Soft Contacts for Keratoconus: Comfort and Clarity for Irregular Corneas

Introduction

Keratoconus is a progressive eye condition where the cornea thins and bulges into a cone-like shape, leading to distorted vision, glare, and sensitivity to light. Traditional eyeglasses often cannot provide adequate correction for patients with keratoconus. While rigid gas permeable (RGP) lenses and scleral lenses are common treatments, many patients seek the comfort and flexibility of soft contacts for keratoconus.

Soft contact lenses have evolved to meet the unique needs of keratoconus patients, offering improved comfort without compromising vision quality. In this article, we explore the benefits, types, fitting process, and considerations for using soft contacts for keratoconus.

What Are Soft Contacts for Keratoconus?

Soft contacts for keratoconus are specialized lenses designed for irregular corneas. Unlike standard soft contact lenses, these lenses provide enhanced stability and thicker zones to accommodate the conical shape of the cornea.

Key features include:

• Custom Design: Soft lenses for keratoconus are often customized for each patient’s corneal topography, ensuring a more precise fit.
• Increased Thickness: Areas of the lens may be thicker to neutralize corneal irregularities and provide sharper vision.
• High Oxygen Permeability: Materials allow sufficient oxygen transmission to maintain corneal health, even with thicker lens zones.

These lenses aim to combine the comfort of soft lenses with the optical precision required for keratoconus correction.

Who Can Benefit from Soft Contacts for Keratoconus?

Not every keratoconus patient will be a candidate for soft contacts, but they can be ideal for:

• Mild to Moderate Keratoconus: Patients whose corneal irregularities are not severe may find soft contacts effective.
• Glasses Intolerance: Individuals who struggle with glasses due to poor vision correction or aesthetic concerns.
• Comfort Seekers: Patients who find RGP or scleral lenses uncomfortable for extended wear.
• Early Stage Keratoconus: Soft lenses may slow the need for more invasive lens types or surgical interventions.

A consultation with a specialized eye care professional is essential to determine suitability.

Types of Soft Contacts for Keratoconus

Several types of soft lenses are available, each designed to address specific needs:

1. Custom Soft Lenses

These lenses are designed specifically for the patient’s cornea, using advanced imaging and corneal mapping. Custom soft contacts provide better stability and clearer vision than standard soft lenses.

2. Hybrid Lenses

Hybrid lenses combine a rigid center with a soft skirt. While technically not purely soft, they offer the comfort of soft lenses while maintaining the sharp vision benefits of rigid lenses.

3. Scleral-Inspired Soft Lenses

Some soft lenses are designed to mimic the vaulting effect of scleral lenses, creating a tear reservoir that neutralizes corneal irregularities and improves visual quality.

4. Silicone Hydrogel Lenses

High-oxygen-permeable silicone hydrogel soft lenses allow long-term wear without compromising corneal health, which is especially important for keratoconus patients.

Advantages of Soft Contacts for Keratoconus

Using soft contacts for keratoconus provides several benefits:

1. Comfort

Soft lenses conform to the eye’s shape, reducing discomfort compared to rigid lenses that rest directly on the cornea.

2. Improved Aesthetics

Unlike RGP lenses, soft lenses are less noticeable, providing a natural look and allowing patients to feel confident during social interactions.

3. Ease of Adaptation

Soft lenses are generally easier to adapt to than rigid or scleral lenses, making them suitable for new contact lens users or children with keratoconus.

4. Good Daily Wear Options

Many soft lenses can be worn on a daily disposable basis, reducing cleaning requirements and minimizing the risk of contamination.

5. Cost-Effective Alternative

Soft lenses for keratoconus are often less expensive than custom scleral lenses while still providing adequate vision correction in mild cases.

Fitting Process for Soft Contacts in Keratoconus

Fitting soft contacts for keratoconus requires precision and professional expertise:

1. Comprehensive Eye Examination – Assessing corneal shape, thickness, and degree of irregularity.
2. Corneal Topography – Detailed mapping of the cornea to guide lens selection and customization.
3. Trial Lenses – Testing different lens designs to evaluate comfort, movement, and vision quality.
4. Lens Adjustments – Fine-tuning lens parameters such as thickness, diameter, and curvature.
5. Follow-Up Visits – Regular follow-ups to monitor corneal health, ensure proper fit, and check vision correction.

Proper fitting is essential to prevent complications such as lens decentration, reduced vision, or corneal hypoxia.

Considerations and Limitations

While soft contacts for keratoconus offer significant benefits, there are limitations to consider:

• Visual Acuity: In moderate to advanced keratoconus, soft lenses may not provide the same clarity as RGP or scleral lenses.
• Lens Stability: Severe corneal irregularities may cause soft lenses to move excessively, impacting vision quality.
• Oxygen Supply: Thicker lenses may reduce oxygen transmission to the cornea; high-oxygen-permeable materials are recommended.
• Durability: Soft lenses are more prone to tearing or wear compared to rigid lenses.

Patients should have realistic expectations and consult with a specialty contact lens professional to explore all available options.

Combining Soft Lenses with Other Treatments

In some cases, soft contacts for keratoconus can be combined with other treatments:

• Cross-Linking: Strengthens the cornea to slow disease progression.
• Hybrid or Scleral Lenses: Patients may transition to hybrid or scleral lenses as keratoconus advances.
• Topical Medications: Eye drops to manage dryness or irritation while using lenses.

This integrated approach ensures both vision correction and corneal health are optimized.

Conclusion

Soft contacts for keratoconus are a comfortable and effective option for many patients with mild to moderate corneal irregularities. They provide enhanced comfort, improved aesthetics, and ease of adaptation while maintaining good vision.

For patients seeking alternatives to glasses or rigid lenses, soft lenses can serve as a first-line solution or bridge before progressing to more specialized lens types. A professional fitting by an experienced eye care provider ensures the best results and protects long-term corneal health.