Kerasoft lenses

[Steven Williams]

http://www.kerasoft.co.uk/

The KeraSoft® range of lenses has been in wide use in hospitals and practices around the world for more than 15 years.

Anyone here managed to get these lenses prescribed at an NHS eye hospital without having to specifically make a request for them?

[GarethB]

The orginal Kerasofts were available at my hospital when I asked about them in 2006. The reason I had to ask was becaues the hospital felt they would not work for me and when we tried they were quite right but they had fitted people with them. This was the Kerasoft 2 soft lens which had a lower gas permiability than the Kerasoft 3 which is much higher. Six months after my rant on this forum about how bad the Kerasoft 2 was I was invited to the manufacturers to see why there was such a problem. This lead to some changes to the Kerasoft 3 they were already developing which have worked very well for me and these lenses then lead to the Kerasoft IC lens which I know have for both eyes.

So in summary, these lenses have been available at Walsgrave Hospital Coventry, I know they are available at Moorfields and Gartnavel, Glasgow. I am pretty sure they are available at the Birmingham Eye Unit, Dudley.

[Fordy]

Steven,

I have requested Kerasoft at my hospital in Cardiff, and it went in one ear and out of the other.

They are of the opinion that they are not often successfull, but I know that is not the case by reading posts on this forum.

Frustrating or what!

Cheers

Fordy

[Andrew MacLean]

Fordy

that must be frustrating! As Gareth said the spread of hospital cl clinics that dispense kerasoft lenses is patchy. This may be due to a mixture of hospital policy and the professional Opinion of individual optometrists.

Why not lobby your welsh assembly member to see if you can influence hospital policy and encourage your optometrist to read these pages? I was tried with a ks lens but without success, so do not imagine that they will work for everybody.

All the best.

Andrew

[DanB]

Hello

I am new to the Support Group and these forums.

I have been treated at the Bristol Eye Hospital for 4 years now and have had Kerasoft lenses from them for almost the whole time without asking.

When I first went to them they tried me on hard lenses but my eyes could not adjust to them. They then put me on Kerasoft lenses - I did not even know what they were at the time, just went along with it. I do not know what type of Kerasoft lenses they are, I've never thought to ask until recently.

They gave me good vision for the first few years, but now they cannot correct my vision any more with them and so are trying me back on hard lenses. So in my opinion Kerasoft's are comfortabe enough, but have not really given me very good vision.

Dan.

[GarethB]

Dan,

At a gues you may have Kerasoft 2, Kerasoft 3 have come out since and now there is the Kerasoft IC. I did have a keraost 3 in my right eye but that has been replaced by the IC lens which I think has more permiatations to it and is a very breathable silicone hydrogel.

Good luck with the RGP's but no harm in asking if they have the Kerasoft IC's to see if they might work for you. Nothing like having a choice!

[Lynn White]

Hi Dan

Just to confirm what Gareth said, if you had KeraSoft lenses 4 years ago, they will be KeraSoft 2. The KeraSoft IC will give you much better vision but this design was only launched a couple of weeks ago, so that hospitals are just now getting their trial sets. Before they put you back to hard lenses, ask about the new design

Lynn

[Ali Akay]

The use of Kerasoft and other soft lenses for keratoconus eg Acuity Soft K around the country is haphazard, mainly because a lot of practitioners dont believe that they work! A few years ago I presented a poster with a colleague at BCLA (British Contact Lens Association) annual clinical conference titled something like "Do Soft Lenses Give Better vision than Rigid in Keratoconus?" where we presented data collected from patients at a major UK teaching hospital showing similar or sometimes better acuities with soft lenses than rigid for patients with various degrees of KC. Unfortuntately the interest from the visitors was disappointingly low, and we were convinced this was because they simply didnt believe that it was possible! Conventional wisdom dictates that rigid lenses should give the best possible vision, and this is true in most cases, but its no good having a lens with excellent vision if patient is unable to wear it! Ideally specialist contact lens practitioners should be au fait with all types of lenses from rigid, soft, hybrid, piggy back, semi-scleral etc and fit whatever serves a particular patient's needs best. There are a lot of practitioners who only fit rigid lenses, and others like Lyn who primarily fit soft lenses. It is a fact that majority of KC suffers across the world wear rigid lenses, and most get on very well with them. If fitted correctly and patients monitored carefully they are still arguably the best type of visual correction for most cases of KC. However where the patients are intolerant to them, or there are other concerns regarding glare, dust, scarring etc. they ought to be offered alternatives. Unfortunately, for most hospital clinics time is an important factor, and they probably tend to fit what they know best and will give good visual outcome quickly, and patients are told to "keep persevering".

[Lynn White]

What Ali says is very true. I remember giving a lecture about soft lenses for KC and there were several optoms in the audience who kept saying.. "Yes, but I cannot understand how they can possibly work!!" Fitting soft lenses is a skill, just as fitting Synergeyes or Soclear is, if you haven't fitted them before. Its a whole new learning curve, as soft lens fits are quite different to rigid type fits and even different to "normal" soft lenses. I made a definite decision a while back to only fit soft lenses as new fits, although I do manage those patients who already wear RGPs. This is because quality of life to me seems paramount. It is, as Ali says, no point at all in having 6/5 vision of you can only wear the RGPs for 8 hours. What are you supposed to do the rest of the time?

There are three main soft lenses for KC in the UK at the moment, Acuity, Soflex and KeraSoft. These have been available for years and as RGPs DO mould the cornea (i.e. change its shape) its much harder starting with RGP lenses and then changing to soft if you can't tolerate them, than starting with softs and moving on only when they stop working. This is because you have a period of time while the cornea settles down again when you come "out" of RGPs and vision can be variable in the soft lenses.

With new technologies in materials and design, soft lenses for KC are improving rapidly. I'll also address here the question of infection rates between the two types, as this appears to be a recurrent theme. Although in general, the largest number of contact lens infections seen in A&E depts are related to soft lenses compared to RGPs, this is in part reflected by:

Soft lenses are worn by the vast majority of contact lens wearers in the country, so statistically, they will show up more in A&E with infections

These stats cover ALL wearers and generally can be tracked back to a lack of hygiene in either the case or in handling the lenses or inappropriate use of solutions (such as reusing solution rather than throwing it away every day). This is one reason daily disposables were brought in, to improve hygiene, and these definitely are a "normal eye" lens type!!!

There are no statistics collated in A&E depts in general as to contact lens type vs eye condition i.e. its impossible to relate infections to type of lens worn for KC as that data is not collected.

Gut feeling amongst most professionals is that infection rates tend to be a bit lower generally for KC patients because they rely on their lenses for quality of life and therefore tend, on a whole, to take more care of them.

And finally...... when I lecture to optoms, the main argument I get back from them for being pro rigid lenses is that patients do not seem to complain of discomfort or quality of life issues. Now I KNOW some of you ask for softs and get told they can't have them for various reasons but I also DO know that patients do not speak up enough about quality of life issues. No-one will know if you don't say. I know because I have subscribed to various patient forums for years and I read and take on board everything you say. This is mainly why I decided to invest my time in contributing to development of better soft lenses for KC and also irregular cornea which includes those adversely affected by refractive surgery.

Lynn

[GarethB]

The HOAC confrence last year on the Sunday (don't think Lynn was there that day), but there was a presentation from i think Sunderland hospital about the way they work in eye casualty. In most hospitals you are seen by a nurse to evaluate the seriousness of the problem and then seen by an opthalmologist. In Sunderland the nurse part is the same but she decides if you see the optom or the opthalmologist. If the optom wants further assistance, then you get seen by the opthalmologist.

The result was that issues due to contact lenses were resolved quicker as were many eye infections due to other occular conditions. A question was asked about infections and the answer was as Lynn states, soft lesnes but due to poor hygiene. I asked the question about infection rates from those with a medical need for contact lenses, was there a difference and the answer was that in Sunderland they see very few infections in our patient group due to patient hygiene. Iasked why he though this was the case and he said because lenses is our only means of seeing so we appreciate the need for good hygiene more than others.

We are not just unique in being the largest patient grup with a medical need for lenses but quite unique in our understanding of how important it is to look after our eyes because it makes such a difference to our quality of life.