Eye surgery is a difficult subject for patients.

While many people use conventional optical aids such as glasses and contact lenses, there are hundreds of thousands of surgical procedures for vision correction done per year. And since most people do not undergo surgical options lightly, they have high expectations for the results.

But can eye surgery indeed meet those high expectations? Unfortunately, not always.

Keratoconus is a condition where the cornea (the clear, front part of your eye) becomes thinner and eventually bulges outward, forming a cone shape. When the cornea gets distorted, your vision blurs and you become sensitive to light and glare.

Patients with keratoconus typically try glasses or contact lenses before surgical options like corneal crosslinking (CXL). At this point, keratoconus patients may try custom soft, hybrid, or even scleral lenses.

Unfortunately, however, because keratoconus presents a host of complex optical issues, conventional contacts or glasses cannot be an adequate solution for most. These solutions vary in effectiveness and tend to fall short of providing satisfying vision as the keratoconus progresses.

Corneal collagen cross-linking (CXL) can be considered as a surgical option for slowing or stopping the vision declines that come with keratoconus. This procedure uses a riboflavin solution activated by UV-A light to strengthen the cornea. However, the procedure itself does not provide the correction of poor vision. There may also be some discomfort associated with the procedure.

Ultimately, one’s eyecare professional will help a person decide how they consent to be treated based on the risks, benefits, and alternatives. It can be a difficult decision to elect for a surgical procedure, and it’s important to temper your expectations and understand the limitations of the procedure.

Scleral lenses are becoming a more popular solution for keratoconus patients. A scleral lens is a large diameter rigid gas permeable lens, which has several advantages over a conventional contact lens.

Scleral lenses vault over the cornea, leaving a small gap between the surface of your eye and the lens. This gap allows for a saline reservoir to fills the space between the eye and the lens. Their large size makes them easier to apply.

And yet, despite their desirable physical qualities and generally superior vision correction versus regular contact lenses, conventional scleral lenses still have limitations—especially for keratoconus patients.

People with keratoconus often have complex vision abnormalities arising from higher order aberrations (HOAs). These HOAs are more difficult to correct than lower order aberrations, which cause basic vision problems like astigmatism, nearsightedness, and farsightedness.

HOAs are caused by imperfections of the eye. Some of these imperfections result in irregular surfaces on the cornea and lens and misalignment between them. This irregular surface means light enters the eye from multiple angles, causing it to refract inconsistently. As a result, HOAs cause significant visual problems, including: glare or streaks, halos or rings, poor, night vision, ghost images, double vision, blurring, starburst patterns.

Scleral lenses cannot correct every HOA or imperfection of the eye’s ability to focus light in the keratoconus condition. To address this shortcoming, some forward-thinking eyecare professionals have tried to address HOA quantification and correction using wavefront technology.

The OVITZ ARES contact lens is designed to correct for the HOAs that cause complex vision abnormalities.

ARES has shown great promise in helping both keratoconus patients and post-crosslinking patient by significantly reducing vision problem such as double vision, glare, and halos during nighttime driving.

If you’re a keratoconus patient who is still looking for improved vision, consider asking your eyecare provider about the OVITZ ARES lens.