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Keratoconus: Living with the Struggle

Woman Blond Closeup 1280×8531 out of 2000 People are Diagnosed with Keratoconus

Have you been recently diagnosed with keratoconus? While the challenges involved with your vision may have been noticeable over the past few years or more, such as poor vision, glare, and dizziness.

Keratoconus is a condition that can develop in the pre-teen years when the cornea starts to change its shape. Often, patients will seek the help of an optometrist when driving at night becomes unbearable from the glare or when they can't view the blackboard or computer screen due to poor, blurry vision.

What is Keratoconus?

When the surface of the eye changes shape from spherical to cone-shaped (or in severe cases ridges & further irregular structure), the light fails to pass through properly. Plus, fitting a regular contact lens to rest on and adhere to the eye surface is painful. These surface variations are unique to each individual, where some may be able to get by with contacts or glasses, while for others will typically rely on a gas permeable lens or scleral lens.

The real challenge for keratoconus patients isn’t from a lack of alternatives, rather finding a balance in their vision. Aside from prescription changes that could develop, keratoconus can cause such discomfort and visual distortion that a corneal transplant would be required.

For those living with Keratoconus, finding a knowledgeable and reliable optometrist with the latest technology is essential. Dr. Moshe Roth and Dr. Steffani Tiomno uses scleral lenses to bring visual comfort and remarkable clarity for patients with keratoconus and irregular corneas.

If you're considering a second opinion or a consultation, call to learn about the various specialty contact lens treatments available. Dr. Moshe Roth and Dr. Steffani Tiomno can custom tailor the solution needed for your unique pair of eyes.

End the struggle with your keratoconus, today!

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Sidebar-CONTACT LENSES

Scleral Lenses

Custom fit scleral lenses provide dramatic improvements in visual acuity and comfort levels to those with corneal irregularities due to LASIK eye surgery complications, keratoconus, astigmatism, dry eye, or other ocular conditions.

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A scleral lens sits on the sclera of the eye and vaults over the cornea, virtually eliminating friction and discomfort. This “dome” creates a new optical surface to replace the damaged cornea.

Moreover, the reservoir of saline solution between the back the lens and the front of the cornea perpetually keeps the eye in a liquid environment, providing the ideal environment for ocular healing.

What Are The Advantages Of Wearing
Scleral Lenses


Scleral Lenses Provide More Comfort and Improved Vision

Scleral lenses, larger in diameter than traditional lenses, spread their weight over a much greater, less sensitive area of the eye. Because the lens sits firmly on the eye, it offers more stable vision than traditional lenses, making them superior for physical activity, but with far less irritation.

Moreover, scleral lenses are composed of highly breathable gas permeable material, which ensures that ample oxygen reaches the eye, leading to healthy eyes and comfortable lens wear. Furthermore, the large size of the lens protects your eyes from debris, dust, and allergens, providing a perfect solution for those suffering from eye allergies.

eye doctor, advantage of scleral lenses
optometrist, Type of Scleral Lenses

How Many Types of Scleral Lenses Are There?


Scleral Lenses are The Gold Standard of Contact Lens Comfort And Can Work for Just About Anyone

  • Corneo-scleral lenses and semi-scleral lenses are much larger than typical GP lenses and rest right by the junction between the cornea and the sclera.
  • Mini-scleral lensesvault over the whole corneal surface and rest on the anterior sclera.
  • Full scleral lenses are the biggest in size and offer the most clearance between the back of the lens and the cornea.

Scleral lenses provide greater durability, easier handling and a lower risk for complications. The Family Eye Care has a wide range of custom scleral contact solutions that can work for you.

Who are Scleral Lenses For?


Anyone desiring to achieve the best vision with contact lenses is a great candidate for scleral lenses.

Scleral lenses are particularly helpful in managing the following conditions:

Keratoconus: Those with Keratoconus (keh-rah-toe-cone-us), an eye disorder in which the round dome-shaped cornea progressively thins and causes a cone-like bulge to develop, can massively benefit from wearing scleral lenses. Their irregular, cone-shaped corneas cannot be properly corrected using glasses or traditional contact lenses. Scleral lenses are therefore the ideal solution. They sit on the sclera without touching the cornea, while providing sharpness, clarity and comfort in vision.

Post-corneal transplant : A corneal transplant replaces diseased or scarred corneal tissue with a healthy cornea donated by a local eye bank. However, following a transplant, the cornea can become irregular and astigmatic. Scleral lenses are the safest and most comfortable way to correct for irregular astigmatism. Furthermore, following a corneal transplant, no part of the cornea should be touched with a contact lens. Scleral lenses are ideal in this case, as they vault over the cornea without touching it directly.

Dry Eyes:Those with Dry Eye Syndrome may find traditional contact lenses difficult to wear. However, given that scleral lenses contain a tear reservoir between the back of the lens and cornea, the front surface of the eye remains moist and comfortable all day long. This makes scleral lenses a great choice for Dry Eyes.

Hard-to-fit eyes: Patients with an irregularly shaped cornea, whether due to natural causes, an eye condition (i.e. keratoconus), or complications following surgery (such as LASIK), can at times develop vision problems which cannot be corrected using glasses or soft contact lenses. In such cases, scleral lenses provide a more comfortable, secure fit, and improved vision.

Scleral lenses also help manage the following eye conditions:

  • Astigmatism
  • Giant papillary conjunctivitis (GPC)
  • Post-refractive surgery (i.e. LASIK, PRK)
  • Presbyopia

Dr. Moshe Roth and Dr. Steffani Tiomno and the caring and knowledgeable staff at Family Eye Care provide advanced custom contact lens fitting for even the most hard-to-fit-patients.

eye exam, who are scleral lenses for

Does Insurance Cover Scleral Lenses?


When it comes to scleral lenses, every insurance company is different. Some cover the examination and custom fitting, but not the actual lenses. Others may cover a portion of the cost or 100% of the cost, but only if other treatment methods have been exhausted. It’s important that you check with your specific insurance provider to understand the particulars of your scleral lens coverage.

If 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 you for the lenses. Scleral lenses require precise customization, and every patient’s case varies in degrees of severity and corneal measurements.

Get advanced contact lens fittings by Dr. Moshe Roth and Dr. Steffani Tiomno at The Family Eye Care. We serve patients from Old Bridge, East Brunswick, Sayreville, Manalapan and throughout New Jersey.

Serving Scleral Lenses Patients from:

Old Bridge | East Brunswick | Sayreville | Manalapan | throughout New Jersey

Soft Contact Lens Complications

Soft lenses are FDA approved to be worn every day and to be replaced after a specific time, for example, there are lenses that are approved for 2 weeks, for a month, for 3 months, and then you begin with a new one.  Lenses that are worn as extended wear (worn during the day and at night while sleeping) cause more problems than lenses that are either worn only during the day or lenses such as orthokeratology molding lenses that are only worn at night.

Soft lenses that are not daily disposable lenses, must be cleaned after every use.  As lenses get older, there are more deposits from your own tears that stay on the contact lens.  When someone wears a lens for longer than they are approved for, then problems associated with contact lens over-wear can occur.

More deposits mean more potential for problems.  When someone does not clean their lenses or does not replace them when they should be replaced, are at a greater risk for problems.  If you or your child can keep to a regimen, these are great.  If not, then this can lead to problems such as:

  • Corneal Ulcer
  • Giant Papillary Conjunctivitis
  • Neovacularizartion

These are some examples of problems that our eye doctor near East Brunswick, NJ want to help you solve BEFORE they ever become a problem.

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Tinted and Colored Contact Lenses

eye colour spectrum pupil close upLenses to change your eye color

Do you want to change your eye color? Do you want it to be wild and dramatic or do you want just a subtle change? We can meet what you need. There are many different types of color lenses. We offer lenses that give:

  • a more subtle color change
  • a much more dramatic change.
  • light eyes a different color
  • dark eyes a light color.
  • special effects; Wild Eyes lenses.
  • disfigured eyes a more natural appearance.

There are many lenses that are already manufactured with certain effects and in certain colors. The advantage of these is that since they are already manufactured, they are more easily obtained.

For people who want a unique color, or if an eye is mis-colored because of a congenital problem( problem at birth) or a problem that occurred due to an injury, we can customize the shape of the contact lens to match the other / existing eye. That is called a prosthetic contact lens,

Lenses to change your eye color are medical devices and require a full eye examination and contact lens evaluation. Sometimes people find “alternative” sources to get plano lenses. Getting lenses from a source other than an eye doctor, puts you at risk. Some people have lost permanent vision when doing that because they are not getting the right instructions for care or the care needed after dispensing the lenses.

 

 

What is Astigmatism?

Astigmatism can be confusing.  It is mistakenly called “stigmatism,” or "stigma".  This common vision problem can be corrected with eyeglasses, contact lenses or Ortho-K.  Like nearsightedness and farsightedness, astigmatism is a type of refractive condition related to the shape and size of the eye that causes blurred vision.  Astigmatism is a relatively common vision problem, but not too difficult to address.  Many people are relieved to learn that astigmatism is not an eye disease.

Uncorrected astigmatism can cause blurred vision, headaches, eyestrain and make objects at all distances appear distorted.  Lenses for astigmatism can be made in several different ways:

  • Soft Toric - these have the advantage of comfort but may not be as sharp as Gas Permeable lenses
  • Oxygen Breathing / Gas Permeable - these often provide the best correction and more clear vision for astigmatism
  • Synergeyes Hybrid contact lenses have a GP center and a soft periphery (outside part) to provide the clarity of gas permeable lenses and wearing comfort that is comparable to soft lenses.
  • Orthokeratology

Other Types of Soft Lenses

Soft Lenses have been around for a long while.  There are soft lenses that are FDA approved for

  • 2 Weeks,
  • 1 month
  • 3 months, also called “quarterly” lenses.

All of these are FDA approved and have been available for a long time.

The advantage these lenses have over Daily Disposables is they cost less.  The disadvantage is they must be cleaned and removed. We are not advocates of extended wear lenses that are worn for long periods (up to 30 days) because there is much more risk for infection and permanent vision loss.

The longer a lens is worn, the more build-up there is on the lenses. It then becomes more difficult to see clearly.  As there is more buildup from your tears, mucin, and protein, the less air (oxygen) gets though and therefore more prone to eye health problems.  These lenses still have the FDA seal of approval but have more complications.  Also, as someone works on the computer or reads for longer amounts of time, these lenses tend to dry out and cause the eyes to feel dry.

For many years, 2-week lenses had been popular, but the problem associated with them is it is hard to remember when they were last replaced. People tend to then over-wear their lenses beyond the lifespan they are FDA approval for, and this increases the possibility of complications. The benefit of 1-month lenses is that it is easier to keep track of when they were replaced.

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Daily Disposable Soft Contact Lenses

Daily disposable lenses have the advantage of having a fresh clean new pair every day.  No need to clean. Good optics. Healthy. No additional cost of contact lens solutions.  Many parents like these for their children.

They are great for everyday wear, or just for sports or special occasions. Some people like the flexibility of switching back and forth between eyeglasses and contact lenses and want to wear their lenses a few times a week.

These lenses are now available for people who are:

  • Nearsighted
  • Farsighted
  • Multifocal – clear vision both distance (driving) and near (computer, reading). Most people begin to notice difficulties witching between distance and near at about 40.  These lenses address that.
  • Astigmatic for those people who have the need to see clearly because of the unique shape of their eye.

Other traditional soft lenses are approved for

  • 2 Weeks,
  • 1 month
  • quarterly (3 month lenses).

AquaComfortPlus productShotAll of these are FDA approved and have been available for a long time.  Non-Daily Disposables have the benefit of reduced cost, but they must be cleaned and removed. Lenses used for longer have more build-up on the lenses from your tears, and it can, therefore, become more difficult to see clearly.  As there is more build-up from your tears, mucin, and protein, the less air (oxygen) gets though and therefore more prone to eye health problems.  As someone works on the computer or reads for longer amounts of time, these lenses tend to dry out and cause the eyes to feel dry.

For many years, 2-week lenses had been popular.  A problem is that it is hard to keep track of when they were last replaced.  People tend to then over-wear their lenses beyond the lifespan they are FDA approval for, and this increases the possibility of complications. The benefit of 1-month lenses is that it is easier to keep track of when they were replaced.

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Contact Lenses – Standard

In our eye care clinic in Old Bridge, we prescribe many different types of contact lenses, from basic standard contact lenses, to more complex and specialty lenses.  There are lenses specifically for children, for teens, and for adults. Our Old Bridge optometrist listens carefully to find out what your specific vision needs so we can help you solve them.

Many people are surprised to learn there are so many different types.  Most people only know about soft lenses and may have heard about gas permeable lenses.

There are contact lenses for people that:

  • are Nearsighted (Myopia)
  • are Farsighted (Hyperopia)
  • need Bifocals or Progressive eyeglasses, and want to be able to see both distance and near (Presbyopia),
  • have Astigmatism.

We have solutions to provide:

  • Vision Rehabilitation after LASIK and
  • Vision correction without surgery.

Each type of lens has its advantage.  Soft Contact Lenses are very popular because they are comfortable almost immediately.  Gas Permeable contact lenses have the advantage of sharper clearer vision, longer life, better eye health, and are easier to care for.  Together we will figure out what you need and what will work best for you.  Some people are driven by comfort and that is their higher priority.  For others, particularly those who have dry eye due to contact lens wear, other lenses work better.  People who have a higher need for sharper vision, particularly on the computer, may benefit from gas permeable lenses.

Soft contact lenses

  • Daily Disposables - A new fresh health pair... Every Day!
  • Other Disposables - 1 & 2 Week Disposables, 1 & 3 Month Disposables
  • Soft Bifocal Lenses to enable you to see at distance and at near.  At about 40, people start to notice some difficulty seeing at near (reading or computer distance) through their contact lenses that they had needed only for distance until then.
  • Special lenses for people who have the Dry eye, Keratoconus, damage after LASIK surgery
  • Prosthetic Lenses - To improve appearance after injury or congenital problems

Gas Permeable contact lenses

Gas Permeable (GP) contact lenses have many benefits and are often better than soft lenses because they provide sharper vision and a more stable and accurate correction of astigmatism.  they have the advantage of allowing more oxygen into the eye and are often a healthier system.  They are easier to insert and remove since they are smaller.  they also have the advantage of lasting longer.  one of the nicest features, especially for children, is that they slow the progression of nearsightedness in most children. The gas peremeable lens material is used for orthokeratology, where specially designed contacts are worn during sleep to reshape the cornea and improve vision.

Some people are more driven by the sharpness and clarity and others are more driven by comfort.  The good news is that we can meet what your demands are.  

Tell me more about Disposable Contact Lenses

All lenses are disposable.  They just differ in how often you dispose of them.  The major advantage of Soft Contact Lenses is that they are comfortable almost immediately.  All soft lenses, however, become coated with your tears, mucin, lipid, protein, etc.  The bottom line is that they become dirty.  Years ago, they started out as a pair was intended to last a year, but what we found is that as people wore their lenses longer, they had more problems.  That is why most soft lenses are disposed of on a regular basis;

  • daily,
  • 2 week,
  • 1 month,
  • 3 months.

Soft lenses are FDA approved to be worn every day and to be replaced after a specific time, for example, there are lenses that are approved for 2 weeks, for a month, for 3 months, and then you begin with a new one.  Lenses that are worn as extended wear (worn during the day and at night while sleeping) cause more problems than lenses that are either worn only during the day or lenses such as orthokeratology molding lenses that are only worn at night.

Soft lenses that are not daily disposable lenses must be cleaned after every use.  As lenses get older, there are more deposits from your own tears that stay on the contact lens.  When someone wears a lens for longer than they are approved for, then problems associated with contact lens over-wear can occur.

Read more