Move to Scleral Lens from RGP

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PJRK20
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Move to Scleral Lens from RGP

Postby PJRK20 » Fri 18 Jun 2021 2:30 pm

Hi, I am 42 and was diagnosed with KC approx aged 20. Since then I have managed with RGP lenses. Comfort and vision have been okay. However, at least once per day I experience soreness, irritation/watery eyes. This is usually to do with the environment I am in; work (too much screen time), being outside and dust getting in the eye etc. Light sensitivity has always been an issue to the point where looking up at anything above eye level causes pain/discomfort/watery eyes. I have just accepted that this is the way things are with KC and have been lucky that the impact on my life has been minimal, mainly frustration dealing with the above. At my most recent check up my ophthalmologist mentioned that new KC patients are given scleral lenses rather than RGP's. We discussed the benefits which he said are usually more comfort, clearer vision and better tolerance. I decided to give them a go. I went to have the left lens fitted 2 weeks ago, the comfort is great, I have mastered insertion and removal however the vision was considerably poorer. I have been back to see him and despite tweaking with the prescription I can't achieve the same level of vison in my left eye as I can with the RGP. The best I can achieve is reading one letter on the 20:30 line of the Snellen Chart. With the RGP I can make out the whole of that line. I left feeling disappointed. The newer prescription will be ordered but I am feeling disheartened at the prospect of the vision being slightly worse. Apparently I have significant scarring on my left eye which is making it difficult to achieve better vision. My right eye is better than the left and he is keen to start the process with the right eye once he is happy that the left is settled. I'm wondering if there is any point pursuing this if I can't achieve the same level of vision that I have now. What are other people's experiences with moving from RGP's to Scleral. Is the better comfort worth the reduction in vision? If my right eye is in better condition could there be a chance that Scleral's improve that eye further and balance out the reduction in vision in the left. Apologies for the long winded post. I have more questions than answers currently!

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gsward
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Keratoconus: Yes, I have KC
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Re: Move to Scleral Lens from RGP

Postby gsward » Fri 18 Jun 2021 4:43 pm

I'm no ophthalmist only a KC sufferer who has been along the path from RGP to Scleral. Many of us get to the point the RPGs are either not comfortable or simply start falling out (in my case). I suspect what is going on here there RGP is physically "correcting" the cornea at the cost of your comfort. Getting sclerals right and stable is often not a one visit appointment and often in a hospital setting can end up with one ophthalmist discussing the fit and options with a colleague. There are parameters they work to, but there are several ways for the lens clearing over the top of your cornea (you can make it larger or move it steeper off the eye). In my experience, better vision is achieved the closer the fit, but that might not 'feel' the best. Settling down over say 3 months would not be unreasonable and then maybe be refitted.

As you are at the moment (with sclerals) can you do what you need or want to for daily living?

Have wearing spectacles over the top for reading/driving been considered?

Did you have any discussion about piggy-backing the RGP on a soft lens at any stage? It didn't work for me but does for some, at least for a while.

What vision do you get with your right eye? Presumably better than 20/30? (6/9 for the rest of us).

Graham

PJRK20
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Posts: 2
Joined: Thu 17 Jun 2021 7:38 pm
Keratoconus: Yes, I have KC
Vision: Contact lenses

Re: Move to Scleral Lens from RGP

Postby PJRK20 » Fri 18 Jun 2021 7:32 pm

Thanks for your reply Graham. To be honest I’m not sure what my vision is with my right eye. It’s been such a long time since I have had that eye tested/looked at! It’s definitely better than the left.

I have to wait 3 weeks for the new scleral to be sent so I’m back in the RGP until it arrives. I could keep using the first scleral I had but the vision in that is so poor it makes me feel a bit nauseous.

Lots to consider moving forwards but I’m feeling more positive!

Thank you

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gsward
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Posts: 123
Joined: Thu 24 Jul 2008 7:30 pm
Keratoconus: Yes, I have KC
Vision: Graft(s) and contact lenses

Re: Move to Scleral Lens from RGP

Postby gsward » Fri 18 Jun 2021 7:54 pm

I didn't quite pick up you hadn't made the swap to scleral yet. I would expect there will be some adjustment as your cornea gets used to the new world of not being 'constrained' by a lens.

Graham


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