Vision worse with RGP Lenses

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Gibbomonkey
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Vision worse with RGP Lenses

Postby Gibbomonkey » Fri 12 Apr 2019 6:59 pm

Hi im 35 and have recently been diagnosed with Keratoconus. Ive been wear glasses sonce i was 4 and contacts from the age of 13. My prescription has generally stayed the same however in October last year my opticians noticed Cornea scarring whicu we think is because i used to wear soft contacts for 12 hours + a day.

I got referred to NHS and it was there they told me ive got KT and apparently ive had it for many years. Anyway they said i need RGP lenses, been wearing them for a few hours a day for a week and half. They are very hard to wear but i can live with that but my vision wearing then is so bad, literally no improvmeent and worse! Never been light sensitive but wearing them i am, blurry, feel like im going cross eyed!

Has anyone had a similar experience and does anyone know why i cant go back to my soft contact lens that i use to be fine with and could see really well with?

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Anne Klepacz
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Re: Vision worse with RGP Lenses

Postby Anne Klepacz » Sat 13 Apr 2019 2:41 pm

This sounds very unusual. Your KC sounds as though it's stayed stable for years and has stayed mild if soft contacts gave you good vision. I haven't heard of soft lenses causing corneal scarring before, but corneal scarring can occur in people with KC who don't wear any sort of lenses, in other words it can be part of the condition rather than being caused by lenses.
I assume you've got a follow up appt soon to check how you're getting on with your rgps, so do tell the optometrist what you've said here. Fitting lenses for KC is an art and can take several goes to get right. I'm just someone with KC, so don't know why you can't stay with your soft lenses if you were doing fine with them. If there's an optom reading this, an expert explanation would be great!

Gibbomonkey
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Re: Vision worse with RGP Lenses

Postby Gibbomonkey » Thu 02 May 2019 9:02 am

I've tried for about a month now with RGP and I have had good days but mostly bad days with them.

Theres some pretty strange stuff going on wearing them!
1. I can wear my glasses and RGPs and I can see better
2. Really light sensitive, not just outside but looking at my phone, laptop or driving at dusk
3. long sightedness has improved but now I'm short sighted

I've stuck my old soft contact lenses today and holly cow they feel good and I can see okay.

I still dont understand why I cant wear soft lenses and have to wear RGP?

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Lia Williams
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Re: Vision worse with RGP Lenses

Postby Lia Williams » Thu 02 May 2019 7:08 pm

Gibbomonkey wrote:I still dont understand why I cant wear soft lenses and have to wear RGP?


You don't have to wear RGPs but you will probably find that contact lenses give you better vision than glasses do. This is because glasses are unable to correct the irregular astigmatism that keratoconus gives us.

For people with mild keratoconus ordinary toric soft contact lenses or glasses may be able to correct vision adequately. However in more advanced cases specialist contact lenses are needed. There are lots of different types, including specialist soft lenses, designed for keratoconus. The problem is that different lenses suit different people.

When are you due to have your next appointment with your optician? As you are new to RGP wear I would expect that you should have one in the next few weeks.

You may find it helpful to look at the videos from the 2018 conference:

https://www.keratoconus-group.org.uk/in ... deos-2018/

In particular look at Waheeda Illahi‘s talk which is about contact lenses for keratoconus.

Lia

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Ali Akay
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Re: Vision worse with RGP Lenses

Postby Ali Akay » Thu 02 May 2019 7:44 pm

Hi,
You raise a number of points and I'll try to address them separately.

There used to be a school of thought that wearing gas permeable lenses stopping the progression of keratoconus by pushing the cornea back. However, we no longer believe this to the case. To have any effect in "pushing the cone back" the lenses have to fitted very flat, and this often used to result in scarring, hence no longer thought a good idea. Therefore, the ONLY reason for fitting contact lenses for KC is to improve vision over and above glasses.

There are a fair number of people with mild KC who can see adequately with glasses and never have contacts, and this is absolutely fine! The modern approach to management of KC, in progressive order is : glasses- disposable soft lenses- specialist soft lenses or gas permeable lenses - semi scleral or scleral lenses - transplant.

Therefore, if you are getting good vision with soft lenses, and they're not doing your eyes any harm, I can't see any reason why you should be asked to stop wearing them. You mention soft lenses causing "scarring" to your corneas. As Anne says this is unusual. It may be that you have some corneal changes related to your eyes not getting enough oxygen through soft lenses, and this may be the reason you were recommended to have gas permeables. However, soft lenses have come a long way, and you may need to be refitted with a new material. This is something you'll need to discuss with your practitioner at your next appointment. If you are told you have to wear gas perms purely because you have KC, I'd question this.

Coming to your symptoms with the lenses, some degree of light sensitivity is normal and it usually improves with time. This is due to "foreign body reaction". When we get a piece of grit in the eye, the eye waters, and we also get light sensitive. This is part of eye's natural defences to alert us that there's a foreign body in the eye, and tries to get rid of it!


Coming to your vision being a lot clearer with soft lenses, this is also unusual, but it does happen sometimes and there can be a number of reasons for it. They may not be wetting properly and "greasing" which would make vision very smeary, and this is more common with people with dry eyes. If you have dry eyes, it could also explain the light sensitivity and discomfort, and "scarring" on your corneas.


My advice is to try to have your appointment brought forward and discuss these concerns with your practitioner.


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