Some of our new patients at the California Keratoconus Center already know they have Keratoconus and have not only received a diagnosis but also have begun to receive treatment. They come to us for a second opinion about their Keratoconus, or because they are unhappy with their current treatment — they tell us that their Keratoconus Contact Lenses don’t work. That’s actually a fairly common complaint, but the reason why their Keratoconus Contacts don’t work can vary.
Figuring Out Why Your Keratoconus Contacts Don’t Work
What’s interesting about these complaints is that usually the patient can see 20/20 with their lenses, but are still left with some other problems and symptoms that interfere with their quality of life. When we bring on a new patient, we do a thorough exam that follows our cKlear Method™ for diagnosing and treating Keratoconus. We will also examine their current contact lenses to see how well they were made to match the condition of their eyes. Often, we’ll find the problem and develop a treatment the same day.
Our approach all starts with their initial complaint. Among them are:
- Night Driving Is Difficult
- Glare, Streaks and Halos
- Fogging and Cloudiness
- My Keratoconus Contact Lenses Hurt
- My Vision Is Still Blurry
While many new patients come to us complaining about more than one of these issues, each one can have multiple causes.
Keratoconus Contact Lenses Don’t Work While Driving At Night
Some people say that their Keratoconus contacts don’t work because they have difficulty driving at night, which is a fairly common problem. There are a few reasons for that, the first of which is that eye exams are most often in a well-lit office when the pupils are small. But night vision involves a pupil opening wider to let in more light. If you have High Order Aberrations (explained below), their effects may be more pronounced when the pupils open wider. Read more about Driving with Keratoconus.
Glare, Streaks, Halos and Other High Order Aberrations
Some people with Keratoconus often see clearly 20/20 when tested in a doctor’s office, but when actively living their lives end up seeing glare, streaks, halos and other kinds of visual anomalies. These and other effects can be seen any time of day or at any brightness, but are usually more pronounced at night, especially while driving.
These anomalies are called High Order Aberrations (HOAs). Think of HOAs as drastic changes in the surface of the cornea, while Low Order Aberrations are more subtle changes (such as nearsightedness, farsightedness, and astigmatism). When light enters the more severe curvatures of HOAs, the light entering the eye can cause a number of problems, including:
- Glare/Streaks
- Starbursts
- Halos and Rings
- Night Vision problems
- Ghost Images
- Double Vision
Keratoconus contact lenses must be specifically designed to (mostly) eliminate High Order Aberrations. Only the most simple HOAs can be eliminated without building in special geometry to eliminate HOAs. Read more about Scleral Lenses for High Order Aberration control.
Fogging and Cloudiness
Fogginess and cloudiness can again be attributed to poorly designed contact lenses. But sometimes it has more to do with the fluids in your eyes than anything else. Your eyes are making tears (“tears” as in crying, not as in ripping) all the time. Contrary to popular belief, tears are not made up of just water, but are instead made up of three layers: an oily Lipid layer that keeps your eyes feeling smooth, an Aqueous layer that retains moisture, and a Mucin layer that helps the tears stay on the eyes.
If the chemical composition of any of these layers is off, either naturally or with artificial chemicals, the tears may not function properly and cause fogging and cloudiness. These chemical imbalances can also cause dry eyes. Read more about Dry Eyes here.
Your eye could also be excreting other fluids due to disease or infection.
If your Keratoconus contact lenses don’t work due to fogging and cloudiness, solving the problem might be as simple as using different contact lens solutions (we recommend Refine OneStep to most of our patients) or artificial tears (We recommend Oasis Tears). Or you may be suffering from allergies, in which case anti-allergy or prescription dry eye drops may help. And in some cases, you may have an infection of some kind, in which case antibiotic drops may help to cure the infection and relieve the fogging and cloudiness.
My Keratoconus Contact Lenses Hurt
As you probably know by now, eyes with Keratoconus have a bumpy and uneven cornea, which is the clear front window that protects the most sensitive parts of your eyes. When the cornea is bumpy and uneven, a contact lens that is designed for a smooth cornea is not going to fit correctly, and will likely hurt.
In some cases, a part of the cornea that protrudes a bit will create a bit of a teeter-totter effect so that the contact lens cannot ever fit properly on the eye. The eyelid passes over the lens with every blink, causing irritation.
This is most often the case with conventional soft or hard (RGP) contact lenses. That’s why we prescribe and design Scleral contact lenses for our Keratoconus patients. These Scleral Lenses are wider and rest on the whites of the eyes, and don’t touch the cornea at all. The result is a much more comfortable Keratoconus contact lens.
Read more about Why Keratoconus Contacts Hurt, Itch, and are Uncomfortable
My Visions is Blurry All The Time
If your vision is still blurry and you can’t see clearly when wearing your Keratoconus Contact Lenses, It just may be that your prescription isn’t correct. Relatively few Optometrists are fully trained in diagnosing and treating Keratoconus, and so they occasionally have no idea why they can’t figure out a prescription that works for their patient. As a result, they do their best and write a prescription that solves most of a patients’ vision problem, but they never realize that the patient has Keratoconus. (Note: That’s why we help to teach other doctors how to diagnose Keratoconus.)
Blurry vision that cause you to say your Keratoconus contacts don’t work, and may also be caused by the prescription in the lens not being properly centered in the lens, which means that specific corrections end up on the wrong part of the eye.
With our cKlear Method for treating Keratoconus, we can design Scleral Contact Lenses that sit stationary on the eye, ensuring that the right correction is over the right part of the eye all the time.
Find Out Why Your Keratoconus Contacts Don’t Work
Your Keratoconus contact lenses might not work as well as they want them to for these and potentially other reasons. Or, it could be a combination of these reasons. Everyone’s eyes are different from any other patients, and most of the time, your two eyes are different from each other. The only way to really know why your Keratoconus contacts don’t work is to have a Keratoconus Eye Exam, and there is no better place to do that than at the California Keratoconus Center in Los Angeles. Make your Keratoconus exam appointment online or call us at 818-891-6711.
