Expert contact lens practitioner Rory McClenaghan shares some of his top tips in contact lens fitting for patients with Keratoconus.
Contact lens fitting in people affected by Keratoconus can be challenging but ultimately very rewarding as contact lenses may offer the very best visual performance. Rory McClenaghan, Principal Optometrist at University Hospitals Southampton is recognised to be an expert in this area with a long experience of treating challenging fits and below shares some of his ‘trade secrets’. Corneal collagen cross linkage (CXL) should be considered if Keratoconus is progressive and contact lens fitting can take place alongside CXL as in most cases keratometry will not be altered by the CXL procedure. Contact lenses can be used to visually rehabilitate patients with primary KCS but also those who may have undergone surgery including intrastromal corneal rings (ICR) or corneal transplant. This article will focus on fitting patients with primary Keratoconus.
Rory’s Secrets for Success
1 Have a few fitting sets and get used to fitting those designs, soft as well as gas permeable contact lenses (GP). Some of the new soft and hybrid keratoconic designs work well in the early stages of the disease.
2 Use lenses designed for keratoconus, not just aspheric design GPs.
3 Don’t fit lenses flat in an attempt to ‘push the cone back in to shape’ it will only scar the apex of the cone and reduce the vision.
4 Fit GP lenses with a feather-like touch on the cone apex. (see picture).
5 Ordering the lenses with different handling tints helps the patient tell the difference between lenses.
6 Know your limitations. If you are not seeing keratoconics regularly it is probably best to refer.
David Anderson will be giving a patient presentation on Keratoconus as part of Eye Health Month at 18:30 Wednesday 22nd June 2016 at Nuffield Health Wessex, please register by clicking here.