Tag Archives: Scleral lens

Correcting Radial Keratotomy (RK) Complications

Radial keratotomy (RK) is a refractive surgical procedure to correct myopia (nearsightedness) that was developed in 1974. It has been superseded by newer operations, such as photorefractive keratectomy (PRK), LASIK, Intra-Lasik, Wavefront Lasik, and others. Although rarely done now, millions of people underwent RK in the 80’s and 90’s around the world with over a million procedures done in the United States. In addition, many of these RK patients had LASIK in an attempt to undo damage caused by their initial RK surgery.

With the RK procedure, incisions are made on the cornea with a scalpel (knife). These tiny cuts flatten the surface of the cornea and reduce nearsightedness. The surgeon may make additional cuts to flatten the misshapen part of the cornea for those people who have both astigmatism and nearsightedness. The long term results of radial keratotomy (RK) complications have truly been horrific for many people. Numerous problems occurred years later. These include:

• Loss of Best Corrected Visual Acuity
• Severe Dry Eye
• Unstable or Fluctuating Vision
• Double or Triple Vision
• Irregular Astigmatism
• Halos, Glare, and Reduced Night Vision

Many RK patients also underwent additional RK procedures followed by one or more LASIK procedures. In every instance, the additional procedures only exacerbated the problem. In recent years, advances in specialty lenses including Scleral lenses and other unique advanced lens technologies have become available which will allow patients to see clearly and comfortably once again, without the risk of further surgery.

The images below show how one of our patients, Sharon B., sees at night after having RK surgery vs. how she now sees with a Scleral lens.

 Post RK Surgery with glasses                   Post RK Surgery Corrected with Scleral lens                                                                       Post RK Surgery Uncorrected and corrected

Keratoconus Specialist in Baltimore

English: Scheme of keratoconus compared to nor...

English: Scheme of keratoconus compared to normal cornea Polski: Schemat porównujący prawidłową rogówkę do stożka rogówki Hrvatski: Skica keratokonusa u usporedbi s normalnom rožnicom (Photo credit: Wikipedia)

Keratoconus is a condition in which the cornea (the lens of the eye) begins to have structural fluctuations, causing it to thin and change to a more conical shape than its normal gradual curve.

The cornea has three major parts, the outer layer, epithelium, the central structural portion, the stroma, which provides the cornea’s shape, and the endothelium, which prevents swelling of the cornea. Keratoconus is a disease of the corneal stroma. The stroma comprises over 85% of the cornea, and is made up of collagen, similar to the material on the tip of your nose. With keratoconus, the cornea loses its usual round shape, and develops in to a cone-like shape.

In the initial stages of keratoconus, vision will fluctuate, causing astigmatism.  As the condition progresses, the cornea becomes too irregular for the use of glasses, and special contact lenses, called Scleral Lenses are needed.  The new generation of Scleral lenses are now very comfortable in the eye and most importantly correct the distortion caused by keratoconus.

Keratoconus is a progressive corneal condition, and regularly starts in the teenage years.  Now with Scleral lenses, people with keratoconus can have great comfortable vision. It’s always in a person’s best interest to avoid corneal transplants and other surgical procedures.

Dr. Irwin Azman specialists in the fitting of Scleral contact lenses for keratoconus, Lasik failures and complications, Pellucid Marginal Degeneration, Stevens-Johnson Syndrome, and other corneal irregularities.

Scleral Contact Lenses for Pellucid Marginal Degeneration

Pellucid Marginal Degeneration:

Pellucid Marginal Degeneration is a sub-category of Keratoconus. Pellucid corneas involve a larger distorted geographic area usually extending from the inferior corneal margins up to the center of the cornea. It is not unusual for 50% or more of the corneal surface to be involved. Because so much of the cornea can be affected, fitting this type of cornea can be challenging. The problem we face as eye care practitioners is fitting the steep areas if the cornea without adversely affecting the flatter areas.

Scleral Lenses:

Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by, keratoconus, Lasik failures, post-surgical complications, and other corneal irregularities.

Because scleral lenses are designed to vault the corneal surface and rest on the less sensitive surface of the sclera, these lenses often are more comfortable for a person with corneal irregularities caused by keratoconus and other corneal irregularities  A special liquid fills the space between the back surface of the lens and the front surface of the cornea. This liquid acts as a buffer and protects the compromised corneal tissue. Scleral lenses are designed to fit with little or no lens movement during blinks, making them more stable on the eye, compared with traditional corneal gas permeable lenses. These lenses are almost always very comfortable and the vision provided by them is extremely good. The great majority of patients are able to wear their scleral lenses almost all of their waking hours without problems.

Dr. Irwin Azman, Keratoconus Specialists in Maryland, prescribes scleral contact lenses for a variety of hard-to-fit eyes, including patients with Stevens-Johnson Syndrome, Radial Keratotomy and Lasik Complications and Lasik failures, keratoconus, Corneal Ectasia, Post-Surgical Vision Loss, and Pellucid Marginal Degeneration.

Dr. Irwin Azman specializes in keratoconus, lasik failures and other corneal irregularities neither avoids nor declines the challenge of prescribing the most difficult cases. Dr. Azman tends to have a perfectionist demeanor.

Corneal topogram of a keratoconic eye

Corneal topog. of a keratoconic eye (Photo credit: Wikipedia)

 

Scleral lenses: Stevens Johnson Syndrome

English: Intraoperative pachymetric-guided cor...

English: Intraoperative pachymetric-guided corneal epithelium removal during corneal collagen cross linking in patient with post-LASIK corneal ectasia and inferior corneal thinning. Kymionis et al. BMC Ophthalmology 2009 9:10 doi:10.1186/1471-2415-9-10 (Photo credit: Wikipedia)

Stevens Johnson syndrome (SJS) and the more severe variant of the disease, toxic epidermal necrolysis syndrome (TENS), are intense autoimmune sensitivity reactions to infections or medications that primarily affect the skin and mucus membranes, including the eyes. Patients with Stevens-Johnson Syndrome have a tendency to have ocular difficulties including dry eyes, eye pain, light sensitivity, scarring, and corneal erosion.  Dr. Azman has helped many patients restore vision and quality of life transformed with his innovative treatments.

Scleral Lenses:

Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by Lasik failures, post-surgical complications, and other corneal irregularities.

Because scleral lenses are designed to vault the corneal surface and rest on the less sensitive surface of the sclera, these lenses often are more comfortable for a person with corneal irregularities. A special liquid fills the space between the back surface of the lens and the front surface of the cornea. This liquid acts as a buffer and protects the compromised corneal tissue. Scleral lenses are designed to fit with little or no lens movement during blinks, making them more stable on the eye, compared with traditional corneal gas permeable lenses. These lenses are almost always very comfortable and the vision provided by them is extremely good. The great majority of patients are able to wear their scleral lenses almost all of their waking hours without problems.

Dr. Irwin Azman prescribes scleral contact lenses for a variety of hard-to-fit eyes, including patients with Stevens-Johnson Syndrome, Radial Keratotomy and Lasik Complications, Keratoconus, Corneal Ectasia, Post-Surgical Vision Loss, and Pellucid Marginal Degeneration.

Dr. Irwin Azman neither avoids nor declines the challenge of prescribing the most difficult cases. Dr. Azman tends to have a perfectionist demeanor.

 

Corneal Ectasia: Scleral Lenses

My Cornea looks like a Black hole!

(Photo credit: Rakesh Rocky)

 Corneal Ectasia:

A condition resembling Keratoconus is virtually always caused by refractive eye surgery, specifically LASIK. After LASIK, the cornea has been made thinner. Because the corneal “wall” has been made thinner, internal pressure from within the eye can cause expansion or distension of the cornea. The resultant distorted corneal surface will usually make it impossible to have clear vision with eyeglasses or soft contact lenses. Most of the time a special gas permeable contact or scleral lens will be needed to restore lost vision. These special high tech lenses (which have only recently become available) will act to create a new corneal surface allowing the patient to regain clear, comfortable vision.

Post Lasik Treatments:

There are a number of specialized lenses now available that will allow post-surgical patients to function on a much higher level and with a much greater level of comfort. To address the vision and comfort issues that most post-refractive surgical patients are facing, Dr. Azman prescribes Post-Surgical Scleral Lenses.

Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by Lasik failures, post-surgical complications, and other corneal irregularities.

Because scleral lenses are designed to vault the corneal surface and rest on the less sensitive surface of the sclera, these lenses often are more comfortable for a person with corneal irregularities. A special liquid fills the space between the back surface of the lens and the front surface of the cornea. This liquid acts as a buffer and protects the compromised corneal tissue. Scleral lenses are designed to fit with little or no lens movement during blinks, making them more stable on the eye, compared with traditional corneal gas permeable lenses. These lenses are almost always very comfortable and the vision provided by them is extremely good. The great majority of patients are able to wear their scleral lenses almost all of their waking hours without problems.

Dr. Irwin Azman prescribes scleral contact lenses for a variety of hard-to-fit eyes, including patients with Stevens-Johnson Syndrome, Radial Keratotomy and Lasik Complications, Keratoconus, Corneal Ectasia, Post-Surgical Vision Loss, and Pellucid Marginal Degeneration.

Dr. Irwin Azman neither avoids nor declines the challenge of prescribing the most difficult cases. Dr. Azman tends to have a perfectionist demeanor.

 

Scleral Lenses: Post-Surgical Complications and Vision Loss

LASIK

LASIK (Photo credit: Wikipedia)

 Post-Surgical Complications and Vision Loss:

Dr. Irwin Azman is one of the leading Pre and Post Lasik consultants with over 25 years of experience in the diagnosis and management of the Post Lasik patient with Lasik failure complications. Together with his knowledge and experience, his team of technicians, new technologies in instrumentation and new treatment modalities, Dr. Azman is able to prescribe each Lasik failure patient with the perfect solution in resolving his/her Post Lasik failure complications.

Post Lasik Treatments:

There are a number of specialized lenses now available that will allow post-surgical patients to function on a much higher level and with a much greater level of comfort. To address the vision and comfort issues that most post-refractive surgical patients are facing, Dr. Azman prescribes Post-Surgical Scleral Lenses.

Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by Lasik failures, post-surgical complications, and other corneal irregularities.

Because scleral lenses are designed to vault the corneal surface and rest on the less sensitive surface of the sclera, these lenses often are more comfortable for a person with corneal irregularities. A special liquid fills the space between the back surface of the lens and the front surface of the cornea. This liquid acts as a buffer and protects the compromised corneal tissue. Scleral lenses are designed to fit with little or no lens movement during blinks, making them more stable on the eye, compared with traditional corneal gas permeable lenses. These lenses are almost always very comfortable and the vision provided by them is extremely good. The great majority of patients are able to wear their scleral lenses almost all of their waking hours without problems.

Dr. Irwin Azman prescribes scleral contact lenses for a variety of hard-to-fit eyes, including patients with Stevens-Johnson Syndrome, Radial Keratotomy and Lasik Complications, Keratoconus, Corneal Ectasia, Post-Surgical Vision Loss, and Pellucid Marginal Degeneration.

Dr. Irwin Azman neither avoids nor declines the challenge of prescribing the most difficult cases. Dr. Azman tends to have a perfectionist demeanor.

Dr. Irwin Azman, Scleral Contact Lens Specialists

Keratoconus Contact Lenses Specialty:

Global Complex Eye Care is the preeminent contact lens specialty practice in the greater Baltimore area. Patients are referred to Global Complex Eye Care from eye care professionals throughout the United States.

Our practice is specifically designed, equipped, and staffed to provide the Scleral contacts lens patients with nothing but the finest in professional care. As contact lens specialists, we have successfully treated thousands of patients, including many who were previously told they could not wear contact lenses. Optometrists and Ophthalmologists from all over Maryland and surrounding states refer their challenging contact lens patients to Dr. Irwin Azman.

When it comes to personalized contact lens care, no doctor can match the attention given by Dr. Irwin Azman and Dr. Thomas Azman. The Azman team is world renowned for their expertise, unwavering commitment to superb patient care, passion, and education in

Dr. Irwin Azman O.D. Scleral Lens Specialists

Dr. Irwin Azman O.D.

providing personalized eye care for contact lens patients. They have earned a reputation by their peers as being the “Doctor’s doctor”.

Times Have Changed – Technological Advances at Global Complex Eye Care 

Contact lenses are not what they used to be… even two years ago. Technological advances have greatly improved contact lenses and lens care products – revolutionizing vision correction.

Scleral Contact Lens
Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by Keratoconus, Lasik failures, post-surgical complications, and other corneal irregularities.

Because scleral lenses are designed to vault the corneal surface and rest on the less sensitive surface of the sclera, these lenses often are more comfortable for a person with corneal irregularities. A special liquid fills the space between the back surface of the lens and the front surface of the cornea. This liquid acts as a buffer and protects the compromised corneal tissue. Scleral lenses are designed to fit with little or no lens movement during blinks, making them more stable on the eye, compared with traditional corneal gas permeable lenses. These lenses are almost always very comfortable and the vision provided by them is extremely good. The great majority of patients are able to wear their scleral lenses almost all of their waking hours without problems.

Dr. Irwin Azman prescribes scleral contact lenses for a variety of hard-to-fit eyes, including patients with Stevens-Johnson Syndrome, Radial Keratotomy and Lasik Complications and failures, Keratoconus, Corneal Ectasia, Post-Surgical Vision Loss, and Pellucid Marginal Degeneration.

Dr. Irwin Azman neither avoids nor declines the challenge of prescribing the most difficult cases. Dr. Azman tends to have a perfectionist demeanor.

At Global Complex Eye Care, our doctors keep well informed of emerging technologies by being involved in research studies and FDA clinical trials. We design and develop new contact lenses on an ongoing basis. Our doctors will recommend the contact lenses that will work best for your eyes and your lifestyle.

Our doctors prescribe contact lenses made by all major manufacturers, as well as contact lenses from smaller custom labs, and even develop our own unique contact lenses for patients whom other doctors may consider difficult or impossible to fit. Due to our doctor’s vast experience in contact lenses, they often find that patients who have not had past success with contact lenses are now able to enjoy safe, healthy contact lens wear.

As experts in the field of contact lenses, our doctors stay involved in research and development of the newest products associated with contact lenses, lectures at vision conferences, and has published numerous articles in professional contact lens literature and journals. You can be assured that our doctors will provide the highest quality of contact lens care, whether your needs are as straight forward as soft-disposable contact lenses, or as complex as fitting lenses for Keratoconus or following corneal trauma.

“One characteristic that sets Azman Contact Lens Specialists apart from other eye care practitioners is that they neither avoid nor decline the challenge of prescribing the most difficult cases. They tend to have a perfectionist demeanor.”

Physicians, Optometrists, and Ophthalmologists from all over the nation refer their challenging and complex contact lens patients to the Azman team. The doctor’s meticulous contact lens evaluation is unique and will not only determine if a patient’s eye are appropriate for contacts; but also will let the Azman team prescribe the correct type of lens that is the most compatible for the patient’s eyes and visual needs. The Azman doctors prescribe all types of contact lenses including; bifocals, progressive, lenses for astigmatism, dry eyes, golf and other sports, color vision correction, theatric, post-lasik, and many other specialty lenses. Only a comprehensive contact lens evaluation will assure long term eye health, perfect all day eye sight, and all day comfort.

The Azman team of specialists have redefined and set the gold standard of care in the contact lens profession and are known as the experts by their peers. When it comes to contact lenses they are the “Doctor’s doctor”.

Keratoconus Treatment

Keratoconus:

Dr. Irwin Azman is one of the few contact lens specialists that has extensive experience in the diagnosis and management of the Keratoconus patient. With over 30 years of experience, his team of technicians, new technologies in instrumentation, contact lens materials and designs, Dr. Irwin Azman is able to prescribe each Keratoconus patient with the perfect fit.

Diagnosing Keratoconus:

We are now able to detect the presence of Keratoconus well before subjective symptoms develop. Corneal Topography and Aberrametry measurements have become the standard of care in diagnosing and management of Keratoconus. A computerized system images the shape of the cornea together with the entire optical system by taking tens of thousands of data points. The results are instantly analyzed and wave front topography maps are generated. These printouts will show Dr. Azman a map print (just like a finger print) of the patient’s location and severity of any corneal distortion and high order aberrations (HOA).

Corneal Wavefront Topography

Corneal Wavefront Topography

Azman Contact Lens Specialists is proud to be the first and only ones in the state of Maryland to employ both new technologies, Marco3-D Wave Corneal Analysis and the Opthonix aberrometer for Keratoconus treatment and management.

Call for a complimentary phone consultation! (240) 782-2020

Health/Life Style and Medical History:
Information concerning your medical health status eye medical status, allergies, family history, and life style and sport activities. Many patients that have allergies have Keratoconus.

Corneal Topography:
The computerized corneal topography measures the cornea’s surface combining, wavefront, auto-refraction, keratometry, and pupillometry — allowing accurate and reliable analysis of corneal High and Low order aberrations. For you, the patient, it is a brief, painless, non-contact procedure that photographs your eye’s surface.

Specular Microscopy:
A noninvasive photographic technique that facilitates accurate and precise diagnosis of corneal disease in the back part of the cornea (endothelium). This instrument can pick up early signs of corneal edema, which cannot be picked up on routine examination. If there is any indication of corneal disease, such as Keratoconus or edema we might recommend a different treatment modality.

Keratoconus Treatment: Scleral Lenses

Corneal specialists agree that it is best to exhaust all non-surgical options for Keratoconus before undergoing corneal transplant surgery, especially for younger patients. Optometrists and Ophthalmologists from all over Maryland and surrounding states refer their challenging Keratoconus patients to Dr. Irwin Azman.

Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by Lasik failures, post-surgical complications, and other corneal irregularities.

Because scleral lenses are designed to vault the corneal surface and rest on the less sensitive surface of the sclera, these lenses often are more comfortable for a person with corneal irregularities. A special liquid fills the space between the back surface of the lens and the front surface of the cornea. This liquid acts as a buffer and protects the compromised corneal tissue. Scleral lenses are designed to fit with little or no lens movement during blinks, making them more stable on the eye, compared with traditional corneal gas permeable lenses. These lenses are almost always very comfortable and the vision provided by them is extremely good. The great majority of patients are able to wear their scleral lenses almost all of their waking hours without problems.

Dr. Irwin Azman prescribes scleral contact lenses for a variety of hard-to-fit eyes, including patients with Stevens-Johnson Syndrome, Radial Keratotomy and Lasik Complications, Keratoconus, Corneal Ectasia, Post-Surgical Vision Loss, and Pellucid Marginal Degeneration.

Dr. Irwin Azman neither avoids nor declines the challenge of prescribing the most difficult cases. Dr. Azman tends to have a perfectionist demeanor.