Proper management of keratoconus requires ongoing care and the ability to modify the contact lens treatment approach. Our patient with keratoconus required an alternative contact lens design to treat his right eye, while our original treatment for the left eye has continued to work very well.This is a follow up on our earlier post about the treatment of our patient who plays competitive pool. As we told you, he had all sorts of trouble in getting a proper diagnosis and then in being fit in an appropriate contact lens to treat his keratoconus. Our post described our initial success in fitting him with hybrid “ClearKone” lenses. For a period of time he did quite well with the lenses in both eyes, however he developed a problem in wearing the lens for his right eye. The lens tightened up on the eye over time which resulted in decreased comfort. We made attempts at modifying the lens parameters (curvature values, etc.), however it was to little avail. We were required to look at other contact lens alternatives for him. We ended up fitting him in a scleral large diameter gas permeable contact lens for the right eye. He is able to obtain clear vision, excellent comfort, and performed well with the lens. His left eye continues to successfullywear his ClearKone hybrid lens. Together his eyes see better than 20/20 with contact lenses and he is doing well!

This case exemplifies the need for ongoing care for the treatment of keratoconus and the willingness to modify our management approaches.

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