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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. Radhika Chawla about scleral contact lenses. At the Richmond Hill Optometric Clinic and Keratoconus Center in Richmond Hill, 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 Richmond Hill Optometric Clinic and Keratoconus Center to discuss your specific payment options and cost of scleral lenses.

Specialized optometrists, such as Dr. Radhika Chawla, 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.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.

TESTIMONIAL:

“ I went to the Richmond Hill Optometric Clinic and Keratoconus Center 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! “

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133
Learn More About Scleral Lenses
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3 Ways That Scleral Lenses Treat Dry Eyes

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3 Ways That Scleral Lenses Treat Dry Eyes

Millions of people over the age of 50 struggle with dry eye syndrome (DES). Symptoms include dry, itchy and irritated eyes. For long-term chronic sufferers, symptoms are more intensely painful and often include the feeling that something is stuck or scratching the eyes. While eye drops and artificial tears can deliver temporary relief, it’s not a long term solution for chronic dry eye.

If you’re struggling with ongoing dry eye symptoms, scleral lenses can provide long-term relief along with exceptional comfort and visual clarity.

Though scleral lenses are typically used to treat corneal irregularities and refractive errors, they have other advantages that can be beneficial to chronic sufferers of DES.

Below are 3 ways in which scleral lenses provide dry eye relief:

  1. Unlike traditional contact lenses, scleral lenses minimize eye irritation: If you suffer from dry eyes, wearing traditional contact lenses can prove to be virtually unbearable, as they sit directly on the cornea, which can exacerbate already irritable eyes. Furthermore, traditional contact lenses tend to soak up the moisture on the surface of the eye — which is the last thing a dry eye patient needs. Scleral lenses, however, vault over the irritated cornea and sit on the sclera (the white part of the eye), offering comfort and clear vision.
  2. Scleral lenses provide ongoing hydration to the eyes: The space between the lens and the cornea contains a liquid reservoir that provides a protective cushion which reduces pain and irritation in those with dry eyes. This reservoir acts as a constant source of hydration for the eye, offering relief to dry eye patients. Furthermore, artificial tears and antibiotics can be administered into the lens prior to insertion to promote advanced healing.
  1. Scleral lenses protect the cornea: Dry eye syndrome renders the eyes more sensitive, and inflamed corneas are more vulnerable to injury. Even something as simple as blinking can irritate the eye or even injure the cornea due to the mechanical friction of the eyelids on the cornea. Scleral lenses can act as a shield between a patient’s eyes and their eyelids/the outside environment, protecting the eyes from further irritation or damage.

For these reasons, scleral lenses can significantly enhance the quality of life for a chronic dry eye sufferer. Scleral lenses provide vision correction, shield the eyes from external irritants and offer constant hydration to the eye. They also reduce pain, itchiness and the need to routinely apply eyedrops, all the while offering comfortable, sharp and clear vision all day long.

If you struggle with dry eye syndrome and have been looking for a more effective treatment method than just eye drops and artificial tears, and ask Dr. Radhika Chawla about scleral lenses. Call the Richmond Hill Optometric Clinic and Keratoconus Center to schedule your consultation and learn more ways these lenses can improve the quality of your life.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133

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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. Radhika Chawla at Richmond Hill Optometric Clinic and Keratoconus Center can help. We serve patients from all over Richmond Hill, Markham, North York and Vaughn, Ontario 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 Richmond Hill Optometric Clinic and Keratoconus Center. Our staff has the expertise in fitting specialty contact lenses. Call or book online and regain your quality of life.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.

“I loved my visit from start to finish. The Richmond Hill Optometric Clinic and Keratoconus Center staff is friendly, caring and knowledgeable. The eye exam that I had for keratoconus was incredibly thorough and Dr. Radhika Chawla 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).

Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133
Learn More About Scleral Lenses
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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 Richmond Hill Optometric Clinic and Keratoconus Center, 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. Radhika Chawla 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 Richmond Hill Optometric Clinic and Keratoconus Center today.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133
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