Which lenses ?????

[Lia Williams]

Hi Cripps Corner,

I think that it could be worth seeing if Kerasoft work for you. The advantage of soft lenses is that it easier to switch between glasses and lenses without the effects of corneal molding.

If soft lenses don't work the next lenses optometrists are likely to try is RGPs. There are lots of different RGPs so even if you've tried one type of RGP and found it unsuitable another may work.

I wear piggybacks, RGPs on top of daily soft disposable lenses. I've been piggybacking for a couple of years. The right eye because although the fit was good and the vision excellent the lens became intolerable after a few weeks daily wear. The left lens I piggyback because I was getting a lot of froth (tiny bubbles) build up under the lens which meant the vision deteriorated during the day. I get 15 hours a day from them.

Different lenses work for different people so it may take time to find the best compromise for you.

Good luck

[CrippsCorner]

Thanks for your input. Because I have already 'trialled' Kerasoft as such, I'm confident they will still give me a huge amount of shadowing and glare... is this something most suffers just put up with in order to get the original image sharp? Technically, I actually get more distortion with my glasses (and lets say soft lenses too) but the actual thing I'm looking at, in the middle of all the distortion is clear. Whereas without, it's just all a blurry mess.

I guess I'm trying to decide whether to trial one way, soft --> hybrid --> RGP or the other way lol, i.e. RGP --> hybrid --> soft hope that makes sense.

[Lia Williams]

Hi CrippsCorner,

As Gareth says the Kerasoft lenses may just need a small tweak to the prescription. It is not unusual for small adjustment to made during the fitting process. You also need to consider how your two eyes work together.

About twelve years ago I was having a refit of my RGP lenses and the new pair allowed me to easily read the 6/6 line, but the vision didn't seem like that in real life due to the residual ghosting. When I went for my check up I explained that although I was wearing my lenses to the clinic I preferred the old ones as the vision was better. The optometrist didn't like the old lenses due to state they were in but did manage to find an alternative for my left eye, but not for the right. So I lived with the residual ghosting in my right eye for years. I really didn't notice it when I was using two eyes together.

Contact lenses should reduce the distortion compared with glasses. The 6/9 vision with glasses for my left eye does have the distortions (barrel distortion and chromatic aberrations) due to being a high prescription and residual ghosting that glasses can't correct. So hopefully you will find a similar improvement with contact lenses.

As for which order you should try lenses I would like to think that the order was something like:

Ordinary soft disposable lenses, specialist soft lenses, RGPs, piggybacking, corneoscleral lenses and finally scleral

The advantage of soft lens is that you wouldn't be getting the problems of spectacle blur when you went back to your glasses.

The problem is that everyone is different. You'll need to be guided by your optometrist and see what they recommend that fits in with your visual needs.

Lia

[GarethB]

I'm confident they will still give me a huge amount of shadowing and glare... is this something most suffers just put up with in order to get the original image sharp?

To a point Yes is the answer to your question, I've never found a lens that eliminates abortions completely, for me the Kerasoft has reduced this phenomenon the most. As we get used to what we can see we know what is real and what isn't and the brain can filer it out. Same goes with hearing, if you listen carefully you can distinguish all sort of background noises but we filter out all the 'noise' and focus on what we want to listen to in most of our daily lives, vision is the same. I spoke to someone who has just had a cataract operation and they asked how do I cope with having vision switched on all the time? Before they could take their glasses off and zone out. In truth we learn to adapt and re-educate the brain. When I first got contact lenses I could see every pore in my face when I looked in the mirror after putting lenses in, now although having 6/5 I don't notice it unless I consciously focus to do so.

With the RGP's being a much smaller lens I found at night with a large pupil that I cold see light reflecting off the edge of the lens, a phenomenon known as internal reflection and seeing people in detail if the light was behind them was impossible, less so with the soft lenses. I also found with RGP lenses I was light sensitive and needed dark glasses all the time which caused their own problems.

It is a case at looking at the overall package, comfort, vision, lifestyle etc. to see which is best overall knowing the limitations of each lens type.

On the NHS you may be unable to try every lens type as due to budgets they may be limited as to the range of lenses they have to offer and the time they can spend fitting you. A private fitting means more time can be spent getting it right but from my experience although very professional they lack the in depth knowledge of a hospital optom and the experience of fitting a wide variety of lenses, plus the expense paying for their time and to test the different lenses out there.

[snorkelboy]

Hi everyone,

Thank you all so much for your replies and the information within them.

I attended the contact lenses clinic and talked through the options with the practitioner. We are going to try a soft lenses which should be here in about another week or so, so fingers crossed. I for got to ask who the manufacturer is so I will post that in due course with another update. They are hopeful that despite a fairly high degree of astigmatism (8 diopters) that my corrected vision should be ok despite this as I was able to achieve 6/9 ("not a perfect" 6/9 according to the optometrist ! At 6/60 before grafting I have my fingers crossed for anything near that).

I shall keep you all posted. Thank you once again for the information. If I can be of any help to anyone out there please get in touch.

Warmest regards.


Paul

[CrippsCorner]

I'm confident they will still give me a huge amount of shadowing and glare... is this something most suffers just put up with in order to get the original image sharp?

To a point Yes is the answer to your question, I've never found a lens that eliminates abortions completely, for me the Kerasoft has reduced this phenomenon the most. As we get used to what we can see we know what is real and what isn't and the brain can filer it out. Same goes with hearing, if you listen carefully you can distinguish all sort of background noises but we filter out all the 'noise' and focus on what we want to listen to in most of our daily lives, vision is the same. I spoke to someone who has just had a cataract operation and they asked how do I cope with having vision switched on all the time? Before they could take their glasses off and zone out. In truth we learn to adapt and re-educate the brain. When I first got contact lenses I could see every pore in my face when I looked in the mirror after putting lenses in, now although having 6/5 I don't notice it unless I consciously focus to do so.

With the RGP's being a much smaller lens I found at night with a large pupil that I cold see light reflecting off the edge of the lens, a phenomenon known as internal reflection and seeing people in detail if the light was behind them was impossible, less so with the soft lenses. I also found with RGP lenses I was light sensitive and needed dark glasses all the time which caused their own problems.

It is a case at looking at the overall package, comfort, vision, lifestyle etc. to see which is best overall knowing the limitations of each lens type.

On the NHS you may be unable to try every lens type as due to budgets they may be limited as to the range of lenses they have to offer and the time they can spend fitting you. A private fitting means more time can be spent getting it right but from my experience although very professional they lack the in depth knowledge of a hospital optom and the experience of fitting a wide variety of lenses, plus the expense paying for their time and to test the different lenses out there.

Just been reading through a few old threads and thought this was an appropriate one to rant in!

I am so thankful to not have such advanced keratoconus that I require grafts etc. but it still doesn't stop frustration. The thing is... I've read about a lot of people with a more advanced condition than mine, that seem to be able to reduce or even completely rid of shadowing and double vision. I have now tried glasses, Kerasoft lenses, RGP's and toric lenses and every single one has given me pretty much the same level of shadowing and double vision. I know there's no one fix for all as such but why am I having such trouble with it?

I'm getting my second set of toric lenses in two weeks time, but thus far I still actually get the sharpest vision from glasses (even though my prescription is starting to go out, it being nearly a year old now) ultimately I don't want to just 'settle' when there could be further advancements to be made. Am I chasing an impossible dream?

[GarethB]

[quote="CrippsCorner]... ultimately I don't want to just 'settle' when there could be further advancements to be made. Am I chasing an impossible dream?[/quote]

Possibly? Until you have tried all the options, how will you know?

KC for some people is an ever changing condition either progressing worse or due to a thinned cornea that fluctuates day to day. So perfect vision in the controlled environment one day can be different the next. Add in to that that you will get subtle differences between lenses of the same prescription due to manufacturing tolerances, changes in environment, lighting conditions and so on can exaggerate or diminish some of the interferences we get.

I may get 6/5 with my lenses but I do notice if the degree of sharpness is better or worse between lenses of the same prescription. Throughout the day that if I have done a lot of close work either using a pc, reading a book or working on something detailed I notice my vision drops off just because I don't blink so much so my eyes dry out a little. My vision changes if I get dehydrated, but if I drink red wine it improves! Outside activities such as gardening, going for a walk or riding my bike my vision will generally be consistent all day long. When my vision drops off it goes to 6/6, but I have never encountered anyone with KC where a lens is absolutely perfect, I consider my vision amongst the best you can get with lens correction.

What I tell people at local group meetings is that you need to determine what the priorities are as a minimum and once those are achieved you can look on building on that. This often means a balance between vision / comfort / wear time. For me comfort and wear time are a priority, I can work round the quality of vision with other visual aids for computers, ideally the driving standard as a minimum, but not end of the world. This I only decided on when I persuade the best vision possible which I cold get but the cost was comfort and wear time. Fortunately this lead me to the road of soft lenses and luckily for me once we got the comfort and wear time we soon got the vision from 6/12 all the way to 6/5 with gradual refinements to the fitting and lens refraction over many months.

There is a reason we are called patients and tat is because to explore the options objectively and give the specialists a chance to refine the different lenses we try, treat dry eyes etc. etc... takes time and patience.

It took me four years of chasing comfort and wear tie with RGP's that gave good vision and when I went to softs it took us a good nine months or more chasing the quality of vision once we had the comfort and wear time.

From experience, expecting perfection from the off leads to disappointment and the resulting negativity can then be self perpetuating.

[CrippsCorner]

but if I drink red wine it improves!

I think I'll take that away from everything you said

In all seriousness, thanks for the reply. I've found the optometrists to be very good at my hospital, I've been seeing them for a few months now and have tried a few different types of lenses. I still get the feeling however, that ultimately they will eventually say, "That'll do". You're right about the patients thing because boy do we need patience!

I'm finding soft lenses (well, and glasses of course) fine to wear almost all day, so that isn't really an issue for me. I can see things sharp, it's just the shadowing and glare around lights that I'd love to be able to fine tune and get rid of. So far I've not seen any evidence of this... it's disheartening, but I'm sure we've all been in the same place at one point or another.