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Posts Tagged ‘keratoconus contacts’

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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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.

Keratoconus Treatment Options

Friday, September 3rd, 2010

By Dr. Brandon Ayres, MD

Keratoconus causes progressive thinning and distortion of the cornea that affects approximately 1 in every 2000 people.  It tends to affect younger people sometimes starting in the early teen years and progresses most rapidly through the fourth decade.  As the dystrophy progresses the cornea takes on an irregular cone like shape and may develop scar tissue.  The changes in the cornea seen in keratoconus lead to “irregular astigmatism.”  Irregular astigmatism means that light is not able to focus on the retina even with the use of glasses or traditional soft contact lenses.

The primary treatment options fall into two categories:  contact lenses and surgery.  This article outlines both options.

Glasses and Contact Lenses

In the very early stages of keratoconus patients may notice a change in their prescription glasses or contact lenses.  Often times what is seen is an increase in astigmatism.  If the keratoconus progresses only minimally, all that will be needed is modification of the glasses prescription or possibly a soft contact lens that also corrects for astigmatism.

Keratoconus Contact Lenses

Once patients with keratoconus are dissatisfied with there vision with traditional glasses or soft contact lenses a special keratoconus contact lens may be necessary.  Most commonly this contact lens will be either a hybrid or rigid gas permeable (RGP) contact lenses.  It is important to understand that contact lenses may allow excellent vision, but do not actually treat or stop the progression of the underlying dystrophy.

A rigid gas permeable contact lens is able hold it’s spherical shape vaulting over the irregular cone shape of the irregular cornea.  This gives a new smooth surface to refract light, restoring good vision.  The use of an RGP is an excellent, non surgical, technique to restore vision in keatoconus,  but the fitting of the lens can be quite challenging.  Each patient with keratoconus has a uniquely shaped cornea and the shape may change over time.  Many different designs of RGP’s are available for patients with keratoconus and patience is needed to get the right fit.  Most people with keratoconus are able to be successfully fit with RGP’s, however, some have persistent foreign body sensation or difficulty with the lenses falling out of the eye.

Hybrid contact lenses work on a similar principal as RGP’s.  This style of contact lens has a rigid gas permeable center that is fused to a soft contact lens “skirt” and therefore a hybrid of hard and soft contact lenses.  By fusing the two styles of contact lenses the visual benefit of a RGP is combined with the comfort of a soft lens.  As with the traditional RGP, these lenses must be specially fitted to ensure function, comfort, and safety.

Surgical Options

Collagen Crosslinking (CXL)

Collagen crosslinking is a technique that is currently under FDA trial here in the United States, but widely available outside the country.  Collagen crosslinking is a technique where vitamin B2 (also known as riboflavin) in liquid form is placed on the cornea.  The cornea is then exposed to ultravioled light (UV-A).  The combination of vitamin B2 and UV light increases the “linkages” in the corneal collagen.  This has been shown in laboratory studies to “stiffen” the cornea.  The goal of collagen crosslinking is to prevent progression of the keratoconus, not to reverse or cure it.

INTACS® Corneal Inserts

INTACS corneal inserts are small inserts that are placed in the cornea.  These inserts help “flatten” the central cone of the cornea in patients with keratoconus.  Once surgically implanted in the cornea the inserts are almost invisible and they cannot be felt.  INTACS have been shown to help with improvement in corrected and uncorrected vision.  INTACS can also be helpful in improving contact lens tolerance by reducing the conical shape of corneal in patients with keratoconus.  Recent studies have shown continued improvement in patients having INTACS placed over the course of 1 year and there is some suggestion that they may help stabilize the cornea.

Corneal Surgery

Approximately 20% of patients with keratoconus will have progression to the degree where corneal surgery is necessary.  The most common procedure performed is a full thickness corneal transplant also know as a penetrating keratoplasty (PKP).  In this surgery the diseased corneal is removed and replaced by a human donor cornea.  Luckly, transplantation of the cornea is the most successful of all organ transplants with a low rejection rate.  The vast majority of patients will achieve excellent vision after a transplant though it may take 12 to 18 months to achieve.  Many patients will still need the assistance glasses or contact lenses for optimal vision.

A second surgical option for keratoconus is a deep anterior lamellar keratoplasty (DALK).  This procedure is essentially the same as a corneal transplant except that the very thin innermost layer of the patient’s cornea, called the endothelium, is spared.  The surgery will look and heal very similar to a corneal transplant except that there is a lower chance for transplant rejection.  The surgery is technically much more challenging for the surgeon and sometime has to be converted into a full thickness transplant.

Most recently there has been an interest in using a laser to make the incisions for both corneal transplants and DALK surgical procedures.  The laser-guided incisions allow for an exact match of the patient and donor corneas.  The exact fit allows for a stronger wound and possibly faster healing with less residual astigmatism after the surgery.

How is Keratoconus Diagnosed?

Thursday, July 29th, 2010

The initial symptoms of keratoconus include frequent and significant changes in a patient’s eyeglass prescription, especially in the amount of astigmatism. This is often followed by progressive vision problems such as halos, glare symptoms, ghost images, double and multiple images perceived by each eye individually, and by numerous attempts at obtaining a good glasses prescription without success.

Early diagnosis is very important in the management of keratoconus. New advanced technologies allow eye doctors to detect and treat the condition very successfully. The most sensitive diagnostic method available for keratoconus detection is corneal topography. This allows the doctor to evaluate the shape of the cornea. The most commonly used topography instruments only measure the front surface of the cornea; however more advanced forms of topography evaluate both the front and back surface of the cornea as well as corneal thickness profiles. This is critically important since the earliest abnormalities found in keratoconus will develop initially on the back surface of the cornea and tend to always be more advanced than the front surface irregularities. Other diagnostic tests may also detect keratoconus at very early stages and also discover progression early on. These include aberrometry techniques which measure various forms of visual distortion, and corneal optical coherence tomography (OCT) which provides exquisitely detailed imaging of the cornea.



Pentacam Corneal Topography

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Pentacam Corneal Topography measuring both the front and

back surface of the cornea as well as corneal thickness profiles.




Aberrometry

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Aberrometry measures vision distortions in keratoconus




Optical Coherence Tomography

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Optical Coherence Tomography (OCT) keratoconus



« READ “What is Keratoconus?” | READ “Non-Surgical Treatment Options” »

Common Questions about Contact Lenses and Keratoconus

Saturday, July 10th, 2010

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To submit a question, please send an email to askanexpert@synergeyes.com. We will review all questions and post an answer each week.

Please note: If you have an urgent question about your eye health, contact your eye care practitioner immediately. This page is designed to provide general information about vision, vision care and vision correction. It is not intended to provide medical advice. If you suspect that you have a vision problem or a condition that requires attention, consult with an eye care professional for advice on the treatment of your own specific condition and for your own particular needs.

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