Had my kerasoft fitting today.

[GarethB]

Today was the day when I tried the Kerasoft lens, but before I could the optom who trained under Ken Pullen and Proffesor Buckley gave me a lecture about the advantages and disadvantages of Kerasoft along with the advantages and disadvantages. So it would appear that Ken and Proffessor Buckley have trained her well. She has one extra thing going for her that the metors have not and that is she is better looking than them

I did ask the optom if she was called Lynn and if she had recently moved from Norfolk as the lecture was the same as Lynn had emailed me

Joking aside, it is very sereous.

Kerasoft is thicker than a normal soft lens so far less oxgyen transfer. This means a higher chance of vascularisation and blood vessels growing towards the cornea and making grafting should it be necessary more complicated. For those already with a graft this means the risk of rejection from an otherwise excelent graft is a higher risk. The quality of vision may not be as good as that you can get from an RGP lens. The plus is that the comfort is supposed to be better.

RGP lenses are usually a compromise between visual aquety and comfort. Great comfort and grat vision rarely go together for us. Oxygen transfer is better but there is always the debate regarding the lens moving on the cornea causing scarring. RGP lenses have a far lowwer chance of causing vascularisation so better for post graft use. RGP lens can be used across a far wider range of KC severety.

So already we have pro's and con's for both.


Why am I looking at using Kerasoft when I have a healthy graft and excellent vision from an RGP lens?

The only thing I can not do is compete in motorsport because I have RGP lenses. This means I will only use the lenses every now and then so effects of a lack of oxygen to the cornea is lessend. Risk of vascularisation and potential rejection is much reduced to about the same risk level as now. Plus if I get 6/6 vsion I can re-apply for my Motor Sport Association licence.


What are my RGP lenses like now?

They are comfortable thanks to the use of Systane eye drops and the amount of watre I drink. I get 6/4 vision and my lens wear averages 12 hours per day with one day rest most weekends.


What were the Kerasoft like?

Comfortable in that I could not feel my eye lids on the edge of the lens. However the cornea felt a whole lot dryer for the 2 hours I had them in. This may have been due to the hospiat aircon which I always have problems with. I could only get 6/6 which is all I need to go racing.


So what is my inittial conclusion?

Overall I would say the comfort was no better or worse than my RGP lenses, the sensation was distinctly different so with more frequent use I am sure i would get used to it. I lost one line in visual aquety but there is a lot higher prescription to make up for the KC. Because there is a larger variety of Rose K lenses to match the cone, the power added to compensate for a lump of plastic in the eye is far less.

Initial feelings is that Kerasoft does have something to offer but not as the first line of KC treatment. I feel if RGP lenses are a problem then softperms or piggybacking is the route to try if lens comfort is a real issue. Failing that and the KC is not too sever then consider the Kerasoft.

For those who are post graft I agree completly with the optoms that the use of Kerasoft is purely for short term use by which I mean a couple of days so you can persue a certain activity.


As with all things KC it is a compromise between good vision and comfort. We should be happy if all we get vision wise is enough for the driving standard with an acceptable level of comfort. Should you get this and improved comfort or better vision should be considerd a bonus rather than a right. If you vision is such that you can get to the legal driving limit then you can do pretty much anything someone with 'normal' vision can do. I can still achieve many things with far worse vision than I used to have it is down to how well be adapt.

Regards

Gareth

[Lesley Foster]

Gareth,

This may sound like a dumb question but why can't you wear RGP lenses to do your motor sport? What sort of motor sport is it that you do?

Just curious.

Lesley.

[jayuk]

Gareth

Im surprised you didnt find them comfortable....more so than RGP...but than I guess its fair to say that your eyes are used to the RGPs?

It would be interesting to see a newbie in KC try both....and see what they thought......as I guess majority of new KC patients seldom get used to RGPs and if they do it takes a while.....

Interesting read!

J

[Ali Akay]

Gareth
I think it's worth pointing out that Kerasoft is a trademark of Ultravision CLPL Ltd based in
Leighton Buzzard. There are other manufacturers making soft lenses for keratoconus.I know people have got in trouble for allegedly promoting certain manufacturers' lenses on this site, but lets face it Kerasoft and Rose K are both trade marks often referred to without anyone getting worked up about it. So, I dont mind saying that I personally use Soft K lens from Acuity Contact Lenses of Hoddesdon. It's a lot thinner than Kerasoft and hence more oxygen transmission. It can work very well, but there's a steep learning curve, and a fair amount of experience is needed to get good results as the fit is rather critical.We have many patients wearing this lens happily and achieving 6/9, 6/6 and sometimes even 6/5. Please note that I have no financial involment with this or any other product. I actually think there may be some patients on this site wearing this lens and thinking it is Kerasoft as they probably dont realise that Kerasoft is a trade mark.

[GarethB]

Lesley,

I used to do Rallying at a semi-pro level after my grafts but then stopped when I got married through lack of time. In 2004 I just started doing some classic touring cars then the KC was diagnosed again. I would like to do a similar thing or one of the cheaper one make challenges on ordinary circuits.

The problem with an RGP lens is that if I were to have an accident and bash my head badley there is a risk (admitedly remote) of the lens breaking in my eye where the concequences are disasterous and would mean paramedics removing a broken contact lens. This why I need a soft lesn as it will not break in my eye, possibly tear when it is removed after an accident but do no damage to my eye.

Jayuk; you are quite right it is probably what I am used to.

As to what a newbie would feel, because they are quite thick my personal view is they would find them uncomforatble to start with but I agree with you not as uncomforatble as an RGP for the first time.

After the fitting I did have a length chat over a cup of coffee learning more about the issues optoms have with lens fitting. She said people are very quick to say what they can see and forget about everything else. That is the information the partient divulges to the optom is all about how much/little they can see, the patient just wants that 6/6 vision.

What they want to know is how does the lens feel, none of this be polite its fine when really it is like sandpaper in your eye and if it is where on the eye is the discomfort. They need as much information as to lens comfort;

Does it feel tight?
Where on the cornea is it comfortable?
How does the lens feel?
What is it like when you blink?
How does the lens feel when you move your eyes?
What happens to your vision when you blink?

The optoms to be honest do not always ask any or some of these questions, but if you try a new pair of shoes you stand up feel where they pinch, check where the gaps are, walk a round a bit and so on so when you walk round in them all day they are comfortable. The choice is not just on how well they look on you.

Getting lenses is mor important which is why we need to describe the sensations and be satisfied with achieving a set level of vision. I think someone wisely posetd recently where is the benefit of getting one extra line down the chart if you have a more uncomfortable lens you wear for less hours?

It is a compromise as is most things in life and it is fact that many people who wear glasses and also those who do not have very fulfilled lives with vision that is at the legal drive limit or only a tad better.

Everyone is entitled to 6/6 vision, but sometimes we just have to accpet what we have got and live life as best we can.

As I have said before I consider myself exceptionally lucky that I have good RGP lens comfort and wear. Is it perfect No but it is acceptable and far better than many people could hope to get so I am more than satisfied.

Getting fitted with Kerasoft was to help the hospital gain more experience and being 'unique' as some of the optoms put it at the hospital I go to an ideal candidate for their new optom to demponstrate her skills. it also taught me that in the more svere cases of KC there is a place for Kerasoft lenses but I would still agree as said before with the optoms that RGP's on balance are the slightly better option.

I am glad this has got some interest as we do get asked about Kerasoft and the subject of lens options is of great interest to us and should be discussed in a frank and open manner.

[John W]

Hmm this has got me thinking

I wear kerasoft lenses, which they definmately are, for 12 hours a day 5 days a week, I have weekends off as i am fortunate that I dont really need to drive at the weekends. The vasularisation is a bit of a worry as i suspect my KC is probably still getting worse, but I also realise that I am at the 2 or 3 end of a 10 scale severity in KC.

I have my next appt on 12th dec and am worried that my vision may not meet the drive standard, but at the same time know if im on softs,,,,there is a long long way to go before a graft will be required.

I will ask my optom what he thinks the benefits/disadvantages of my kerasofts are and I will mention the vascularisation aspect of it as I definately get what appear to be bloodshots in the corner of my eyes after prolonged wear, as soon AS I take them out they disappear (and no its not cos i cant see them they disappear). I was never offered any other lens when I was first diagnosed and was put straight on to kerasofts.

qwith regard to vision with them, during the dat it is mostly fine, some days i get a tiny ghosting effect, but it is hardly noticeable when I do have it.

At night, as with many of us, lights are a massive problem and keeping my windscreen clean is the ultimate solution really. I get some star-bursting, but dont find it a problem.

Ill let yall know how my discussion with Mr Holland goes on the 12th Dec.

[GarethB]

John,

Vascularisation was mentioned in a big way to me purely because I have grafts and this would be extremely bad. Bit different if you are pre-graft.

You say your eyes are red at the end of the day, this is classic lens over wearing and the eye is trying to get oxygen to the cornea by pumping more blood to that region.

It is something your optom needs to be aware of.

The optoms have always expressed surprise at the level of detail I give them, even if it means they have to tell me off. As far as I am concerned the more info I can give them, the better they can help manage my KC.

[Andrew MacLean]

Gareth

I tried Kerasoft, but couldn't cope with them. They moved me onto a scleral.

All the best with yours.

Andrew

[GarethB]

Thanks Ali for a point well made.

It is for that reason that I named exactly what soft lens I had tried.

What I did not point out is that the RGP lenses I have are Rose K which again is a brand name for the type of lens, not the supplier!

Soft lenses are relatively new to the hospital I go to and Kerasoft are the only ones they provide at this moment in time.

[Matthew_]

Glad to hear you're back on the track. That should make the roads a whole lot safer
No seriously, good luck and I hope you enjoy it!