How to select contact lenses for Keratoconus ? | Hong Kong | EYE.hk

SPECIALTY

CONTACT LENSES

Irregular Cornea Management

(keratoconus, post-lasik, post-trauma and post-graft)

EYE.hk Eyesight Hong Kong Optometry Center is founded by four experienced optometrists. It aims to provide public an "one stop optometry service". 

In our center, there are state of the art equipment and contact lenses. After eye examination, our optometrists will provide you professional advice on your contact lenses options.

Our Mission

Besides regular disposable soft lenses, we also fit specialty contact lenses. They can improve the quality of life for those needed, such as people with complicated prescription, irregular cornea, post-LASIK, post-graft and sever dry eye cases.

We would like to help people see better. We would like to provide vision rehabilitation service by contact lenses fitting.

"美觀自信,健康淸晰"

"We care about your look and how you look"

 

scleral classification.jpeg
 

Special Prescription Lenses

(high myopia, farsightedness, astigmatism and presbyopia)

We have different types of custom made contact lenses for people with high level myopia, farsightedness, astigmatism and presbyopia. Those custom made contact lenses includes soft, rigid and gas permeable lenses.

Rigid Gas Permeable (RGP) Contact Lens Benefits and Applications

1. Excellent Vision

(capable to correct -20.00D myopia, -10.00D astigmatism and presbyopia)

Automatically corrects most corneal astigmatism

Excellent optical quality

Good surface wetting ability with tear

Wide range of bifocal lens designs

2. Excellent Eye Health

On average 2-3 times more oxygen supply to the cornea as compared to most hydrogel soft contact lenses.

Fewer deposits due to advanced surface wettability.

RGP good.jpg

3. Easy Handling (wear)

Small size of RGP lenses allow easy handling (wear), better tear exchange and debris removal

4. Durability

Gas permeable lenses may last longer and don't need to be replaced as often as soft lenses.

5. Easy Cleaning

Simple cleaning and disinfecting systems can be used comparing to conventional soft contact lenses.

6. Slow Down Shortsightedness Progression

There are some special design gas permeable contact lenses, orthokeratology lenses, for slow down myopia (shortsightedness) progression.

**Case examples:​ 

Example 1.:

- Cathy had approximately -12.00D myopia and -3.50 astigmatism in both eyes. She was used to wear soft contact lenses for 10 hours per day. However, she experienced some common problems associated with soft contact lenses, such as unstable vision with blink, dryness and redness.

- Then, she switched to rigid gas permeable contact lenses (GP lens). Now, she's enjoyed stable, clear vision for more than 16 hours of wearing without dryness and redness.

Example 2.:

- Elizabeth is a yoga enthusiast. She had -3.00D myopia and -2.00D astigmatism. She used to use rigid gas permeable lenses since 16 year's old. Her wearing schedule was 14 hours per day, 7 days for week. She enjoyed stable and clear vision without dryness and redness whole days.

- Now, in order to manage age related reading problem, her gas permeable lenses were upgraded with multifocal reading function. She can enjoy clear distant and near vision in both office and home conveniently.

**To comply with privacy regulation, the aforementioned case information was modified.

 

Irregular Cornea Management

(keratoconus, post-lasik, post-trauma and post-graft)

For cases with irregular cornea, such as keratoconus, post-lasik, post trauma and post-graft, light cannot be focused sharply on retina because of unstable optical power. By use of regular smooth optical surface of specialty contact lenses, light can be focused sharply on retina again. 

Specialty contact lenses are widely used as non-surgical management for irregular cornea rehabilitation world wide. The goal is to create a smooth optical surface over the diseased cornea to improve vision. In our center, we fit different types of contact lenses to improve vision of persons with irregular cornea, such as conventional soft lenses, rigid gas permeable lenses, hybrid lenses and scleral lenses. The choice of specialty contact lenses will be advised by our experienced optometrists and based on the severity of the corneal surface irregularity. In case of keratoconus, generally, the bigger and steeper the corneal cone, the bigger the size of contact lenses will be needed to vault and spare the central cornea.

Large diameter 10mm Bi-toric RGP for Keratoconus cornea. Tailor made to increase the edge lift.

 

Scleral Lenses for Irregular Cornea:

Scleral lenses are contact lenses designed to treat a variety of eye conditions which may not be treated any other type of therapy [1]. Scleral lenses are made out of super oxygen permeable Boston, Menicon or Optimum materials. They are different from other contact lenses because they usually rest onto sclera (eye-white) instead of the cornea.

Because scleral lens vaults over the compromised cornea and is covered by the eyelids, they are comfortable and are very secure.

 

Our scleral lens can offer patient relief from the following devastating vision and ocular disorders: keratoconus [1], post-lasik complications, distorted corneal transplants, severe dry eye [2-4] , Stevens-Johnson Syndrome (SJS), Sjogren’s Syndrome, pellucid degeneration (PMD), chemical and burn injuries to the eye.

Scleral Lenses Reduce the Need for Corneal Transplants in Severe Irregular Cornea.

A report indicated the most common eye disease needed full thickness corneal transplantation in 2014 was keratoconus because of corneal scarring and contact lens intolerance.

http://restoresight.org/wp-content/uploads/2015/03/2014_Statistical_Report-FINAL.pdf

By avoiding corneal scarring caused by traditional small rigid gas permeable lenses, scleral lens may restore sight to functional levels, delaying or avoiding the need for corneal transplantation by more than 50% [5,6]. For detail assessment and consultation, you may contact us by Tel:21530008 to make an appointment with our experienced optometrists.

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In addition to conventional contact lens fitting assessment, the fitting of special contact lenses including scleral lenses will be assisted by corneal-scleral topography sMap3D and optical coherence tomograhy (OCT) to ensure precise fitting relationship between the lens and eye. The cross sectional view of cornea and contact lens can be assessed qualitatively and quantitatively.

First sMap3D scleral shape scanner in Asia

**Case examples:​ 

Example 1.:

- Mr. Cheung had myopia surgeries (RK and LASIK) done for his right eye. The outcome was unsatisfactory, because of optical zone decentration and aberration. His quality of vision and  life was impaired. By use of glasses, his best corrected visual acuity was only 0.4. 

- By use of 16mm scleral lens, the corneal irregularity was masked, his best corrected visual acuity was improved to 1.0.

Example 2.:

- Newly graduated Mr. Lau was suffered from keratoconus for both eyes. His right eye had corneal transplantation done, but the vision was only 0.1. By use of 18mm sclera lens, the corneal irregularity was masked and his vision was improved to 1.0.

- One year later, his left eye had keratoconus progressed. His visual acuity dropped to 0.4. After discussion with ophthalmologist, he decided to postpone the pending corneal transplantation for left eye. Instead, he used 18mm scleral lens on left eye to achieve visual acuity 0.8.

**To comply with privacy regulation, the aforementioned case information was modified.

Hybrid Lenses for Irregular Cornea:

(SynergEyes Duette, UltraHealth, ClearKone, Multifocal, Progressive lens)

 

There are several types of Synergeyes Hybrid contact lenses: Dutte HD for high astigmatism, Ultrahealth and  ClearKone for keratoconus and irregular cornea.

​By use of hybrid lens platform, it provides superior visual acuity, stability, centration and all-day comfort. The patented design is optimized to vault the surface of cornea, thus, restoring vision without compromising comfort.

The features of Synergeyes hybrid contact lens include the patented vault design and the soft fitting system. 

Dry Eye Management

 

Besides traditional eye drop usage for alleviation of dry eye, scleral lenses and eye massage methods were getting popular in dry eye management in western countries.

 

Scleral lenses for Dry Eye:

 

Large diameter scleral lenses were used widely in severe dry eye rehabilitation [2,3,4]. They cover and bath the desiccated cornea. They reduce evaporation of tear on the cornea surface. The space between the cornea and the scleral lens is filled with artificial tears or saline solution. As the irregularities of cornea being masked by the filling fluid, the vision will be restored. In addition, the fluid may serve as bandage to protect the cornea from exposure to air and the rubbing effects of blinking. The goal is to create a smooth optical surface over the diseased cornea to improve vision, relieve symptoms and promote healing.

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**Case example:​ 

Example:

- Internist Dr. Chen suffered from severe dry eye associated with immune system disorder. Frequent application of eye drops significantly interrupted her duty in hospital. She experienced photophobia, red eye and foreign body sensation, because of wounds on corneal surface.

 

- She was fitted 14mm semi-scleral lenses binocularly in other centre. She experienced irritation and foreign body sensation, because of the small diameter of the lenses.

- Finally, she got 16mm 3D bespoke scleral lenses from our centre. After few hours of wearing, her cornea showed spontaneous healing. She used the 16mm 3D bespoke scleral lenses every day. After one year, she was satisfied with the improvement of her quality of life. She experienced no dry eye symptoms with her scleral lenses  such as photophobia anymore.

**To comply with privacy regulation, the aforementioned case information was modified.

 

Moist and Comfortable Eye Massager for Dry Eye:

(supportive management for dry eye conditions) 

 

It is an eye massaging product for tired and dry eyes, which moisturizes dry eyes, alleviates eye fatigue as well as improving and maintaining healthy eyes.

Advantages
- Alleviates eye fatigue by massaging the eye contours and temples.
- An appropriate amount of heat and moisture massage has the effect of cleaning the eyelids and squeezing out the meibomian glands (oil glands) to alleviate eye dryness.
- Use a wet pure cotton pad to supply ample moisture to the eyes.
- You may freely select from various functions (massage, hot and cold massage, massage + heat).

1. Visser ES, Visser R, van Lier HJ, Otten HM. Modern scleral lenses part I: clinical features. Eye Contact Lens. 2007 Jan;33(1):13-20.
2. Jackson WB. Management of dysfunctional tear syndrome: a Canadian consensus. Can J Ophthalmol. 2009 Aug;44(4):385-94.
3. Jacobs DS, Rosenthal P. Boston scleral lens prosthetic device for treatment of severe dry eye in chronic graft-versus-host disease. Cornea. 2007 Dec;26(10):1195-9.
4. Hanisch KT, Neppert B, Geerling G. Gas permeable scleral lenses as a conservative treatment option for extreme corneal ectasias and severe dry eye. Ophthalmologe. 2005 Apr;102(4):387-92.

5. Deloss KS, Fatteh NH, And Hood CT. Prosthetic replacement of the ocular surface ecosystem (PROSE) scleral device compared to keratoplasty for the treatment of corneal ectasia. Am J Ophthal. 2014;158:974-82.

6. Koppen C, Kreps EO, Anthonissen L, Van Hoey M, Dhubhghail SN, Vermeulen L. Scleral Lenses Reduce the Need for Corneal Transplants in Severe Keratoconus. Am J Ophthal. 2018;185:43-7.

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Rm1518, Leighton Centre, 77 Leighton Road,

Causeway Bay, Hong Kong

info@eye.hk \\ Tel: (852) 21530008 

Service Hours

Monday – Saturday  10:30AM – 07:30PM

Closed on public holiday

 

 

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Wan Chai Branch: PhD Vision

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info@phd-vision.com \\ Tel: (852) 21109701 

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香港灣仔皇后大道東200號利東街G21店

info@phd-vision.com \\ 電話: (852) 21109701

www.phd-vision.com

Wan Chai Branch: PhD Vision

灣仔分店: 博士光學

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星期一 至 日 11:00AM – 9:00PM

CWB Head Office:

銅鑼灣總店:

Rm1518, Leighton Centre, 77 Leighton Road,

Causeway Bay, Hong Kong

info@eye.hk \\ Tel: (852) 21530008 

銅鑼灣禮頓道77號禮頓中心1518室 

info@eye.hk \\ 電話: (852) 21530008 

CWB Head Office:

銅鑼灣禮總店:

Monday – Saturday  10:30AM – 07:30PM

Closed on public holiday

 

星期一 至 六 10:30AM – 07:30PM

公眾假期休息

CWB Head Office 銅鑼灣總店

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