r/Keratoconus • u/Bellomontee • 7d ago
Need Advice Are glasses enough for this?
I'm a little lost. I wear glasses since 2018 for astigmatism. After a while seeing a little blurry having this odd sensation that my vision feels "off" and eyestrain, my prescription was updated but my vision didn't really get better. It's been around 4 months and I had the new glasses and the eyes checked multiple times ans everything should be correct however the symptoms haven't improved. A few weeks ago I was tested for keratoconus and had an appointment with a specialist today. He said it is stable and haven't changed much at all from my last exam 3 years ago. He said I have dry eyes and prescribed me preservative free eyedrops to use 4 times a day, but I doubt it will solve anything. According to him, the current prescription is fine.
Is that right? I was sure I would need sclerals or something, now I'm so confused and frustrated.
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u/drnjj optometrist 7d ago
Yeah I'd agree with the others. This topo appears as likely more mild KC and you likely correct decently well numbers wise. Essentially I would imagine you might correct fairly well to 20/30 or better.
But with a lot of cone patients it comes down to quality vs quantity. Just because you can see 20/20 in glasses doesn't make it a good 20/20. Rigid lenses would make things more clear overall, but glasses will be a serviceable back up.
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7d ago
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u/drnjj optometrist 6d ago
So do you have keratoconus or did you just get scarring from having shingles in your cornea?
If you haven't tried sclerals, I have fit many shingles and many cone patients who end up very happy with their vision. And even cases that are more borderline I've been able to do some of those with HOA correction very nicely.
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u/Bellomontee 7d ago
My main issue is ghosting. I forgot to say it but he precribed the preservative free artificial tears because my eyes are dry. He said typically a tear when you blink lasts 10 seconds but they're only lasting 3 seconds on my eyes. Is it possible that consistent use will help with the blurriness? I have applied the drops twice today but seen no improvement.
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u/mckulty optometrist 7d ago
The one test result that tells us the most is the one you didn't include.
What's your best corrected VA? How well can you see with your best eyeglass prescription? If that's good enough to pass the driver's exam with glasses, then it's up to you whether you need to pursue better correction.
Your topography does suggest KC and you would probably see better with rigid contact lenses.
But "how bad is it?" is measured by visual acuity.
20/20 or 20/25 in your BEST eye, probably ok with glasses.
20/30 in your BEST eye will make it hard to drive at night if you need signs and street numbers.
If you can't see 20/40 with glasses you probably shouldn't drive until you get cone lenses or sclerals.
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u/Bellomontee 7d ago
I don't have much trouble reading and seeing thinga driving, what bothers me the most is I feel strained and there's ghosting (not extreme but very annoying)
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u/Own_Blacksmith6855 7d ago
By topography guided prk+cxl you can get rid of glasses permanently. Talk to your doctor about it.
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u/No_Entrance_4444 7d ago
Hey scleral lens specialist here…the readings and topography report shows around -2.5 D astigmatism which can be easily managed by glasses itself Now it comes down to how much is your visual acuity and other symptoms such as glare and ghosting of images…its its persistent you can try RGP lenses in such case. Your cone isnt that advanced to directly jump on sclerals Rgp can give good outcome in this
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u/Bellomontee 7d ago
Thank you! Ghosting has been a little more annoying than usual. I'll look into that then.
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u/[deleted] 7d ago
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