Specialty Soft Design for Keratoconus

Explore a success story of a patient with keratoconus who found relief through custom soft lenses after conventional lenses failed, shared by Dr. Lindsay A. Sicks.

By
Lindsay A. Sicks, OD
October 1, 2025
4 min

Contact Lens Spectrum

At a Glance

Category	Detail
Condition	Keratoconus causing irregular astigmatism and visual impairment
Key Mechanisms	Corneal thinning and irregular astigmatism leading to distorted vision; specialty soft lenses designed to improve fit and visual acuity
Target Population	Patients with keratoconus intolerant to conventional contact lenses or seeking alternative lens options
Care Setting	Optometry or ophthalmology clinics specializing in contact lens fitting and keratoconus management

Key Highlights

Conventional corneal gas permeable lenses may cause discomfort and poor tolerance in keratoconus patients.
Specialty soft contact lenses (e.g., KeraSoft Thin) can provide improved comfort, stable fit, and better visual acuity in keratoconus.
Long-term use (8 years) of specialty soft lenses demonstrated sustained patient satisfaction and manageable disease progression.

Guideline-Based Recommendations

Diagnosis

Confirm keratoconus diagnosis with corneal topography and slit lamp biomicroscopy.
Assess keratometry values and manifest refraction to evaluate severity and astigmatism.
Evaluate best-corrected visual acuity and pupil size.

Management

Consider specialty soft contact lenses for patients intolerant to rigid gas permeable lenses.
Use diagnostic fitting with specialty soft lenses and refine overrefraction to optimize visual acuity.
Provide patient training on lens application and removal.

Monitoring & Follow-up

Schedule follow-up visits to assess lens fit, comfort, and visual stability.
Monitor for corneal health and any signs of compromise after lens removal.
Adjust lens parameters as keratoconus progresses or if visual acuity changes.

Risks

Potential discomfort or poor lens tolerance with conventional lenses.
Risk of corneal compromise if lenses are not properly fitted or monitored.
Progression of keratoconus and development of cataracts may alter lens requirements.

Patient & Prescribing Data

Adult keratoconus patients with intolerance to conventional gas permeable lenses

Specialty soft lenses can achieve stable, comfortable wear with improved visual acuity (20/20) and sustained use over years, with periodic parameter adjustments as disease progresses.

Clinical Best Practices

Perform comprehensive ocular examination including corneal topography and keratometry before lens fitting.
Start with diagnostic specialty soft lenses and refine fit and prescription based on overrefraction and patient feedback.
Ensure lens movement and centration are adequate to maintain corneal health and comfort.
Educate patients on lens care, insertion, and removal techniques.
Schedule regular follow-ups to monitor ocular health and adjust lenses as needed.