Newbie

[Martin Kuster]

Hi everyone,

I am Martin and I am 33 years old. I had an eye exam a little less than a year ago because my vision was rapidly deteriorating in the preceeding months (unfortunately haven't done an eye exam for a number of years). It was then confirmed that i have KC. At the eye clinic the consultant determined from the corneagram that it should be fixable with RGP lenses, they also did these tests with glasses with asymmetrical lenses and in the right eye I could read the lines required for driving standard. On my first appointment at the contact lens clinic the lens fitter tried several lenses (which I now conclude were RoseK) and 2 months later I picked up the ordered lenses. I had been wearing these lenses for a month and whilst tolerance was not an issue and the general blurriness was gone, they gave me severe ghosting/multiple images in both eyes (To give you and idea: Without lenses I can read a normal book, with lenses I needed large print books). On the follow-up appointment at the contact lens clinic, the lens fitter said that if the vision with RGPs was that bad I'd probably need grafting but then suggested trying scleral lenses.

Basically, I am now waiting another 2.5 months for my appointment to try sclerals. In the mean time I have read a few posts in this group and I have realised that grafting should really only be the last resort. Where I am slightly confused, and maybe members of this group can help, is why the RGP lens does not give me the same correction that the special glasses at the eye clinic gave me in the right eye?

It's good to have this group.

Martin

[Lynn White]

Hi Martin

Well its a bit difficult to answer this without more details but possibly it is because of fitting issues with the RGP. You sound like you had what we call residual astigmatism - which is where you have more power in one direction than another. This is usually concentrated on the cornea but can occur in the lens of the eye as well, in which case an RGP may well neutralise any corneal astigmatism but fail to correct that in the internal lens of the eye. On the other hand it may just be down to the way the RGP fits on your eye.

You do need to ask your fitter more about this!

I do agree graft is the last resort and again, if this is again presented as the only option, you should obtain as much information about your eyes' condition before agreeing to go ahead.

Lynn

[Annmarie Miles]

Hi Martin

welcome to the forum.

I am afraid i can't help you as I don't know rnough about it - but I hope being in contact with others with KC will be enciuraging as well as infomrative

A

[Emma_Marie]

Hi Martin,

I couldn't help but notice that you are from Belfast. Does that mean that the consultant you are seeing is in the Royal? I am being treated in the Altnagelvin in Derry. The large waiting period for lenses is indeed a problem in N. Ireland. My consultant explained to me that as there is no specialist lens supplier in NI and due to the complexity of KC lenses, they have to place orders with companies in mainland Britain. Hence the 6-8 week waiting list. Hope all goes well with the new lenses tho (When they eventually come!)

Emma

[GarethB]

Those of us who are pro-graft like me say grafts are a last resort is because at the ned of the day it makes sight correction easier in most cases.

Once done, there is no revrsal and a good many still need contact lenses of one type or another. So if you just have a lens fit or tolerance issue, it is quite possible to gain nothing.

If left as a last resort you have everything to gain and as a worst case nothing to loose if the graft does not work.

I know this sounds depressing, but that is basically how it is.

Good luck with the scleral.

[Andrew MacLean]

Martin

I am 100 percent pro graft, but I'd not have even contemplated the operation until I had exhausted all other options.

when the graft is done, remember it does not come with any guarantees.

andrew

[Martin Kuster]

Thanks to all those who replied.

To Lynn: I know it's a bit vague. From what I heard and having seen the corneagram, the cornea in both eyes is essentially sagging and therefore there is a large difference in curvature in the horizontal v. vertical direction. My lens fitter explained the ghosting with the fact that the refractive index of lens, tears and cornea are only approximately equal and due to the shape of the cornea the thickness of the tear film is obviously varying.

To Emma: Yes both the consultant and lens fitter are at the Royal. Actually, I think the waiting time between appointments is more related to the fact that these people only work at the NHS hospital one day per week. Currently, I am not waiting for lenses but simply for the appointment to try some from their scleral 'test set'.

Martin

[Martin Kuster]

Hi everyone,

I thought I'd post an update:
In mid June, I tried scleral lenses and whilst they were ok to wear and the lens fitter found a good fit, they gave me the same amount of ghosting than the RGPs. Actually, with just the scleral the vision was not too bad but when they apply the correct lens power, it gets bad. The lens fitter has now referred me back to the corneal specialist and they both want to check together why I get that much ghosting in my vision. Anyway, it's almost August and I haven't even received a new appointment letter.

I am leaving Northern Ireland and the UK again in September 2007 and the bets are on that it won't be resolved by then.

Thankfully, I went to the optician after Easter and he was able to prescribe me a pair of glasses with which I can work halfway effectively on a computer.

Martin

[Andrew MacLean]

Martin

Thanks for the update.

I am sorry about the problem with the scleral, and am a bid bamboozled by the fact that the scleral on its own gave you half way decent sight, but the correction made it all go wonky. I just do not know what to make of that!

All the best

Andrew

[rosemary johnson]

I've had the experience before that a test lens feels fine, and the vision is OK, but when the "real one" arrives it isn't so good.
There are too possible reasons for this that I've come across:
The first was that the slight change in shape caused by grinding the lenses to the right power (rather than a "plain" test lens and power lenses in those glasses-things) makes enough difference to be different
These days maybe more to th point: many/most test sets are made of PMMA (Perspex) and the real lens is made of RGP material. And the characteristics of the two materials as they affect wear can make the difference.
Hope you get it sorted out.
Is the comfort different or just the extra ghosting?
Rosemary