Contact Lens or Intacs for Keratoconus

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There are a few options for treatment of keratoconus in the early stages. The traditional glasses can do good for young children. As the disease progresses the kids would do better with soft lenses. These contact lenses wrap around the abnormal cornea and utilizing tear film create a smooth surface. To explain it further, the tear film fills up divets in the corneal irregular surface in keraotoconic corneas. The soft lens floats on this tear layer. The final surface represented to the incoming light is a smooth surface. As the diseas progresess this mechanism may not be enough. Attention is than directed to corneal maps and keratometry readings.

A soft toric lens may be the next choice to ameliorate the symptoms. And the step ladder treatment approach to keratoconus than progresses to hard contact lenses, hybrid lenses.

Finally when there is contact lens intolerance Intacs or CXL is the choice. It is important to do these procedures before there is any corneal scarring, as that is a relative contraindication. Why does corneal scarring develop with contact lenses? as you may remember keratoocnus is the forward bulging of the cornea. The hard contact lenses push this bulge inward to get better vision. This causes friction,heat and burn leading to corneal scarring.
Hence it is better to do Intacs as the disease starts worsening.

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