Keratoconus

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Dr. Thanh Mai is the best of the best when it comes to specialty contacts.  His patients with keratoconus are being treated at the highest level of care and are achieving amazing results with their scleral lenses..” – Dr. David Shin, eye physician Gig Harbor Eye.”

How to Treat your Keratoconus without Eye Surgery

Learn the best way to treat keratoconus

  • Do you have keratoconus or pellucid and is it greatly impacting your vision?
  • Did your doctor tell you that you must have a corneal transplant?
  • Did your doctor recommend implant eye surgery called INTACS?
  • Does the thought of eye surgery seem frightening?
  • Are you worried you won’t pass your DMV test or are unsafe to drive (especially at night time?)
  • Does keratoconus make you feel down and depressed because you’re having trouble reading, driving, or performing your daily activities?
  • Have you tried hard contact lenses that kept popping out of your eyes and felt very uncomfortable?

If ANY of the above applies to you, then you’ve come to the right place. We see many patients with keratoconus who have started to give up hope, or were told that their only option was a corneal transplant when it just is not true with modern day technology. We see patients that have had INTACS yet still do not see clearly. Corneal transplant surgery is the last option (not the first!) when dealing with keratoconus.

Night time vision is poor when you have keratoconus

What is Keratoconus?

Keratoconus, which literally means “cone-shaped cornea,” is the most common corneal dystrophy in the US, affecting 1 in every 500 people. This noninflammatory, progressive thinning of the cornea causes the front part of the eye to bulge outwards, resulting in a pointed shape like the end of a football. There is no known significant geographic, cultural, or social pattern to the prevalence of keratoconus; it occurs all over the world and affects all races and genders equally. It is very similar to pellucid marginal degeneration.

Those with keratoconus usually start in their late teens or early twenties. It usually progresses for 20 years until it finally stabilizes. Meanwhile, one’s vision will progressively get worse and worse, leading to extreme myopia, halos at night, and glare and blurred vision. Keratoconus seems to be increasing in prevalence and in general it is best to avoid rubbing your eyes if possible.

Symptoms of Keratoconus

The earliest symptoms of keratoconus include slight blurring, distortion, and increased sensitivity to light due to the abnormal shape of the cornea. It can lead to extreme nearsightedness, or myopia, and astigmatism. Double vision in one eye and “ghost” images, or the appearance of several images when looking at an object, may also occur. In more severe cases, the protruding shape of the cornea can even cause a tiny crack to develop and the cornea to swell.

Unfortunately, keratoconus may be mistaken for other eye conditions such as cataracts or even a mere change in prescription, so it is important to get your eyes checked! An eye professional can detect changes in your cornea that may not be so obvious by just looking in the mirror. The main sign that an optometrist will sees is an abnormally high curve or steepening of your cornea. One of the diagnostic tools your optometrist will use is a corneal topographer. This will measure the curvature of your cornea.

Why Do Keratoconus patients suffer?

Initially, glasses or soft contact lenses can correct for mild myopia and astigmatism with keratoconus. However, as the cornea continues to thin, patients will usually need a rigid gas permeable lens to correct the visual aberrations. Unfortunately, many patients with rigid gas permeable lenses report a foreign body sensation, irritation, and overall discomfort. When a patient was intolerant to rigid gas permeable lenses, it was common to be told they need a corneal transplant. We’ve met many patients who could not wear a rigid gas permeable lens and did not have corneal transplant. These patients usually suffer for many years, in many cases needlessly as the treatment options and technology is much improved these days.

Causes of Keratoconus

Keratoconus occurs when the collagen of the cornea is weakened. When that part of your cornea weakens, your eye will sort of bulge outward causing an unnatural steepening. Scientists believe that there is an overabundance of free radicals and an enzymes that cause the cornea to degrade. Genetics definitely plays a role, so if there is a family history the chances that you may develop keratoconus increases dramatically. For this reason, we recommend that children of all parents with keratoconus have a comprehensive eye examination. With modern day technology, we can slow down or halt entirely the progression of keratoconus.

The life of a patient with keratoconus

Here is the personal keratoconus story of Jessica.

“My name is Jessica and when I was a kid up until my teenage years my vision was fine. I didn’t know I had any problems and no one else in my family as far as I knew had keratoconus.

In 2005 I went to my local optometrist and they tried giving me a pair of glasses when I first noticed my vision wasn’t good. I was having glare problems at night, and everything I saw had a ghosty or sort of shadowy outline haze to it. Even with glasses I couldn’t see that well and I was referred out. The specialist told me I had keratoconus and since then it’s become a big part of my life. I was fit with hard contacts but they never felt right and would pop out of my eyes. I gave up on them after 2 years because my eyes would get red and felt itchy when I wore the gas perm lenses. They told me eventually I would need a corneal transplant. I was pretty scared about getting a transplant… I was in my 20’s and started to worry if I would go blind because of keratoconus.

In 2015, my vision was getting really bad. I was driving around a lot for work and social events but I would get double vision, and driving at night time was nearly impossible. Headlights on the road would look streaky, and elongated. I was miserable and semi-depressed because I was having a hard time working as well. I probably looked mad all the time too because I was squinting nonstop at the computer screen when working. I didn’t tell many people about it and suffered silently.

I did some research online and went to Insight Vision Center Optometry where I heard worked a lot with people with keratoconus. Dr. Mai was excited and had a lot of energy, but I was a little nervous. He told me good news, that because my cornea didn’t have any severe scarring that my outlook was pretty good. I appreciated hearing that because even though my other docs were nice, they were not excited or positive about what they could do but sort of felt sorry for me.

He took measurements and ordered scleral contact lenses for me. 10 days later I got them and was BLOWN away. Everything was so clear, even better than my small gas permeable lenses. The lens felt really comfortable, almost like I was wearing nothing at all.

He measured my vision at 20/20 in both eyes. I was floored. I feel like I’ve never seen that clearly in the last 10 years. I can wear my scleral lenses all day long and can now drive at night much easier. I feel like my life has really opened up. I’m so grateful.”

Non-surgical treatments for keratoconus

With the appropriate treatment, at Insight Vision Center Optometry we are able to restore patients with keratoconus often to 20/20 vision! The treatment options may include scleral contact lenses, gas permeable lenses, hybrid lenses, or corneal crosslinking.

Our doctors focus on non-surgical treatment options for keratoconus. We have treated countless patients who were told they needed a corneal transplant but just needed the properly fit specialty lens. In fact, we often see patients who have already have eye surgery who still have vision issues. After treating them with a custom made gas permeable lens or scleral we’ve had tremendous success.

We have restored vision in patients with keratoconus who:

  • Are entirely new to keratoconus
  • Have tried other gas permeable lenses and failed
  • Considering INTACS or other types of surgery

We treat keratoconus with 4 options:

Scleral contact lenses

This is currently the most popular and successful method of treating keratoconus. Scleral contact lenses are larger than your traditional gas permeable lenses. They do not touch the cornea at all, which causes less rubbing on the cornea and thus are very comfortable to wear. Scleral lenses rest on the white part of the eye called the scleral. The lenses are filled with sterile saline solution before applying them to the eye. This bathes the eye with liquid and can help tremendously with chronic dry eye as well.

Rigid gas permeable contact lenses.

This involves a small hard contact lens that is placed directly into the cornea. It is gas permeable which means that oxygen can flow freely through the material as well. This helps to create a smooth refracting surface to improve vision that corneal irregularities are responsible for.

Custom Soft Contact Lenses

For some patients we can design a soft contact that that is more durable than the traditional disposable contact lens in order to treat the visual abnormalities associated with keratoconus

Piggyback contact lenses

Some patients cannot tolerate a hard contact lens on their eye. In this scenario we consider adding a soft contact lens to the eye and then placing a gas permeable lens over the soft lens. This makes it more comfortable and there will be less rubbing on the cornea from the gas permeable lens since there is a soft barrier in between.

Surgical Treatment options for Keratoconus

At Insight Vision Center Optometry, we are proactive in treating keratoconus and halting it progression so that our patients are able to achieve clear vision life long.

In these cases, we often recommend an FDA approved procedure called corneal crosslinking. Our doctors comanage with the best corneal surgeons and can discuss with you if pursuing corneal crosslinking is appropriate for you. Schedule an evaluation with our doctors to see if corneal crosslinking is right for you.

In the worst case scenarios, a corneal transplant might be your best option. It is never the first option, but there are circumstances where it is the only way to restore vision.

What Keratoconus Treatment is Best for YOU?

Our doctors LOVE to speak directly to you before you come in for an evaluation. This helps us to understand your history and gives us an opportunity to review your case before you even come into the office for our evaluation. This phone conversation is free and will help us learn more about your case and what can possibly be done to treat your condition.

If you are reading this, you have come to the right place. We treat patients with keratoconus every day. You need your vision to live your life to the fullest. Time to stand up to that bully that is keratoconus and fight back. Because life, takes vision. Give us a call and let’s get after it.

Meet Our Team

 

 

 

 

 

 

 

Dr. Thanh Mai has a passion for treating irregular corneas from keratoconus or after eye surgery. He has tremendous experience and is extremely successful in arriving at an amazing fit even in the severely damaged corneas. He has fit other optometrists and even their children in specialty contact lenses. In addition, he is a past-president of the Orange County Optometric Society and teaches younger optometrists and optometry students about fitting specialty contact lenses. He graduated from Marshall Ketchum University with summa cum laude.

“Nothing is more gratifying than to have my patients who have been struggling for years tell me they are now able to live their life so much either or even get their driver’s license back after years of not driving. Many of these patients have been bounced around from office to office and have never received lenses that they can comfortably wear all day long. Treating patients with keratoconus is the best part of my day.” – Dr. Thanh Mai

 

 

 

 

 

 

 

Dr. Valerie Lam has tremendous success with treating corneas of all shapes and sizes. Keratoconus patients traveled far and wide to come see her. She is one of only few optometrists to have a fellowship from both the American Academy of Optometry as well as the College of Optometrist for Vision Development. She completed a residency in Vision Therapy at the Marshall Ketchum University where she graduated magna cum laude.

“I really love making life-changing improvements to my patients with scleral lenses. The feeling of sheer gratefulness and joy from patients is the best part of my job here at Insight Vision Center Optometry. It is a blessing in my life to be able to help these wonderful patients.” – Dr. Valerie Lam

CALL US AT 714-486-3315.

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Scleral contact lenses can improve vision for those with keratoconus. Dr. Thanh Mai with one of his many happy patients who now have excellent vision! He hasn’t seen this clearly in over 20 years!

Keratoconus successfully treated to 20/20 vision! We love to help our patients live life to the fullest.

Come visit us at our Orange County office for keratoconus treatment. We are located in Costa Mesa but service all surrounding areas and would love to be your keratoconus doctor in Santa Ana, Irvine, Tustin, Huntington Beach, Fountain Valley, Newport Beach, Garden Grove, Fullerton, Orange, or Placentia.