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Succeeding With Sclerals

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Succeeding With Sclerals

Healthy corneas normally bend incoming light toward the retina so we can see clearly. However, certain corneal conditions, such as keratoconus and astigmatism, lead the light’s path to the cornea to diffuse, resulting in reduced and blurred vision.

That’s precisely what happened to three patients: Ben, Georgette and Fred, who have irregular corneas that caused them to struggle with their vision. Thanks to scleral lenses, they and countless other patients with corneal conditions have experienced improved visual clarity, sharper focus and unparalleled comfort. But before we delve into their stories, what are scleral lenses and how exactly do they benefit those with irregular corneas?

Irregular Corneas and Scleral Lenses

Irregularly shaped corneas are most commonly caused by or associated with astigmatism, keratoconus, prior eye surgeries (such as LASIK, cataracts, corneal transplant), trauma, scarring and pellucid marginal degeneration.

Irregular corneas cannot be corrected with eyeglasses or traditional contact lenses. An excellent non-surgical solution is scleral lenses, which provide clear vision and better comfort while keeping your eyes hydrated throughout the day.

The lenses vault over the cornea and rest on the sclera, the white part of the eye, which prevents corneal irritation. The liquid reservoir fills in the surface irregularities of the cornea, restoring vision and enabling the eye to comfortably heal. The smooth optical surface replaces the distorted corneal surface, resulting in dramatically improved vision and comfort.

Read how scleral lenses have helped address Ben’s, Georgette’s and Fred’s irregular corneas, and enabled them to experience improved vision and a higher quality of life.

*These patient testimonials are meant to reflect actual testimonials of patients but not necessarily our patients.

happy man smilingEverything Is Now in Focus for Ben

Ben entered college excited for life’s newest adventure. He made friends and studied hard. But his struggle to read the content on the classroom whiteboard and in his textbooks presented the same challenges he’d experienced for much of his life.

“Here we go again,” Ben thought. Ben had astigmatism, meaning that his corneas were unevenly curved. As a result, images and texts appeared blurry. To see clearly, he resorted to squinting, which, in turn, led to frequent headaches.

Although Ben had regularly been updating his eyeglass prescription over the years, and tried wearing standard contact lenses, he still struggled with his vision. “Enough is enough,” Ben decided. “It’s time to consult a vision expert!”

That’s when Ben went to see his eye doctor, who suggested he wear scleral lenses to help see clearly with his astigmatism.

The scleral lenses worked wonders by allowing Ben’s eyes to properly focus light to the retina. Several appointments with his eye doctorensured that the scleral lenses were fit just right. Ben can now see clearly and effortlessly, read the board and his textbooks, all of which have enabled him to graduate from college with honors.

If you or your child have astigmatism, make your life easier by following in Ben’s steps and ask Dr. Brian Berliner about scleral lenses.

happy woman smilingFor Georgette, Sclerals Are the Perfect Fit

Just imagine how Georgette felt, at age 15, when she was diagnosed with keratoconus.

No one wants to hear that their cornea is thinning and gradually bulging outward into a cone shape. But that’s exactly what happened to Georgette. Because keratoconus causes blurred vision and sensitivity to light, Georgette often found herself squinting to help her see clearly.

That’s when her eye doctor suggested scleral lenses. Having never worn contact lenses, Georgette hesitated, then reconsidered. “Let’s do it,” she concluded.

Georgette left her eye doctor with her new pair of custom fit scleral lenses, fully excited at the prospect of experiencing great vision. Thanks to sclerals, she not only sees clearly, but now finds her eyes to be significantly less sensitive to light, which allows her to enjoy the outdoors during the day.

happy american familyFred Likes What He Sees Following His Corneal Transplant

“It still hurts,” Fred complained as he looked into his eyes in the mirror.

The corneal transplant he underwent 10 months earlier effectively addressed his corneal scars following a workplace accident. Fred recovered as the operation’s physical effects receded. Post-operative medications prevented not only inflammation and infection, but also the rejection of his newly transplanted corneas. However, the standard contact lenses he began using a few months after the transplant were painful to wear, and his irregular astigmatism—far from corrected—continued to cause fluctuating vision.

Imagine Fred’s excitement at learning that scleral lenses enable clear and painless vision for keratoplasty (corneal transplant) patients like himself. He read a 2016 study published in the Eye & Contact Lens journal that found that sclerals in post-keratoplasty patients are safe and effective, with most patients attaining 20/40 vision or better.

How did things turn out? With attentive care, really well. Fortunately, Fred now experiences both comfort and excellent vision with scleral lenses.

REFERENCES

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Scleral Lenses For Keratoconus And Other Eye Conditions

The cornea, which is the clear tissue on the eye’s outermost surface (covering the pupil and the iris), bends and focuses light going into the eyes. However, for those with irregularly-shaped corneas, the light entering the eye is not properly focused — which results in distorted vision.

Thankfully, scleral lenses offer excellent visual acuity and comfort for those with corneal irregularities, due to their large shape, unique features and customized fit.

Scleral Lenses for Keratoconus

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

Because patients with keratoconus have irregular, cone-shaped corneas, glasses cannot be used to properly correct vision. The ideal solution, therefore, are scleral contact lenses. They sit on the sclera without touching the cornea, while providing sharpness, clarity and comfort.

Scleral Lenses for Severe Dry Eye

People suffering from severe dry eye can find therapeutic benefits from transitioning to custom designed scleral lenses. Scleral lenses tackle three factors simultaneously: they provide vision correction, they protect the eye, and they serve a therapeutic purpose by lubricating the eye.

Scleral lenses also decrease pain, discomfort, eye redness and itchiness in those with dry eyes.

Scleral Lens RA Transplant 1280×853Scleral Contact for Astigmatism

Astigmatism is a refractive error caused by irregular corneal curvature, resulting in blurred and distorted vision. Scleral lenses offer exceptional vision correction in patients with astigmatism, whether by birth, following post-refractive surgery, or due to other corneal procedures. The lenses improve visual acuity and comfort while keeping eyes hydrated all day long.

Scleral Lenses for Myopia and Presbyopia

Scleral contacts are ideal for anyone with severe nearsightedness or farsightedness. For presbyopic patients, scleral contacts can be designed as multifocal contacts to correct nearsightedness and farsightedness simultaneously. Because scleral lenses are firmly positioned on the eye, they provide significantly more comfort when compared to standard multifocal lenses.

Mini Scleral Contacts Vs. Full-Size Scleral Contact Lenses

All scleral lenses rest on the white part of the eye, the sclera. However, Dr. Brian Berliner will customize the scleral lenses by determining the exact diameter and space needed between the cornea and sclera. Certain scleral lenses may have a space of a few millimeters (mini scleral lenses), while standard scleral lenses are larger, full-sized lenses. Larger scleral lenses are typically recommended for highly irregular corneas.

Ask Us About Scleral Lenses

If you struggle with keratoconus, astigmatism, dry eyes or any of the other conditions listed above, ask your Specialty Contact Lens Center At Long Island Vision Care doctor about scleral lenses. Dr. Brian Berliner will patiently assess and explain your condition to you, and will perform a specialized, scleral lens custom-fitting to ensure that you receive the best fit for optimal visual clarity and comfort.

Call the Specialty Contact Lens Center At Long Island Vision Care today to schedule your consultation.

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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 Dr. Brian Berliner about scleral contact lenses. At the Specialty Contact Lens Center At Long Island Vision Care in Huntington, 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 Specialty Contact Lens Center At Long Island Vision Care to discuss your specific payment options and cost of scleral lenses.

Specialized optometrists, such as Dr. Brian Berliner, 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 Specialty Contact Lens Center At Long Island Vision Care 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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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, Dr. Brian Berliner at Specialty Contact Lens Center At Long Island Vision Care can help. We serve patients from all over Huntington, Lake Grove , Hicksville and Brentwood, Long Island 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 Specialty Contact Lens Center At Long Island Vision Care. 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 Specialty Contact Lens Center At Long Island Vision Care staff is friendly, caring and knowledgeable. The eye exam that I had for keratoconus was incredibly thorough and Dr. Brian Berliner 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 Lenses For Post-LASIK, Post-PRK And Post-RK Surgery

LASIK, PRK and RK are common refractive vision surgeries that correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism by altering the shape of the cornea using a laser. While these surgeries have a high success rate, eye complications can occur, such as Post-LASIK, Post-PRK and Post-RK ectasia, a corneal distortion or irregularity that causes the cornea to weaken and bulge.

Those with surgery complications develop vision problems that cannot be fully corrected using glasses or soft contact lenses, as their newly shaped cornea often causes the lenses to easily dislodge. For those people, scleral lenses are the ideal option for clear and comfortable vision.

Have you experienced complications following your laser eye surgery? Speak with Dr. Brian Berliner at Specialty Contact Lens Center At Long Island Vision Care to find out how scleral lenses can help you see clearly and comfortably again.

Why Wear Specialty Contact Lenses For Post-Surgery Complications?

Post-LASIK, Post-PRK, and Post-RK patients with eye complications tend to experience poor, distorted vision, resulting in an inability to wear standard contact lenses due to their sensitive cornea. In fact, attempting to wear soft contact lenses can be extremely painful and can further damage the cornea.

Scleral lenses provide clear vision and all-day comfort to those with corneal aberrations, whether due to existing eye conditions or following corneal surgery. These customized hard lenses are larger in diameter than standard contact lenses and because the lenses vault over the cornea, they spread their weight over a much greater, less sensitive area. These specialty contacts are made of highly oxygen permeable materials and provide a soothing bath of artificial tears that hydrate the ocular surface all day long.

Getting Fitted For Scleral Lenses

Once you have been properly fitted for scleral lenses, you can expect to see significant improvements in clarity, color and contrast between multiple images and objects within your visual field. The comfort you’ll experience allows you to wear your custom-made scleral lenses all day long so that you can keep doing all the things you love.

Does Collagen Cross-Linking Correct Post-LASIK Ectasia?

Patients with corneal ectasia resulting from LASIK surgery complications may be advised to undergo collagen cross-linking — a new method in treating advanced cases of keratoconus and diseased corneas.

Note that many patients who undergo collagen cross-linking may still require specialty contact lenses to achieve clear vision. Speak with your eye doctor to learn more.

Can a Second LASIK Surgery Repair My Ectasia?

Certain LASIK surgeons may recommend a follow-up enhancement procedure to improve your vision. This may lead you to undergo several corrective LASIK surgeries, potentially leaving you with scarred corneas and even poorer vision.

The safest and best option is to wear scleral lenses, as they correct astigmatism, farsightedness and hyperopia, and are perfectly safe on corneas. Our patients who got fitted for custom-designed scleral lenses report feeling thrilled with how sharp and comfortable their vision has become.

For more information or to book a consultation, contact Specialty Contact Lens Center At Long Island Vision Care today.

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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 Specialty Contact Lens Center At Long Island Vision Care, 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 Dr. Brian Berliner 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 Specialty Contact Lens Center At Long Island Vision Care today.

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