Information i can understand please

[ashton287]

i found out i had keratoconus when i was 15, after years of squinting at the board in school. They sent me for an eye test when i tried to join the army.I'm 23 now and since getting contacts i havent given it much thought. i never really wear my contacts as in my right eye where it is the worse the contact falls out all the time and its just a pain. when i do have them in i get quite an improvement but still not happy with them and there not comfertable.

SOOOOOO i would like to know what other options i have ie surgery. i googled a few diffrent things but im reading gobbledy gook that doesnt help me atall. i know i can have a corneal graft but there seems like 3/4 other options in the treatments section of wikipedia and i wanted to know if any of them would allow me to take jobs that a graft would prevent (i'm thinking of joining the police, if im allowed with my eye's anyway).

[Anne Klepacz]

Welcome to the forum.
Corneal grafts are only done as a last resort, when contact lenses can't give good vision. Only around 1 in 10 of people with KC ever get to that stage, and you sound a long way off it. And none of the current surgical options provide any guarantee that contact lenses won't be needed. Most people still need contact lenses after a graft. Intacs (corneal rings inserted into the cornea) are designed to make the cornea flatter but again people often still need a lens to get good vision afterwards. Collagen crosslinking is a new treatment which aims to stop KC progressing, not to improve the vision although some people have gained a line or two on the chart. So none of the surgical options are a short cut out of contact lenses.
If your lens is constantly popping out, it sounds as though the fit could be better. And in the last few years there's a variety of new lens types so there may well be one that would suit you better. There are now special soft lenses for KC which some people get on really well with. There are also hybrid lenses (hard middle, soft on the rim) and scleral and semi scleral lenses. So it would be worth getting referred to an eye clinic again (if possible one with its own contact lens department) to see what the options are for you.
Good luck
Anne

[Lizb]

in addition to what Anne has said, i went privately for CXL 6 months ago, and at my last appointment my consultant did say that one option now was intacs and a lens inserted in the eye as well. He then looked at my eye and tested my sight - then said that the option he had mentioned previously was not suitable for me as my vision was to weak for it work...
That saying i am still suitable for intacs regarding the thickness of my eyes then hopefully i would get some vision from CL or glasses depending on the sucess

[Neofate]

Ash,

I don't know if you are in the UK or not -- as not everyone on this forum is. At least I'm not.

I know of one of the best, if not *the* best lens developer and custom 'fitter' (sorry not sure of a more technical term, I'm sure there is) in the world. He is located in the United States, in Texas. I can give you his information if you wish to follow up and are willing to travel.

From all the reports I've read and personally talked to him -- this is highly worth the travel. It isn't cheap, a few thousand dollars if I recall correctly. However, the general treatment is you travel to his location,.. stay a few days or so and go back home. The few days are for him to process your eyes, get them made.. then further 'tweak' to your eye shape and vision correction in the following days.

I can't explain the technical process of what he does exactly, but he works largely with a scleral design (though will work with other forms if you so prefer) -- basically meaning the contact rests essentially on the 'white' part of your eye instead of ON the cornea. This generally allows for much more comfort.

This would be good for you due to you achieving better vision with your contacts already (which is common in KC) but them being uncomfortable and even popping off (which is also common).

He would, likely, be able to custom design some lenses that give you optimum comfort and usually provide the best possible contact 'lens' correction currently possible.

I've questioned why this guy over everyone else -- but from what I can tell just like some great artists or sculptors etc -- he has a passion for what he does, he has developed a 'niche' with this process and he has , apparently, an ability to know how to mold and adjust the lenses to best fit KC eyes. (Which are notoriously hard to fit).

Again though, don't know your location -- and it is some money.

Otherwise, it seems like everything I know of has been mentioned. Basically you have contacts, glasses, (recently - CXL, Corneal Cross Linking), and ultimately a graft if it progresses to that point. Usually glasses only work so much, as with KC we need something that is PHYSICALLY on our cornea to reshape it properly to bend light the way it is meant to be. Glasses typically (for obvious reasons) cannot do this.

As for the police:

I'm sure there are differences in the various states, departments and so on.. but as an example, for the San Diego Police Dept this would apply to you:

If you wear eyeglasses or hard* (non-orthokeratology) contact lenses, your uncorrected vision may be no worse than 20/70 both eyes together. Uncorrected vision worse than 20/20 but not worse than 20/70 must be corrected to 20/20 both eyes together.

* "Hard" contact lenses also include semi-soft, semi-rigid, semi-permeable, gas permeable, and similar lenses.

Good luck,