Customized Scleral Lenses for Keratoconus

One of the best ways of making people with keratoconus see better is by making customized scleral lenses. Keratoconus makes the cornea bulge in an irregular manner, with each irregularity distorting the image that hits the retina. This results in people experiencing halos, “ghosting”, blurred vision, or even double, triple or quadruple vision.

Scleral lenses get their name because they rest on the white part of the eye, the sclera, and create a tear-filled vault over (but not touching) the cornea. This results in smooth, rather than irregular, optical surface, and can dramatically improve vision. Scleral lenses should be comfortable to wear too: each scleral lens is custom-made to each patient’s eye, and scleral lenses are also sometimes used to treat dry eyes: the reservoir of tear fluid that bathes the eye is therapeutic and moisturises the cornea.

To give an example of just how successful scleral lenses can be for correcting vision in people with keratoconus, here is a case report of a recent patient at the ELZA Institute.

A patient with keratoconus presented to the ELZA Institute in December 2019, taking an emergency appointment, and complained of red eyes and pain. The patient had been wearing scleral lenses, each day, for the last 10 years.

The patient complained of red eyes and pain
The patient complained of red eyes and pain. Scleral lens in situ.

We prescribed topical antibiotics and eye lubricants. Despite advice to stop wearing the scleral lenses while she was taking the prescribed medications, she refused, and continued to wear them throughout the treatment period.

While at the ELZA Institute for the appointment, we performed an OCT scan of the eye, with and without the lens. We found that the left eye’s lens was pressing against the cornea. After some investigation, we found that the patient was wearing an old right eye lens on her left eye, which is why it fitted the eye so badly. With these lenses, her left eye could only see 20/80. The Kmax value (the steepest part of the cornea) in this patient was 115 D just after the contact lens was removed, and was 144 D after 1 day of not wearing the lens. For reference, the average Kmax of a person without keratoconus in Europe is around 44 D. This patient had the steepest cornea we have measured at our institute.

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Using the scans we made of the patient’s eye, we had a new custom scleral lenses made, and now the patient sees 20/30 in her left eye, rather than 20/80.

 

A new fitted scleral lens improved visual acuity from 20/80 to 20/30
A new fitted scleral lens improved visual acuity from 20/80 to 20/30

The ELZA Institute

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Augeninstitut ELZA
4.7
Based on 97 reviews
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Serena Fazio
Serena Fazio
11:15 06 Mar 22
I have been to the ELZA clinic to have surgery for my miopy, as my eyes were rejecting the contacts and I was tired of... wearing glasses. From the first preliminary visit, to the actual surgery and post-surgery care Dr. Hafezi and all his collaborators have been extremely professional, considerate and helpful. All the steps of the (very short!) surgery were thoroughly explained to me in order to be as calm as possible, together with the medication plan and precautions to be aware of so that my eyes could heal in the best way possible. By following their exact instructions, the healing process has been very successful and smooth, and after about one week I was able to see perfectly. I absolutely recommend this team and their expertise!read more
Robin A
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
Thunder Shiviah
Thunder Shiviah
14:05 23 Nov 21
After some research on local options I decided to go with ELZA since it stood out as the best. The operation and the... post-operation recovery went extremely smooth (something I was worried about with PRK). Now my vision is much better than I had hoped and I have no side effects such as dry eye or night vision problems. Thank you!read more
Squitieri Elias
Squitieri Elias
12:43 08 Sep 21
Die Behandlungen waren bei mir erfolgreich, alle waren sehr nett und haben mein Leben vereinfacht.Danke
Eliane Bossart
Eliane Bossart
13:01 05 Sep 21
Vor einem Jahr war ich einer ganz verzweifelten Situation und total im Stich gelassen. Meine Augen wurden aufgrund... eines ausgeprägten Kerakotonus immer schlechter, ich hatte Angst und war alleine mit meinen Problemen. Zudem vertrug ich die Kontaktlinsen nur noch ganz schlecht und hatte jeden Tag Schmerzen.Professor Hafezi hat mir mit zwei Operationen wieder das auf Grund der Situation mögliche an Lebensqualität zurückgebracht. Es war ein starpaziöses Jahr mit vielen Entbehrungen aber es hat sich gelohnt! Herzlichen Dank fuer die Unterstützung.read more
Gabriela Meyer
Gabriela Meyer
18:32 22 Aug 21
Ich wurde von meiner Optikerin auf Prof. Dr. Dr. Hafezi aufmerksam gemacht. Es war mir vorher nicht bewusst, dass meine... Augenkrankheit (Keratokonus) operativ mittels Cross Linking behandelt und so gestoppt werden kann. Die Beratung und Behandlung war sehr kompetent und ich fühlte mich jederzeit wohl. Die Operation verlief gut und das Ergebnis ist einwandfrei.read more
Naomi
Naomi
11:38 11 Aug 21
Ich bin sehr glücklich, dass ich das Elza Institute gefunden habe. Ich wurde von anderen Augenärzten abgewiesen, da... meine Augen zu kompliziert/schwierig zu behandeln waren. Prof. Dr. Dr. Hafezi konnte mir jedoch helfen und ich bin sehr glücklich und zufrieden mit dem Resultat. Vielen Dank!read more
Till B
Till B
08:30 19 Jul 21
Ich habe eine überaus kompetente Beratung und Behandlung erlebt. Die gesamte Betreuung war sehr freundlich und... professionell. Herzlichen Dank!read more
Thomas S.
Thomas S.
09:37 07 Jul 21
My left eye had to be operated on because of a cataract. As I had an Artiflex lens implanted a few years ago, it had to... be removed first before a modern lens could be implanted to correct the cataract. Prof. Hafezi treated me in an very competent and friendly manner. I am very happy with the result.read more
Selma A. Rahim
Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
Gianluca Ricci
Gianluca Ricci
12:46 10 Apr 21
Great team and service!
rehaneyecare
rehaneyecare
05:36 08 Apr 21
Excellent surgeon
Steven H.A
Steven H.A
16:13 11 Jan 21
Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
Online Commande
Online Commande
09:19 05 Dec 20
Totally creepy, very arrogant Prof.He just want your money.It may explain, why this Prof. is not in the center of the... city of Zürich and why he has been thrown away from University of Geneva.read more
Elena Churilova
Elena Churilova
10:06 17 Nov 20
At the moment, 3 months have passed since the moment I made laser vision correction in this clinic. and I can say that... I am happy that I chose this particular clinic and Prof. F. Hafezi. The entire staff of the clinic is very friendly, treats patients with sympathy and patience if they are nervous before surgery (my big gratitude to Aida Alili for all support and patience). The doctor Hafezi and other doctors of the clinic are very professional and ready to explain to you as many times as you need. I can only recommend!read more
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Augeninstitut ELZA
4.7
Based on 97 reviews
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