dr jeffrey sonsino reviews a patient the eye condition keratoconus

The statistics are sobering.

According to the latest optometric research, the eye condition keratoconus now affects 1 in every 7,500 people. That means approximately 24,000 people in the 13 counties of Greater Metro Nashville may have this serious eye disorder—and many may not even know it.

Keratoconus is a disorder of the eye that causes progressive thinning of your cornea. And the results can including blurred vision, nearsightedness, double vision, astigmatism, and light sensitivity. Usually the disorder affects both your eyes, and in severe cases a scarring or circle will occur within your eye’s cornea.

The precise cause of eye condition keratoconus is not known

, but researchers believe it results from a combination of genetic, environmental, and hormonal factors. About 7 percent of affected patients have a history of the condition within their family. Among the environmental factors possibly causing the condition are rubbing of the eyes and allergies (which are a huge problem in Nashville). No matter the cause, the condition is marked by a gradual change of your cornea to a cone shape. This is detected and diagnosed via an examination with a slit lamp.

Very often, the condition can—if detected early enough—be treated with prescription eyeglasses or soft contact lenses. As the disease worsens, however, special contact lenses may be required. (More about this below.) In most cases, the condition will stabilize after a few years, without severe vision problems resulting (again, if treated properly). But in a small number of cases, scarring of the cornea occurs and you may require a corneal transplant.  The good news is that if the doctor who is evaluating the contact lenses knows which lenses are appropriate, the risk of scarring is lower.

While the precise cause of keratoconus is a mystery, how to treat it is not. But that hasn’t stopped some of our competitors from offering “one-treatment-fits-all” solutions that can place your vision at serious risk.

What’s Going On . . . and How It Affects You

I am so concerned about some of the less-than-adequate keratoconus treatments being offered, that I regularly lecture on the topic. My lecture is entitled “The Continuum of Care in Keratoconus” because it’s essential for folks to understand there needs to be a continuum of care—not just one-keratoconus-treatment-fits-all.

Let’s take a moment to dive deeper into this. This will allow us to spotlight an important distinction between the care you receive at Optique versus what you receive at certain other eye care clinics.

Sadly, there are optometrists in Nashville who treat keratoconus with one tool and one tool only—scleral contacts lenses. But there’s a huge problem with that: It’s like a carpenter using a hammer to address every carpentry issue. The truth is, there are 5 distinct stages of keratoconus development in the cornea, and each stage needs to be addressed differently. The 5 stages are:

  • Pre-keratoconus;
  • Mild;
  • Moderate;
  • Severe;
  • Corneal transplant surgical.


Why Do These 5 Stages Matter?

By identifying these 5 distinct stages, we, at Optique, can more precisely and thoughtfully monitor the progression of the eye condition keratoconus. That, in turn, allows us to treat the condition in a way that—as often as possible—allows us to keep the condition in check, such that surgery never becomes necessary. The 5 distinct stages are based on highly specialized testing, so the doctor can tailor treatments specific to each of the 5 stages.

Consider what happens if you don’t do this. We are aware of one practitioner who routinely uses a hard contact lens to push on the tip of the cone.  This accomplishes his goal of providing good vision (because the cone basically is smashed into the shape of a normal cornea), but we know that this dangerously increases the risk of corneal scarring.  That’s why mindful monitoring and management of the disorder—and application of the appropriate treatment at each distinct stage—are so critical.

Expertise in EVERY Type of Contact Lens

Unlike this practitioner, we at Optique offer nationally recognized expertise in every type of contact lens, along with the cutting-edge optometric knowledge to know which type of contact lens should be introduced to the patient at each distinct stage of keratoconus. We can offer you any of the following types of lenses to help treat your keratoconus:

  • Soft contact lenses;
  • Custom-made soft contact lenses;
  • Corneal gas-permeable lenses;
  • Special-design corneal gas-permeable lenses;
  • Hybrid lenses (gas-permeable center with soft skirt);
  • Scleral lenses;
  • Custom-molded scleral lenses.



Not Just “Fitters” But Problem-Solvers

If you walk into some offices, they will tell you, “We can fit you with such-and-such type of contact lens.” Or perhaps the optometrist will say, “In this office, we’re scleral lens fitters.” But think about that. What he or she is saying is, “We use the same type of contact lens each time, including to treat keratoconus—irrespective of the stage to which your keratoconus has advanced.”

And there’s something very wrong with that. Saying you “fit the patient with such-and-such type of lens” is essentially saying, “I’m not studying the visual problem as deeply and thoroughly as I should be. Instead, I’m opting for one-treatment-fits-all.”

Here at Optique, we take exactly the opposite approach. We don’t see ourselves as “fitters”; rather problem-solvers. Our eye specialists deep-dive into your specific eye issue—keratoconus or otherwise—to ensure the best possible outcome for you, the patient.


Don’t Entrust Your Eyes to an Inferior Keratoconus Treatment Process

Where keratoconus is concerned, there is a precise, well-thought-through, based-on-the-latest research treatment model that must come into play. Essentially, that model is:

  • Analyze the condition with state-of-the-art tools and knowledge, to arrive at the exact right diagnosis;
  • Include in the diagnosis detailed findings as to which specific stage the keratoconus has progressed;
  • Address the condition by evaluating which type of lens is best, or with a surgical procedure.

There simply is no substitute for this world-class, specific-to-the-patient treatment. And you should not entrust your precious eyesight to anything less.