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Scleral Lenses For Visual Rehabilitation Following a Corneal Transplant

Tens of thousands of corneal transplants, or keratoplasty procedures, are performed every year. Several reasons explain why one would undergo keratoplasty.

  • Eye diseases or eye injuries that are left unmanaged or uncorrected
  • Severe cases of glaucoma, age-related macular degeneration or cataracts
  • Advanced stages of corneal degeneration or dystrophy

Essentially, a diseased cornea can lead to blindness without proper care from an eye doctor, and keratoplasty is meant to restore as much vision as possible. However, following the surgery, patients may experience vision problems and may require specialty contact lenses to see clearly and comfortably.

Post-Keratoplasty: Treatment & Recovery

Recovery from a corneal transplant might take up to a year, as the eye needs time to adjust to the new cornea. Many patients emerge from the surgery nearsighted or with astigmatism. Often, eye doctors will prescribe eyeglasses or specialty lenses to help with vision during this interim period that may at times have to carry on being worn after the eye has fully healed.

Visual Rehabilitation With Scleral Lenses

Keratoplasty frequently results in irregular corneal surfaces due to the transplant’s inability to fully adapt to the eye. Rigid gas permeable lenses (RGPs), hybrid contact lenses, or scleral lenses may be recommended to give a patient clear and comfortable vision without the need for additional surgery.

Scleral lenses are often the optimal choice, as the lens is designed to vault entirely over the cornea rather than rest on it. Scleral lenses allow a patient’s cornea to remain hydrated, provide clear vision, and avoid any risk of corneal scarring.

Contact Family Eye Care to learn how scleral lenses can provide you with clear and comfortable vision following a corneal transplant.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
Book An Appointment
Call Us 844-450-6850
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What is Corneal Dystrophy

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What is Corneal Dystrophy and How Can Scleral Contact Lenses Help?

There are many different corneal dystrophies with overlapping symptoms. Among these symptoms is distorted vision due a misshapen corneal surface, more commonly referred to as corneal irregularity. Scleral lenses offer the perfect solution, as they even out the corneal irregularity, thus providing clear and sharp vision.

An eye exam at Family Eye Care can examine your eyes and determine whether scleral lenses are appropriate for you.

What is Corneal Dystrophy?

Corneal dystrophy refers to a group of genetic and often progressive eye diseases characterized by the accumulation of abnormal material in at least one of the five layers of the cornea.

Most corneal dystrophies progress slowly and in both eyes. The age at which one can expect symptoms varies on a case-by-case basis.

Diagnosis of Corneal Dystrophy

An optometrist can usually detect the presence of corneal dystrophy with a slit lamp microscope during a regular eye exam. During this simple test the doctor shines a bright, thin beam of light into your eye. With the help of a slit lamp, discoloration or deformation of the cornea become visible. The exam can also show the build-up of abnormal material in the cornea.

The eye care professional will look into your family history of eye diseases, as corneal dystrophies are generally inherited. In some cases, genetic testing can reveal whether you are affected.

eye layersSymptoms of Corneal Dystrophy

People with corneal dystrophy may not experience any symptoms, while in others, the disorder may lead to significant vision impairment. Vision can be affected by the irregular shape of the cornea, as light is not bent correctly onto the retina. In addition, the accumulation of foreign material within the cornea can cause it to become foggy. In many cases, patients experience recurrent corneal erosion. This occurs when the top cell layer (the epithelium) detaches from the layer beneath.

Common symptoms for most corneal dystrophies include:

  • blurred vision
  • increased sensitivity to light (photophobia)
  • the feeling of having a foreign object in the eye
  • itching, pain, or severe discomfort
  • vision loss

How Can Corneal Irregularities Be Treated?

Traditional soft contact lenses cannot correct vision, as the lens merely takes on the irregular shape of the eye surface. Similarly, regular eyeglasses provide improvement only for moderate astigmatism; however, in high irregular astigmatism, eyeglasses are not able to correct the condition.

Corneal erosion may be treated with medication, such as antibiotics, lubricating eye drops, or ointments, to repair damage to corneal tissue. Laser treatment may be applied, or, in severe cases, a corneal transplant may be required.

Rigid Gas Permeable (RGP) lenses for Corneal Dystrophies

RGPs can correct a patient’s vision since the inner surface of these lenses can be adapted to the irregular cornea, while the outer surface maintains a smooth round shape, thus correcting refraction at each point of the cornea.

Scleral Lenses for Corneal Dystrophies

Scleral lenses offer clearer vision than RGP lenses as they vault over the corneal irregularity, forming a smooth dome-shaped surface. They are larger in diameter and rest on the sclera, the white part of the eye surrounding the cornea. The dome-shaped scleral lens spans over the cornea, creating an optically perfect surface with a liquid-filled vault underneath.

In addition, the lens is more comfortable to wear than most other lenses. The larger diameter prevents it from moving around on the eye, and the extra liquid between lens and cornea ensures that the eye remains well lubricated.

Types of Corneal Dystrophies

There are around 20 different types of corneal dystrophies, which can be divided into three distinct categories:

Anterior Corneal Dystrophies, which affect the outer layers of the cornea. These include Map-dot-fingerprint dystrophy, Lisch dystrophy, Meersman corneal dystrophy, Reis-Buckler corneal dystrophy and Thiel-Behnke corneal dystrophy.

Stromal Corneal Dystrophies, which affect the central or stromal layer of the cornea. These include granular corneal dystrophy, Lattice corneal dystrophy and macular corneal dystrophy.

Posterior Corneal Dystrophies, which affect the innermost layers of the cornea. These include congenital hereditary endothelial corneal dystrophy, Fuchs’ corneal dystrophy, posterior polymorphous corneal dystrophy and Schnyder crystalline corneal dystrophy.

woman in sunflowersWhy Should I Contact an Optometrist? I already See a Corneal Specialist!

A corneal specialist is a surgeon. What you need is someone to monitor the status of your dystrophy. We will carry out regular eye examinations to detect changes in your cornea’s health before you experience discomfort and feel the need to contact a specialist.

At Family Eye Care we have the knowledge and technology to monitor your eye health closely. Many patients are astonished at the level of diagnostic equipment and the extent of examinations at our practice. With early detection, Dr. Moshe Roth and Dr. Steffani Tiomno can prescribe whatever treatment is necessary at any time or refer you to a corneal specialist, who we keep updated.

Also, at Family Eye Care we are trained in fitting specialty contact lenses and can evaluate whether scleral lenses are the ideal choice for your condition. We will conduct all the necessary eye exams, such as the exact mapping and measuring of your cornea’s surface, and provide you with the best lenses for optimal comfort and clear vision.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.

Resources

Book An Appointment
Call Us 844-450-6850
Learn More About Scleral Lenses
What are Scleral Lenses Thumbnail 1.jpg

What are Scleral Lenses?

Scleral Lenses for Keratoconus Thumbnail.jpg

Scleral Lenses for Keratoconus

eye pain Thumbnail.jpg

Corneal Disease and Scleral Lenses

beautiful eyes1.jpg

Who Wears Scleral Lenses?

Specialty FAQ Thumbnail.jpg

Scleral Lenses: FAQ

tips and researches Thumbnail.jpg

Tips and Resources

Scleral Lens Blog Thumbnail.jpg

Scleral Lens Blog

Read Our Latest Posts
Everything You Need To Know About Keratoconus 640×350 11.jpg

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Scleral Lenses 4 Facts You Should Know 640×350 1.jpg

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Are Contact Lenses Not Working for You 640×350 1.jpg

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Stay Active and See Better With Scleral Lenses 640×350 1.jpg

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