Sam went on a trip to Mexico for his honeymoon saw… a blurry tropical view.
“I was so disappointed to be somewhere new and not able to see it,” he says. “Looking up at the night sky I’d see six moons instead of one.”
Living with Keratoconus
Sam has keratoconus. Keratoconus is a condition that affects at least 1 in 2,000 people in the U.S. It is a leading cause of corneal transplantation and a life-long disease that can cause blindness if left untreated. Keratoconus causes progressive thinning or distortion of the cornea, including a bulging cornea. This changes the corneal shape and significantly impacts vision. Symptoms can include higher order aberrations (HOAs) such as blurry vision, double vision, ghosted vision, and glare and halos around lights, as well as light sensitivity, corneal scarring, difficulty seeing at night, and eye irritation or headaches with eye pain. However, most cases of keratoconus can be successfully managed.
Sam’s Journey
Sam’s keratoconus journey began when in seventh grade. He had already been wearing glasses since fourth grade, but his eye care provider noticed something unusual and sent him to a specialist, where he was diagnosed with keratoconus. He started wearing hard contacts to manage the condition. Later, a practitioner moved him into rigid gas permeable lenses, known as RGPs. Sam says that many keratoconus patients are started with RGPs. But RGPs were uncomfortable sitting on his distorted and thinned cornea, left significant ghosted images, and required a lot of care.
“I always had my lens case and eye drops with me because at any moment because sometimes they were so uncomfortable, I’d have to take them out in the middle of the day. And they would just pop out sometimes if I touched the corner of my eye,” he says. “When it was windy, debris easily got under the lenses. Then I’d have to remove them, clean them, and put them back in again.”
In 2006, Sam moved to Boston and began seeing Dr. Samir Melki, a corneal specialist at Boston Eye Group in Brookline who manages Sam’s keratoconus. It was here at Boston Eye Group that an optometrist, who provided contact lens fittings, introduced Sam to scleral lenses. They tried a series of scleral lens brands, wearing each brand for about a year. However, none of the lenses worked well enough to improve visual acuity, comfort, blurriness, and ghosted vision.
Managing Keratoconus with Scleral Lenses
Then, Dr. Emily Nangle at Boston Eye Group suggested BostonSight SCLERAL lenses. BostonSight SCLERALs were new to the market and were designed based on years of clinical patient outcomes at the BostonSight PROSE® clinic in Needham, Massachusetts. Sam also has a pinguecula on each eye (a bump on the surface of the eye) compounding the lens fit. The practitioner must fit the lens so that the edge (the landing zone) does not rest harshly on the bump. When lenses land harshly over anatomical bumps on the surface, the eye develops redness (hyperemia) and there is often lens intolerance and discomfort with increased wear time. By using a larger lens, Sam’s practitioner was able to distribute the weight of lens so that it did not land harshly over the pingueculas, resulting in greater comfort.
Evaluating Lens Size
Sam has been wearing 18.5mm BostonSight SCLERAL lenses for four years. He loves the size of his lenses, saying, “They cover so much surface area that wind is not an issue like it was with RGPs. I no longer get dust or debris under the lens.”
He also has very dry eyes and is on a computer all day for his work in digital services. “I would use lubricating drops at night, wake up in the middle of the night, and use them again. In the morning, I’d have to wait an hour before putting in my old scleral lenses. But with BostonSight SCLERAL, I can put them in right away. They’re so comfortable, they stay in all day.”
But with the progression of keratoconus, Sam calls his vision a moving target. He is having a corneal cross-linking procedure on his right eye soon. Corneal crosslinking is a surgical treatment that attempts to make the cornea stronger. He will still require scleral lenses to manage his keratoconus and plans to continue with his BostonSight SCLERAL lenses.
The Benefits of BostonSight SCLERAL lenses
“Nothing else has done as much for fixing the ghosting as these lenses,” Sam says. “I don’t see six moons anymore. Now I only see one and a half.”
All BostonSight SCLERAL lenses are designed with a technology called SmartSight to reduce HOAs, such as Sam’s ghosting. SmartSight is incorporated into every lens from the start and can be adjusted for each patient to provide the best possible outcome.
“Every morning I put my BostonSight SCLERAL lenses in and check my vision by looking at the roof tiles on the house across the street. The clarity is amazing. These lenses have had a profound impact on the quality of my life, and I want to help get the word out about how good they are and about the work BostonSight is doing.”