerful squint.

Now I’m locked into a smeared world filled with beautiful works of art and brilliant literature, as well as the simple pleasures and necessities of sight – the daily newspaper, the buttons in the elevator, the menu at the meat-and-three, the birthday card from a friend, the calorie count on a carton of yogurt. I can’t see any of them clearly enough to use them. Bursts of light are excruciating for my damaged corneas. Sometimes it’s seemed easier just to stay in bed in despair and sleep the days away.

To adequately explain why ClearKone® lenses made such a difference in my life, I have to explain the impact of my RK surgery. I started wearing glasses when I was eight and contacts when I was 12. I could always read without correction, but the glasses and/or contacts were critical if I needed to see anything beyond my books. When RK surgery came to the forefront in the early 1990s, I jumped on the bandwagon and had one major procedure and one “touch-up” performed on each eye by one of the city’s most prominent ophthalmologists. For a few weeks, I lived the miracle of 20/10 vision. I could see the lighted display on my clock in the middle of the night. I no longer had to baby expensive contact lenses or endure the pain of getting debris caught under them. I could move from reading to driving to computer work seamlessly, ride freely in a convertible without worrying about dirt flying into my eyes or my contacts drying out, swim and see at the same time, and best of all – my vision was better than it had ever been in my whole life!

My 20/10 days lasted for about a month, and then the unthinkable happened. My vision began to deteriorate, both at near vision and at a distance. My new crystal-clear world slipped away from me day by day, and I began what would be a 17-year quest to regain my sight. My doctors tried every contact lens available. While I could see fairly well with gas permeable lenses, they were pure misery to wear, rubbing against my RK incisions and forcing me to take them in and out, over and over, every day. My vision fluctuated so much in the course of a day that no prescription glasses ever gave me clear vision at any distance. With menopause, my dry eyes dried out even more. I had my tear ducts cauterized. I tried wearing nothing but glasses for months in hopes that my vision would stabilize and adapt to the glasses, but it didn’t work I moved to another city and new optometrists tried to help me. We tried various soft lenses, but they only draped themselves over my flat cornea and many incisions and did little to help me see, although they were more comfortable than gas perms. My optometrist tried piggy-backing a gas perm lens over a soft lens, but the lenses wouldn’t center. I spent endless hours on the internet and phone, talking with specialists throughout the country, trying to find the one doctor who might have a rare and unpublicized solution for failed RK procedures.

Finally, with the dawning of the new century, the first hybrid lenses came on the market, and after weeks and weeks of fittings and trial and error, for the first time, I had decent vision and decent comfort with monovision Soft Perm lenses. I still couldn’t be corrected with glasses, so I was heavily dependent on my contacts to read, drive, and work. Because my RK incisions were so prone to irritation, the hybrid lenses would periodically cause one or more of the incisions to open up. That was agony, both because of the pain and because I would be unable to wear the lens (and thus become visually disabled) until the incision healed enough for me to tolerate it again. This year I developed yet another problem with my hybrid lenses. Almost as soon as I’d insert them, they would cloud over with a thick, gluey substance. I spent more time taking them out and cleaning them than I spent actually wearing them!

Having moved back to Birmingham, I went back to UAB Eye Care and met Dr. Adam Gordon, who told me about ClearKone® hybrid contact lenses. From the first moment I felt that lens on my eye, I knew it was the answer I’d been searching for. Because the lens floated on a layer of fluid above my RK incisions, they were incredibly comfortable, and my visual acuity was better than it had been since my one-month bout of 20/10 vision 17 years earlier.

SynergEyes Grants Life Changing Gift for Holidays: Ability to Distinguish Family Faces Keratoconus Patients Granted New Hybrid Contact Lens Technology

Tuesday, December 21st, 2010

Carlsbad, CA (December 20, 2010) – This holiday season patients are receiving the life-changing gift of clear and comfortable vision thanks to the Sharing Vision Grant Program sponsored by SynergEyes, Inc. This program was created to bring the new technologically advanced ClearKone® hybrid contact lens to keratoconus patients who may otherwise not have access.  Keratoconus is a degenerative eye disease that occurs 1 in 1,000 people causing substantially distorted vision and in many cases changes how they live their lives. Patients can apply for the program on at www.TreatKeratoconus.com.

Cassidy Randle was a successful college student looking to go to nursing school, after graduation. Just as any young girl, she wanted to get rid of her glasses and therefore underwent refractive eye surgery in 2003. Initially her vision was okay and then it started deteriorating. In no time she was almost blind in her left eye and had poor vision in the right eye.  She had seen many cornea specialists and tried many type of lenses, but unfortunately, none of the lenses gave her the comfort or the vision back. It came to a point that she was unable to drive a car and her hopes of nursing school were fading.  “I began to worry and think to myself: ‘How will I be able to focus in school if I am unable to see?’” Cassidy said.  And her worries were more personal as well. “The worst feeling imaginable is being unable to distinguish my family’s faces and see their expressions.”

After Dr. Gupta at the University of Texas Medial Branch (UTMB) Eye Center volunteered her time and provided a free fitting for Cassidy in ClearKone® lenses, provided free by SynergEyes, Inc., Cassidy is now able to see again. “When I tried on the lenses for the first time I knew the difference in my vision was going to be life-changing,” said Cassidy.  Thanks to the Sharing Vision Grant Program and Dr. Gupta, Cassidy can see her father’s face again and she can pursue her dream of becoming a nurse.

Currently, over 15 patients are enrolled in the program; receiving free lenses from SynergEyes and free fitting from participating eye care practitioners. One of these patients is Melanie LeMay who is working with Dr. Adam Gordon to achieve clear vision for the first time in 17 years. “I can’t think of a better Christmas gift than a pair of ClearKone® lenses!” said Melanie. “These lenses will be life changing for me and for others as well.”


The ClearKone® hybrid contact lens is the only hybrid lens of its kind for keratoconus and is having a significant impact on thousands of patients.   Available for less than a year, this new technology offers both clear vision and comfort for patients who would otherwise have to compromise their vision.  SynergEyes is the only company that makes a hybrid lens which has a “hard” center for the clear vision, and a soft outer skirt that provides comfort.

About SynergEyes®:

SynergEyes®, Inc. was founded in 2001 with a recognized need for a hybrid contact lens that combined the superior visual acuity of a rigid gas permeable lens with the comfort of a soft contact lens. The patented SynergEyes® hybrid technology with FDA market clearance is providing comfortable clear vision through the services of more than 5000 eye care practitioners throughout the United States, Canada, Puerto Rico and the United Kingdom.

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Tear Proteomics in Keratoconus

Wednesday, November 10th, 2010

Originally published in Contact Lens Today.

Abstract:

The purpose of this work was to identify potential tear-film based proteins expressed in keratoconus.

Recruited subjects were normal GP contact lens wearers, keratoconus subjects wearing GP contact lenses, and keratoconus subjects without contact lenses. Subjects wearing soft lenses or having previous ocular surgeries were excluded from participating. Approximately 5 microliters of tears were sampled from both eyes of each subject using glass microcapillaries. Additional testing included a brief history, visual acuity, slit lamp examination, and topography. Proteomic analyses used to compare samples included Bradford assays, cytokine arrays, SDS-PAGE, and mass spectrometry.

Forty-four subjects were enrolled in the study including 20 normals (GP wearers-controls), 18 with keratoconus and wearing GPs, and six with keratoconus (non-lens wearers). Across all proteomic approaches, several proteins were identified as possibly being unique to keratoconus. Increased expression of matrix metalloproteinase-1 (MMP-1) was found in keratoconus subjects with and without GP contact lenses (p=0.02). Unique proteins more associated with keratoconus included several keratins, immunoglobulins alpha and kappa, precursors to prolactin, lysozyme C, and lipocalin.

Initial analyses indicate that keratoconus may be associated with the differential expression of several proteins. Further testing is needed to determine any causal relationship or correlation with the etiology of this condition.

Pannebaker C, Chandler HL, Nichols JJ. Tear proteomics in keratoconus. Mol Vis. 2010;16:1949-57

Contact Lens Options for Keratoconus

Monday, October 18th, 2010

Author:  Dr. Anderson, OD, FAAO

Keratoconus is a bilateral, progressive corneal thinning disorder which manifests as irregular, asymmetric astigmatism. Symptoms include blurred, subacute distorted vision which is usually more pronounced in one eye than the other. Refraction is often difficult and patients may not be adequately corrected with spectacles. Contact lenses are the best form of visual correction in most cases of clinically significant keratoconus. There are many different types of contact lenses available for keratoconus. Depending on the degree of clinical significance, lifestyle and ocular health, the optimal contact lens can be determined for each patient. This article describes the different design options currently available, along with the goals to keep in mind when fitting these patients.

Soft Toric Lenses

Many times, patients in the early stages of keratoconus do well with soft lenses. A satisfactory baseline refraction, which will most likely have a moderate amount of cylinder, is necessary in order to determine the soft lens prescription, which will most likely be toric. Occasionally, a spherical equivalent will produce good visual results. Patients with forme fruste keratoconus may also do well with soft toric lenses since adequate spectacle refraction is often possible.

Rigid Gas Permeable (RGP) Lenses

RGPs are the most commonly prescribed lenses for keratoconus. Traditionally, these lenses were fit with small diameters, three-point touch and variable edge lifts to improve comfort. However, this type of fit often results in a low-riding lens, decentered inferiorly over the pupil which induces aberration. More recent RGP designs for keratoconus have incorporated aspheric or biaspheric optics to decrease aberration, along with larger diameters to improve centration.

Piggyback Systems

Keratoconus patients who are currently fit with RGP lenses oftentimes experience discomfort and decreased wearing time as their condition progresses. The cone steepens and the apex thins to the point of inflammation, abrasion and irritation from RGP bearing. A simple way to halt this cascade of events is to place a soft lens beneath the RGP. Using a low minus power will flatten and protect the corneal surface as well as improve the comfort and wearing time. High Dk soft and RGP materials work well to maintain corneal integrity by decreasing the incidence of neovascularization.

Hybrid Lenses

These lenses consist of an RGP center with a soft skirt edge. They combine the benefits of rigid lens optics, including better lens centration and decreased aberrations, along with the comfort of a soft lens. The results are improved vision and increased wearing time. This is especially beneficial in keratoconus patients whose cone apex is very steep, thin and decentered. Traditional small diameter RGP lenses tend to decenter downward over the apex, inducing bothersome aberrations over the pupil. SynergEyes is currently the only manufacturer of hybrid lenses in the U.S. The designs available for keratoconus include the SynergEyes A, KC and ClearKone. Patients with mild to moderate keratoconus may fit into the A lens which has a spherical RGP center. The KC lens has an aspheric RGP center and is reserved for more advanced cones. ClearKone consists of a reverse geometry RGP center which is fit upon elevation or sagittal depth rather than base curve. This allows for clearance, centration and stabilized vision over a decentered cone. Because it achieves clearance by vault, ClearKone offers lower powers and reduced aberrations as compared to lenses fit according to base curve.

Scleral/Semiscleral Lenses

Rigid gas permeable lenses with diameters of 13mm or greater fall into this category. The benefits of these large diameter RGPs in keratoconus are a large,well-centered optic zone, minimal movement with blink, stabilized vision and improved comfort. Fitting these lenses requires a great deal of skill, which is acquired from experience. The dynamics are quite different from corneal lenses. The parameters of the larger periphery determine the patient’s ability to wear the lens comfortably and must be fit independently of the central base curve. The ultimate goal in fitting any keratoconus patient with contact lenses is good vision and comfort. This is relatively easy to achieve in early cones and becomes more difficult as corneal thinning and steepening progress. Determining the best lens to fit in order to achieve these goals is as much of an art as it is a science. For example, a patient who has worn small diameter RGPs unsuccessfully may do better in a hybrid or semi-scleral design. Regardless of lens design, finding the best lens begins with careful measurement of corneal curvature and diagnostic lens fitting.

I’ve Just Been Diagnosed With Keratoconus

Sunday, August 1st, 2010

By: David Kading, OD, FCLSA, FAAO

If you have just been diagnosed with keratoconus, let me first of all reassure you that there have been many recent advancements in the realm of keratoconus to equip eye care professionals with the proper tools to help you.

Keratoconus is a vision disorder that affects the front surface (cornea) of the eye.  The changes that take place occur because the cornea becomes thinner in certain areas.  The condition causes the normal regularly shaped cornea to become microscopically irregular in shape.  This causes light to scatter in irregular ways causing vision to be blurry, distorted, warped, and haloed as opposed to crisp and clear.  Because glasses and normal off-the-rack contact lenses cannot help to make the surface of the eye even and regular, for most keratoconus patients, they are not able to provide ideal vision.  Additionally, lasik surgery is not an option for patients with this thinning disorder because lasik surgery thins the cornea in an effort to correct vision.  Therefore it would only make the condition worse.

Keratoconus affects thousands of Americans and people all across the world.  It is believed that there may be a genetic component to the disease as it has been seen in identical twins.  However many keratoconus patients develop the condition after a mild accident, trauma to their eye or after years of eye rubbing.  Many other patients are not able to trace the condition to a family member or any type of eye trauma.

The first thing that you should do when you are diagnosed with the condition is ensure that you are under the care of an eye care practitioner who is knowledgeable about the condition.  A knowledgeable practitioner will know, understand, and be able to decide on the best course of treatment for you.  Although many keratoconus patients appear similar when they present to an eye care office, no two patients are alike.  Each has specific needs related to the shape of their eyes and how they use their vision on a daily basis both for work and recreation.  It is critical that your practitioner knows both you and your eyes.

In order to get the best idea of what the shape of your eye is, your practitioner may consider using an instrument called a corneal topographer.  This allows them to measure the specific areas of the eye in order to get the best assessment of the shape and contours of the eye.  This is extremely helpful in order to properly diagnose, and decide on the proper treatment options.

In mild cases of keratoconus, eyeglasses can still be used to help correct vision.  However, in most all cases of the condition, proper vision correction is best achieved with the use of specially designed contact lenses.  Depending on the shape of the eye, type of prescription, and discussion with you, your eye care practitioner will decide on an initial contact lens type.  In order to get the proper contact lens for you, a contact lens fitting must be performed.  This is often times performed as a separate visit to the office.  Following this visit, the lenses will be ordered from a contact lens laboratory or manufacturing plant.  Typically contact lenses can be made in several days, but it can take up to 2 weeks in some cases for the lenses to arrive back in the office.

Once the lenses arrive in the office, an additional visit is usually scheduled to ensure that the lenses are fitting on the eyes correctly and giving the optimal vision.  At this visit you are typically instructed on how to insert and remove the contact lenses.  Many times a wearing schedule will be described to you so that you can begin to adjust to the lenses.  As with most medical devices and things that are new to our bodies, it may take several days to weeks to adjust to the comfort, vision, and feeling of the new lenses.  This is very typical in most cases.  Most offices will request a follow up visit within one to three weeks to ensure that the lenses are fitting correctly.  Make sure to wear the lenses for several hours prior to this visit as an assessment of the lenses is best done after the lenses have been worn for at least three hours.  It is critical to ensure that the fit of the lenses is correct as they can cause damage to the eye if they are incorrect.  On occasion the initial type of lens that is tried does not work.  This is not uncommon and should not cause alarm.  Fortunately as stated earlier, there are many options.  The practitioner may switch you from one type of contact lens type to another if your eyes were not able to adapt to the initial lens type.

In very severe cases when contact lenses cannot provide ideal vision, there are also surgical options available.  These surgical options are progressing and are showing improving results.  However they are not a perfect solution, they require a significant healing time and most patients still must wear specialty designed contact lenses following the procedure.

Keratoconus is a condition that will last a lifetime.  Within the past 10 years dramatic insight, knowledge, and research has come out regarding the condition, its diagnosis, and treatment options.  Find a practitioner that you can trust and is up to date with the most recent advancements.  Make sure that they know everything there is to know about your eyes and vision, but most importantly, they should know you.  This is the type of relationship that will last a lifetime.

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