The California Keratoconus Center has made an agreement with Bostonsight, maker of the BostonSight Scleral Lenses, to conduct a study of Keratoconus Patients with High Order Aberrations. The goal of the Keratoconus High Order Aberrations Contact Lens study is to develop a technique for eliminating the High Order Aberrations common to people with Keratoconus (“Keratoconics”).
What Are Keratoconus and High Order Aberrations
Keratoconus is a complex eye condition that results in an uneven cornea with pits and valleys. This oddly shaped cornea causes vision to be different and blurry depending on from which direction the light enters the eye. Imagine looking through a wavy piece of glass. We’ve been very successful in non-surgical Keratoconus treatment for our patients using Scleral lenses for many years.
While we can treat Keratoconus and achieve 20/20 vision with many patients, some Keratoconics still may notice and be affected by bright light entering the eye, causing halos, rings, glare, starbursts, double vision and worse. It’s like looking at a bright light through cut glass or crystal.
What Causes High Order Aberrations?
These High Order Aberrations are caused by dramatic inconsistencies that can occur anywhere along the light’s pathway to the retina — the most dramatic being both the front and back of the cornea — and have traditionally been much more difficult to correct.
High Order Aberrations (HOA’s) can be genetic. However they can also be caused by numerous other eye conditions, injuries or surgeries. Some surgeries, such as LASIK and PRK, are performed for more common vision issues like Myopia, Hyperopia, Astigmatism and Presbyopia. Ironically, the insertion of Intacs Rings, a surgical Keratoconus treatment, have been known to also cause HOA’s.
Why Are High Order Aberrations So Difficult To Correct?
In a typical contact lens or pair of glasses for conditions such as nearsightedness or farsightedness, the cornea is consistent — round like a basketball — and the lens is designed to refract light somewhat consistently across the entire 360 degrees of the lens. But Keratoconus and High Order Aberrations are positional — every spot on the cornea is different. Keratoconus Contact Lenses are prescribed by mapping the front surface of the cornea and designing the lens to deal with the differences at every point.
One of the reasons we are so successful at treating Keratoconus is our technology, and in particular the Eaglet Eye Surface Profiler, which maps up to 350,000 points on the surface of the eye, covering 100% of the cornea and most of the sclera (the white part of the eye).
But High Order Aberrations can also be caused by deformities in the back of the cornea, the lens, or the vitreous, which requires the use of other technology to diagnose and detect. We use the Nidek OPD III, which has many features including aberrometry — detecting and measuring High Order Aberrations. It’s because of our expertise with the Eaglet and the Nidek OPD III, combined with our experience in designing and fitting Keratoconus Contact Lenses that BostonSight asked us to partner with them on this Keratoconus High Order Aberrations Contact Lens study.
How This Keratoconus High Order Aberrations Study Will Be Conducted
The motivation for this study is the large percentage of Keratoconics that are bothered by High Order Aberrations. They can often see 20/40 or better, but still cannot drive at night or experience pain when looking at bright lights.
Participants in the study will first be diagnosed and scanned with both the Eaglet and Nidek OPD III, as well as other advanced technology in our office. We use these technologies to help design scleral lenses that fit perfectly for the patient, which is a requirement of the study’s process.
BostonSight then makes an HOA Measurement Lens, which are similar lenses of the same shape but without the prescriptive corrections. With these lenses on the patient, we then measure the HOAs in a light and dark environment. Using our instruments, we can actually show the patient pictures of the HOAs that they see, which is often a very emotional moment for the patient.
We send the data we generate to BostonSight, who then adds the HOA corrections into the original prescription lenses, resulting in a single pair of lenses that contain both the vision correction and HOA corrections in the same lenses.
These final lenses often improve the patient’s vision by one or two lines on the eye chart with significant or near total elimination of the glare, halos and other HOAs they experience without these lenses. The final result is often another emotional moment for the patient.
How To Apply To This Keratoconus High Order Aberrations Contact Lens Study
This study is not free, but partially subsidized by BostonSight and the California Keratoconus Center. If you have Keratoconus and also suffer from High Order Aberrations, you can apply to participate in this study by contacting our office online or calling Dr. Barry Leonard, Director of the California Keratoconus Center at 818-891-6711.
