Living with both Keratoconus and Astigmatism
July 16, 2006 9:49 PM   Subscribe

Has anyone sucessfully had keratoconus and astigmatism treated at the same time?

I am 35 and I have had astigmatism since kindergarten. I wore glasses for reading only until I was about 27. When I went to glasses full time, the doctor could not believe I had not done so sooner.

When I about 30, I started wearing toric contacts and liked them.

Then, when I was 32, I started noticing some double vision. It is not terrible, as in "OH CRAP! WHICH ONCOMING CAR IS THE REAL ONE?!" But it is enough to make it hard to focus.

So I get diagnosed with keratoconus (KC). I am fortunate that it started so relatively late in life, becuase it should not get too much worse.

The problem is that the doctor can treat the astigmatism with glasses or contacts or the KC with the new soft contacts for KC (don't get me started on RGP). Yet they can't seem to treat both at once, so I either get blurry single vision or clear double vision. I have tried to get new glasses, but they seem to just amplify the KC.

As a result, I am still wearing glasses I bought in 1999. Tonight, I was in Barnes and Noble and miserable because it is such a pain to read the signs for the book categories unless I was right in front of them.

Any ideas? Could I wear contacts and glasses at the same time? Is a cornea transplant the only option? Do I have to just live with it?

Any suggestions will be greatly appreciated.
posted by 4ster to Health & Fitness (14 answers total)
Get a second opinion.
posted by elisabeth r at 4:49 AM on July 17, 2006

Wow, what timing. I don't mean to piggyback but maybe we can work together here 4ster.

I've just started a battle with KC myself after a lifetime of severe astigmatism. I am currently struggling with my first pair of RGP contacts after a lifetime with just glasses. It's been a month now and the RGP's are basically unacceptable, itching and burning all the time.

The doc has suggested Torics which I really hope are better. You mention new soft contacts for KC? What are these?

There is another option before cornea transplant, I forget the name of it but they insert crescent shaped pieces of plastic underneath the cornea to bulge it outward again, have you looked into this?
posted by Cosine at 10:53 AM on July 17, 2006

I have a similar situation, severe astigmatism with KC developing at about 26 or 27. I reverted to glasses for many years and only had decent vision. Last year I took a chance on a new procedure that implants a device called Intacs in my KC eye. It was expensive about 3K USD(and not covered, of course). At first I didn't think it helped much, but in the end I was able to get fitted with contacts that brought me back to 20/20 vision (RGP lenses).

Definetly something to look into. The surgery was about 10 minutes and I've had no ill effects. After a year my cornea still has a clean bill of health.

With goggles I was able to swim in a pool last weekend and actually see what was going on for the first time in 30 years. A very cool experience.
posted by morrisokr at 11:38 AM on July 17, 2006

And after posting I can see that I'm filling in the blanks for Cosine. The crescent shaped pieces of plastic are Intacs.
posted by morrisokr at 11:39 AM on July 17, 2006

So after your Intacs you still needed RGP's?
posted by Cosine at 11:44 AM on July 17, 2006

I did, but I met another patient who didn't need anything after the surgery. It depends on how bad the KC is. Mine was described as sailing on an open ocean and coming across Mt Everest.

I wore RGP's for about 8 years for astigmatism and my KC was diagnosed while we were trying to figure out why one of my lenses kept popping off my eye.

For me, since I was "correctable" with glasses (sort of) and my cornea was basically healthy a cornea transplant was the last resort. My goal was to be able to wear contacts again.

You need to get a good measurement of how bad your KC is (there's a pretty cool machine for that) and weigh your options.

As for trouble with RGP's, I have uncomfortable days and I hate having to take them out and clean them everyday but the improved vision for me was dramatic.
posted by morrisokr at 11:52 AM on July 17, 2006

I have had all the tests and such but I am not aware of how severe the KC is at this point. My astigmatism however is extreme and is in the opposite direction in each eye plus I am nearsighted in one plane and farsighted in the other.

Even with glasses things were very limited and night driving was soon to be off limits. With the RGP's I am 20/20 in one eye and 20/25 in the other, truely stunning. The problem is now that I know how good it can be I can't go back to glasses yet the RGP's are very uncomfortable. Are the Torics better for comfort?

What are these "new" KC soft contacts?
posted by Cosine at 12:00 PM on July 17, 2006

Response by poster: Toric contacts are for astygmatism.

For years, there were only RGPs for KC. However, there are now soft contacts for it. Basically, they feel just like regular contacts, just a tad thicker.
posted by 4ster at 12:20 PM on July 17, 2006

Are the Toric lenses soft?
posted by Cosine at 12:47 PM on July 17, 2006

Response by poster: Yes. They are weighted, so there is a "top" and "bottom." The bottom usually has three small lines on it, so you put them in right.
posted by 4ster at 1:34 PM on July 17, 2006

damn... that's gonna be tough
posted by Cosine at 1:46 PM on July 17, 2006

I corrected the spelling of astigmatism in the post, which the admin fixed, then deleted my correction, but the tag still says astygmatism, and should also be fixed for future reference.
posted by weapons-grade pandemonium at 2:14 PM on July 17, 2006

Response by poster: Thanks for fixing things, WGP, and my apologies for my bad spelling.
posted by 4ster at 2:22 PM on July 17, 2006

Happens to everybody. It seemed like a functional thing to correct you in this case.
posted by weapons-grade pandemonium at 2:44 PM on July 17, 2006

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