Keratoconus in kids or teens? What to do?

Hearing the words that your child has keratoconus can be daunting. What does it mean? Will this affect his future? Keratoconus is a progressive corneal thinning condition, making the outer transparent part of the eye look like a cone. The instability of the corneal structure in susceptible patients may lead to the worsening of keratoconus. Keratoconus is usually diagnosed in the 2nd decade of life, but we have also seen an increased number of patients referred to us who are still in their teens. The youngest keratoconus patient recorded in publications was a 4-year-old boy.

When we have kids in our chair, we discuss cross-linking, which stabilizes the keratoconus progression; and contact lenses for vision rehabilitation. We also discuss issues of eye itchiness. An important thing to consider too is to stop your child from eye rubbing. Eye rubbing is associated with keratoconus and its progression. Manage the reason why he rubs his eyes. Is it an allergy? Could it be his hair is irritating his eyes? Is it eyelashes poking his eyes? Is it mannerism? In kids, the advancement of the condition is more aggressive than adults, so we extensively advise controlling the situation and then contact lens wear. Without cross-linking, the rate of the changing of contact lenses will be higher, as the increased curving (steepening) of the cornea will need an alteration of the contact lens fitting.  

Our clinic’s youngest was 9 years old. An ophthalmologist referred him to us for contact lens fitting. His cone was so steep that we cannot fit him with a GP (gas permeable lens) anymore as the lenses pop out. Since he was still young, and the goal is to delay corneal transplant for as long as possible, we fitted him with scleral contact lenses. The scleral lenses allowed him to see well for far and near, which significantly helped his studies. If you think that 9-year-old is too young to wear contact lenses, not really, kids follow instructions well. The safety of contact lens wear is similar to adults, if not better. 

Contact lenses for keratoconus patients can improve their self-esteem. Some keratoconus patients feel down due to their blurred vision, so we encourage parents to explore contact lenses for them to wear. These will help your child reach his potential. 

There are several contact lens options for keratoconus patients; visit our clinic for an evaluation to know which one will work best for you. We will be with you on this journey.

You can reach us via the following:

https://goldheartoptical.com/

https://www.facebook.com/GoldHeartOptical

Email: goldheartoptical@gmail.com

Mobile: 09215452389

Reference:

  1. Kankariya VP, Kymionis GD, Diakonis VF, Yoo SH. Management of pediatric keratoconus – evolving role of corneal collagen cross-linking: an update. Indian J Ophthalmol. 2013;61(8):435-440. doi:10.4103/0301-4738.116070
  2. Sabti S, Tappeiner C, Frueh BE. Corneal Cross-Linking in a 4-Year-Old Child With Keratoconus and Down Syndrome. Cornea. 2015 Sep;34(9):1157-60. doi: 10.1097/ICO.0000000000000491. PMID: 26165788.
  3. Walline JJ, Lorenz KO, Nichols JJ. Long-term contact lens wear of children and teens. Eye Contact Lens. 2013 Jul;39(4):283-9. doi: 10.1097/ICL.0b013e318296792c. PMID: 23771010.
  4. Wu Y, Tan Q, Zhang W, Wang J, Yang B, Ma W, Wang X, Liu L. Rigid gas-permeable contact lens-related life quality in keratoconic patients with different grades of severity. Clin Exp Optom. 2015 Mar;98(2):150-4. doi: 10.1111/cxo.12237. Epub 2014 Dec 29. PMID: 25557946.
  5. Picot C, Gauthier AS, Campolmi N, Delbosc B. Qualité de vie des patients équipés en verres scléraux [Quality of life in patients wearing scleral lenses]. J Fr Ophtalmol. 2015 Sep;38(7):615-9. French. doi: 10.1016/j.jfo.2014.10.018. Epub 2015 May 20. PMID: 26001955.

Scleral Contact Lens Fitting in the Philippines

Scleral contact lens fitting is available in the Philippines.  It was not available though in the earlier years.  I have come across one foreign keratoconus blog with a Filipino with keratoconus asking where to get scleral lenses in the Philippines.  He seemed desperate, I tried to reach out but the blog was no longer active.  That was where the idea started.  I used to think that small rigid gas permeable lens is  the answer for all corneal irregularities, now I know I am wrong.

As more literatures are coming out, I realised that scleral lenses are invaluable in managing complicated corneas such as keratoconus, post surgical corneas such as in post LASIK and other post refractive surgery complications and corneal transplants.   These lenses act as band-aids with cushions, vaulting the entire injured or compromised area.  And since the lenses are filled with  saline, these are great too for patients with ocular surface diseases such as dry eyes.  The skirt of the scleral lens lands on the least sensitive part of the eye which is the sclera, that is why patients tolerate scleral lenses more than small rigid gas permeable lenses.  As to the cost, it may be more than what conventional rgp’s would cost, but the outstanding vision and comfort that these lenses provide make it all worth it. When we do scleral contact lens fitting, we do series of tests and fittings before finalising the best fit for you.

How long does a scleral contact lens last?  Well, depends on the progression of the condition as well as how well you clean them.  A safe estimation will be  2 years or so.

We welcome inquiries on scleral contact lens fittings.