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Welcome To The Monroe Vision Associates Scleral Lens and Keratoconus Center, Helping Patients From All Over Monroe Township, NJ

What Is Keratoconus?

Keratoconus is an eye disorder that causes the cornea to lose thickness, changing from its natural round shape to a cone-like shape. Keratoconus occurs when the collagen fibers inside the cornea become too weak to support the round shape. This abnormality makes it difficult for light to enter the eye, resulting in vision problems such as blurriness and sensitivity to light. This, in turn, makes certain tasks like driving or reading extremely difficult. The condition typically affects both eyes, but it is possible to have varying degrees of vision problems between the two, which can change over time.

A Number Of Medical Professionals Believe That

Why the cornea begins to thin is a matter of some debate. A number of medical professionals believe that certain people are genetically predisposed to this condition, while others believe it is the result of an eye injury or disease, or caused by behaviors like excessively rubbing your eyes.

Children with keratoconus playing

Who Is At Risk For Developing Keratoconus?

According to the National Eye Institute, Keratoconus is one of the most common eye disorders in the US. Nearly 1 in 2,000 Americans have the condition. Keratoconus most often affects children from adolescence through their early 20s. Sometimes, it can occur in people in their 30s and 40s, but these cases are unusual.

There are number of studies showing the likelihood of developing Keratoconus based on ethnicity and gender. The commonly accepted belief is that it is more prevalent in Asians, who are 4 times more likely to develop the condition than other ethnic groups.

More Information About Keratoconus

There are a number of risk factors that are more likely to cause Keratoconus to develop. These include behaviors and conditions such as:

  • Allergies
  • Asthma
  • Frequent eye rubbing
  • Down Syndrome
  • Genetics/family history
  • Hay Fever
  • Floppy Lid Syndrome, a type of chronic conjunctivitis
  • Retinitis Pigmentosa
  • Sleep Apnea, a condition that causes someone to stop breathing during sleep

Someone who has - or is beginning to experience - Keratoconus may notice any of the following symptoms:

  • Blurriness
  • Cloudy vision
  • Eye strain from squinting to read
  • Halos around bright lights
  • Headaches
  • Night vision problems
  • Persistent changes to eye prescriptions
  • Sensitivity to glares or strong lights

If you have any one or more of these symptoms, especially if there is a family history of Keratoconus, speak with your eye doctor right away. The sooner a diagnosis is made, the earlier that treatment and management of the condition can begin, so you can start to experience improved vision.

To check if you are a good candidate for scleral lenses, contact Dr. Donlon and Dr. Bubnovsky at The Monroe Vision Associates Scleral Lens and Keratoconus Center in Monroe Township or Trenton in NJ. Our eye doctors and professional, courteous staff will be more than glad to help you with scleral lenses as soon as possible.

Keratoconus is typically diagnosed by performing a number of eye exams and tests to determine the size and shape of your cornea. Dr. Donlon and Dr. Bubnovsky will begin by conducting a routine eye exam to check for overall eye health and visual acuity. The doctor will speak with you about your medical and family history, including any existing symptoms or complaints you may have about your vision and how it affects your everyday activities.

The surface of your cornea may be measured with a special computerized system. This process, known as corneal mapping (or corneal tomography), is exactly what it sounds like: it maps your cornea so that Dr. Donlon and Dr. Bubnovsky can obtain exact measurements and details about its shape and size. The curvature is measured with a keratometer, a device containing prisms that guarantee accuracy and stability of the corneal images.

At The Monroe Vision Associates Scleral Lens and Keratoconus Center, we have the most advanced equipment and modern tools to ensure that our patients receive the highest standard of care that they deserve. If you have questions during the exam or would like to discuss your diagnoses in detail, just ask - we’re here for you.

Like most physical conditions, ignoring the signs and not seeking treatment won’t make it disappear. If Keratoconus is left untreated, the condition will gradually deteriorate. This can lead to increased blurriness, corneal scarring or swelling, or significant vision loss. If the vision loss is severe enough, it may even be categorized as a physical disability.

Unfortunately, Keratoconus is not curable at this time. Once diagnosed, it is a lifelong eye disease. Thankfully, there are treatments that can be successfully managed. That’s why it’s critical to seek the expertise of an eye doctor like Dr. Donlon and Dr. Bubnovsky, who can look at the whole ‘you’ and create a customized treatment plan for your vision and lifestyle needs. The sooner, the better.

The most common forms of treatment for Keratoconus include Collagen Cross-Linking, scleral lenses, Intacs, and in more serious cases, a corneal transplant.

Collagen Cross-Linking (also known as CXL) is a procedure using special eye drops together with an ultraviolet (UV) light. Through this process, the cornea becomes flatter, its tissue becomes stronger, and it stops progressing into a cone-like shape. However, the procedure is intended for more acute cases, and along with some mild pain, recovery time can take up to 2 weeks.

Intacs is a device that flattens the cornea and gently reshapes it into its natural form. It is inserted surgically into a thick section of the cornea and is the only FDA-approved one of its kind. Many patients with Intacs find that their case of Keratoconus improves to the point where a corneal transplant is no longer needed.

In addition to the above, there are a number of other surgical procedures for the most serious cases of Keratoconus. These can include a partial or complete corneal transplant, which involves the removal of a damaged cornea, replaced with a donor cornea which is round-shaped and healthy.

However, for the majority of patients, the most effective way to treat Keratoconus is with scleral lenses.

young woman holding eyeglasses

What Are Scleral Lenses?

Scleral lenses are special types of contact lenses used to treat a number of eye diseases, including Keratoconus. Scleral lenses contain a small section that holds artificial tears, which coat the misshapen areas of the cornea, helping to keep them moist, restore vision clarity, and sharpen the patient’s focus.

They Cover A Larger Area Of The Eye

Unlike basic soft contacts, scleral lenses have a larger diameter and therefore, they can cover a larger area of the eye without actually touching the cornea. This larger size results in a more comfortable fit.

Rigid Gas Permeable Lenses (RGPs)

In its early stage, Keratoconus is often treated with glasses or traditional soft contact lenses. As the condition progresses, rigid gas permeable lenses (RGPs) are used instead of soft ones. This is because RGPs can naturally conform to the shape of the cornea, counteracting its effects. However, they may also increase the risk of corneal scarring, and many patients find them uncomfortable to wear for more than a few hours at a time.

More Comfortable And Efficient Alternative

When other types of lenses or eye treatments have been unsuccessful at sufficiently treating Keratoconus, scleral lenses are recommended. For example, after a patient has undergone LASIK surgery, scleral lenses may be needed to help stabilize the patient’s vision or to simply provide basic vision correction assistance if the LASIK wasn’t successful. When a patient's cornea has a high level of sensitivity to a basic soft lens, the doctor will prescribe scleral lenses as a more comfortable and efficient alternative. Studies show that wearing scleral lenses can even reduce the need for a corneal transplant in patients with severe Keratoconus.

Cross Linking For Keratoconus & Why Scleral Lenses Are A Better Option For Early Stages

While cross-linking is most effective for repairing late-stage Keratoconus, it is not recommended for the earlier stages. For one thing, it requires the use of artificial tears on a consistent basis. For another, a patient must be above 14 years old to receive CXL treatment.

This is why scleral lenses are recommended for the earlier stages of treatment. Since they have a built-in area for artificial tears, a patient doesn’t need to constantly manually administer them throughout the day. Scleral lenses can also be used by children under 14, although the exact age that is most appropriate for contact lens wear varies among different eye doctors.

If you are in the earlier stages of Keratoconus and interested in scleral lenses, our eye doctors at The Monroe Vision Associates Scleral Lens and Keratoconus Center can help patients from all over Monroe Township, NJ. Dr. Donlon and Dr. Bubnovsky will do a thorough, comprehensive work up and our staff will make you feel right at home.

girl in the grass, wearing scleral lens

Scleral Lenses For Children

How Young Is Too Young For Lenses?

When it comes to basic soft contacts, there is a difference of opinion among eye doctors. The American Optometric Association surveyed over 4,000 optometrists and found that over 50% believe children aged 10-12 may wear contacts, 12% said 8-9 years old was age appropriate, and 11% stated under age 8 was acceptable.

However, when it comes to cases of Keratoconus, many optometrists will go even lower. Studies show that from infancy up to puberty-aged kids can experience positive results from scleral lenses.

Because our youngest patients need extra care and special attention, we make sure they get the proper eyecare that their still-growing bodies require. When it comes to Keratoconus, this is even more important. Vision difficulties can have a serious impact on a child’s education, extra-curricular activities, and social life. As essential as an early diagnosis and treatment is for adult patients, it’s even more critical for kids in early childhood.

Young children can also benefit from scleral lenses. Since the large diameter of these lenses allows them to cover more of the eye, they can be particularly effective on pediatric patients. This is because the smaller sizes of a child’s eyes allow for an even larger coverage area.

african american woman with pretty eyes, wearing scleral lenses
Common Questions

Once you have been properly fitted for scleral lenses, you can expect to gradually see improvements in clarity, sharper color, and detailed contrast between multiple images and objects in your visual field. The level of comfort you’ll experience means that you’ll be able to wear your custom-made scleral lenses all day long, so you can keep doing the things you love, but with better, clearer vision.

Watch these testimonials to learn how others have experienced a huge difference wearing scleral lenses for the first time and how easy and comfortable they are to put in, take out, and wear all day.

Once you’ve decided to get scleral lenses for your Keratoconus, be sure that the eye doctor you visit has the knowledge and experience required to correctly fit you for the lenses. Not every eye doctor does. That’s because scleral lenses require precise customization, and every patient's Keratoconus case is different with varying degrees of severity.

Dr. Donlon and Dr. Bubnovsky has this expertise, and the entire staff at The Monroe Vision Associates Scleral Lens and Keratoconus Center will ensure that you receive the top quality eye care and custom-made scleral lenses that will help improve your Keratoconus condition, and ultimately, your quality of life.

Most health insurance plans cover healthcare services which are either routine or deemed medically necessary. However, each insurance company has a slightly different version of what is considered medically necessary versus something that is an elective procedure or benefit.

In the case of scleral lenses, every insurance company is different. Some cover the examination and custom fitting, but not the actual lenses. Other providers cover a portion of the cost, while another may cover 100% of the cost, but only if other treatment methods have been completely exhausted. It’s important that you check with your specific insurance provider to find out the particular details of your scleral lens coverage.

Some of the latest Keratoconus research involves a variety of scientific studies and clinical trials aimed at understanding more about the condition and developing more advanced and effective treatments.

The Keratoconus Genetics Research Program at Cedars-Sinai Medical Center is running a study to identify specific genes which may be a factor in the development of Keratoconus. The center also offers a number of clinical trials for the research and advancement of Keratoconus treatments. One such study involves the use of phakic intraocular lenses, which are FDA-approved to treat vision problems in Keratoconus patients.

iVeena Delivery Systems has developed a pharmaceutical eye drop named IVMED-80. This drug is intended to treat Keratoconus by flattening the cornea in as little as 6 weeks, making more invasive treatments unnecessary. The FDA has already granted IVMED-80 orphan drug status, and human clinical trials are expected to begin soon.

Serving Patients From:

Other Specialty Contact Lens Fittings In Monroe Township

Our practice specializes in custom contact lens fittings for a wide range of specialty contact lenses. This includes:

  • Gas permeable (GP) and rigid gas permeable (RGP) lenses
  • Multifocal contact lens fitting for presbyopia and myopia
  • Soft daily lenses for moderate dry eye, discomfort, and eye allergies
  • Scleral lenses for patients with keratoconus, corneal scarring, severe dry eyes, corneal transplants, and irregular astigmatism.

Our optometrists, Dr. Donlon and Dr. Bubnovsky, have successfully helped many patients come from all over NJ including Monroe Township, Trenton, Edison, and Easton