Contact Lenses for Keratoconus

Moodi Kupperman B.Sc SOFLEX

Keratoconus

is a non-inflammatory eye condition in which the normally round dome-shaped cornea progressively thins causing a cone-like bulge to develop

keratoconus causes blurring and distortion of vision

Corneal Topography

Is a non invasive medical imaging technique for color mapping the surface curvature of the cornea This instrument has become for the last years a part of the checking room Computerized Corneal Modeling System (CMS) is used to evaluate (type and size) corneal shapes

The most common Keratoconus types

NIPPLE CONE
Advanced keratoconus, K readings 5.20 to 6.40mm

The most common Keratoconus types

OVAL CONE
The most common, K readings 5.80 to 7.20mm

Other types of Keratoconus

KERATOGLOBUS
Wide area at the center of the cornea blow off the shape of the cornea K readings 6.60 to 7.80mm

Other types of Keratoconus

Pellucid Marginal Degeneration

Is a rare condition where the lower part of the cornea becomes thinner and irregular.

The shape of the topography is like

two birds kissing !!!
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Other types of Keratoconus

Post Lasik Ectasia

Keratoconus that is caused by the change in the thickness of the cornea

The main problems caused by keratoconus

Vision loss the cornea gradually thins and becomes misshaped. The cornea surface becomes irregular similar to the shape of a cone from the I.O.P . Opaque cornea An advanced stage of the keratokonus, where the cornea cracks and becomes opaque, in this stage the only solution is a corneal transplant
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What to do ?? The most common ways

Fitting Contact Lenses

Intact rings implantation Corneal Implant

Specially designed RGP lenses Soft contact lenses designed specifically for Keratoconus Piggy back - soft contact lenses to "carry" a gas permeable lens Soft lens with a hard center Scleral contact lenses

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Treatment with contact lenses

The main goal Good vision

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RGP Lenses
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Soflex special lenses for Keratoconus

Naturalens Multi curves with special landing shape

For early keratoconus

OP8 High aspheric (ecc=0.8)

Especially designed for the most common types

Piggy-Back Lenses Hi DK GP lens on top of a thin soft lens

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All lenses are manufactured from Hi DK materials

RGP Lenses
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Soflex special lenses for Keratoconus

(cont)

Asymmetric
Especially designed for PMD

McGuire lens system Multi curves (5)

3 sets designed for nipple, oval and for globus cones

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All lenses are manufactured from Hi DK materials

Soflex special lenses for Keratoconus

Soft Lenses
SOFT K. & SOFT K. Toric
for Keratokonus and irregular corneas

Front Toric can be added

to part of the lenses, RGP and Soft !!!
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All lenses are manufactured from Hi DK materials

The target in fitting contact lenses for Keratoconus

Excellent vision day and night, no glare (pin hole) Hi level of comfort for many hours High oxygen material for corneal health Easy to fit and adapt Available to all
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Fitting guide for keratoconus contact lenses

Case history Total check up with slit lamp Evaluate tear quality and quantity Refraction and free vision quality Topography check of the cornea

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Fitting guide for keratoconus contact lenses (cont)

Selecting the first choice Trial Lens Evaluate fitting with slit lamp using fluorescien for GP lenses Changing the lens if needed Over refraction Ordering the lens

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Fluorescien pattern

The most common is the THREE POINT TOUCH Avoid having air bubbles

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Special !!

Fitting Tips For Soft

K.

Try to use the Soft K. for all types of distorted cornea. First check with Trial Lens after 30 minutes and change if necessary Final check for fitting and over refraction after at least 2 hours. Cleaning !! Using daily cleaner & H2O2 systems
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Follow up and lens care

Call the patient for regular checkups Give the patient solutions for taking care of his lenses Demonstrate and give written instruction of how to take care his lenses Instruct your patient to call you immediately when he feels any change in:

Visual acuity Comfort Any health change in his eyes

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THANK YOU VERY MUCH !!

QUESTIONS PLEASE
http://www.opt.pacificu.edu/ce/catalog/15167-AS/Keratoconus.html