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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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Enhanced Vision & Comfort with Scleral Lenses

Have irregular corneas or severe dry eye?
Try scleral lenses!
They’re custom fit, providing more comfortable, clear, and improved vision.

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What are Scleral Lenses?

ScleralLens-Diagram-dark

Scleral contact lenses are rigid gas permeable lenses with an extra-wide diameter. As opposed to traditional contacts, scleral lenses vault over the entire cornea, leaving a gap between the lens and the corneal surface before coming to rest on the white part of your eye (your sclera).

Their unique design has taken scleral lenses to the top of the charts for ultimate wearing comfort, healthy eyes, and excellent vision for people of all ages.

They are custom-fit to your eye and are perfect for those with hard-to-fit eyes, astigmatism, keratoconus, severe dry eye, or for those simply seeking more comfort when wearing contact lenses.

Read More about Scleral Lenses

With scleral lenses, you’ll experience consistently clear vision—even if you have an irregular cornea. Here are some of the benefits provided by scleral lenses:

  • Their super-size diameter ensures that they stay centered and stable on your eye, which also prevents them from popping out easily, even if you play sports or lead an active lifestyle.
  • They are made up from high quality, durable materials to last for the long haul.
  • The large size of the lens protects your eyes from debris, dust, and allergens, providing a perfect solution if you suffer from eye allergies.
  • They are composed of highly breathable gas permeable material, which ensures that ample oxygen reaches the eye, leading to healthy eyes and comfortable lens wear.
  • These lenses have a pocket that fills with moisturizing tears. This wet, lubricating cushion leads to a very comfortable wearing experience, as well as healthier eyes.

Ready to say goodbye to all those contact lenses that felt uncomfortable and didn’t give you sharp vision?

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Who Wears Scleral Lenses?

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Some wear them for increased comfort, while others choose sclerals because specific eye problems prevent them from wearing regular contact lenses or glasses.

Scleral lenses are extremely helpful in managing the following conditions:

Dry Eyes: For people with gritty, itchy and dry eyes, wearing traditional contact lenses are an added irritation. In contrast, the tear reservoir between the back of the scleral lens and the cornea, the front surface of the eye, allows your eyes to remain moist and comfortable all day long. This makes scleral lenses ideal for those with dry eye syndrome.

Hard-to-Fit Eyes: Those with 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 that cannot be corrected using glasses or soft contact lenses. In such cases, scleral lenses provide a more comfortable, secure fit, and sharper vision.

Scleral lenses are particularly useful for managing these eye conditions:

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

Whatever your case, we welcome you to call Dr. Moshe Roth and Dr. Steffani Tiomno to discuss your needs and assess whether scleral lenses are a suitable and effective solution for your unique case.

Learn More about Scleral Lenses | FAQ

medical-plus medical-plus How do Scleral Lenses Help with Dry Eye Syndrome?

Scleral lenses tackle three factors simultaneously: they provide vision correction, they protect the eye, and they serve a therapeutic purpose by lubricating the eye. 

By filling the bowl of the lens with unpreserved saline solution prior to inserting it in the eye, you ensure that your eyes are always in a hydrated and comfortable environment. This provides relief from unpleasant dry eye symptoms such as pain, discomfort, eye redness, and itchiness while providing sharp, clear vision.

medical-plus medical-plus Why Do Scleral Lenses Offer Superior Comfort?

Scleral lenses are custom-fit to each person’s unique eye shape, corneal curves, and contours, providing unparalleled comfort. Their size and shape also ensure stability.

To design the lenses, Dr. Moshe Roth and Dr. Steffani Tiomno will take exact measurements of your cornea through a process called corneal topography. This process ensures that your personal pair of scleral lenses allows the right amount of light in and sits stably on the eye, thus offering superior vision, all-day ocular hydration, and increased comfort. 

If other contact lenses haven't worked for you, don’t despair — you may be a candidate for scleral lenses. Talk to Dr. Moshe Roth and Dr. Steffani Tiomno to determine your best course of action.

medical-plus medical-plus Does Insurance Cover Scleral Lenses?

When it comes to scleral lenses, every insurance company is different. Some cover the eye exams 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 consult with your  insurance provider to understand the particulars of your scleral lens coverage.

It is our strong belief that one’s quality of life is profoundly associated with one’s vision. Vision problems, whether due to keratoconus, LASIK, ocular trauma corneal irregularities, or dry eye syndrome, affect all aspects of a patient’s life.

Relieve your discomfort by scheduling a consultation with Dr. Moshe Roth and Dr. Steffani Tiomno and we’ll help you find the best solution for your condition and lifestyle.

Book An Appointment

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