Keretoconus

[Kaelub]

I went to my yearly eye exam on Dec. 17, 2007.  The doctor said that I had a slight astigmatism in one eye.  He said it was so slight that special lenses like torque lenses would not be necessary.  I left the exam with my new lenses and I was seeing great.  About a month later I started noticing that my left contact seemed like it was not the right prescription.  This went on for a couple of days so I decided to put a new pair of contacts in.  This changed nothing.  I went back to the doctor for a follow up and after examining me he said that I had a large increase with my astigmatism.  He said that I went  from a .50 to a 2.25 in a month.  He said he never has seen this before.  I decided to get a second opinion and that turned out to be the same.  I got a corneal tomography and that showed that I was maybe showing the thinning of the cornea.  After all of that they checked my eyes to see if everything else was fine, which was fine.  So my questions are does this look like keretoconus?  If it is, why did everything change so fast?  He was telling me that astigmatism never really changes that fast.  Could this be something else?  He told me to come back in a couple of months to see if something else has changed.  Since this has changed so fast, I'm worried that it will keep changing rapidly.  He also said that it would be a good idea to give my eyes a break and just wear glasses for awhile.  He said it was a possibility that my cornea is just swollen and might need a good rest.  Any info would be great.  Thanks!

[John C Hagan III, MD, FACS, FAAO]

First you should be under the care of a MD physician Ophthalmologist, ideally one that specializes in corneal disease. If you are not find one at www.aao.org   You should not be under the care of a non-physician non-MD optometrist.

In my experience you problem does NOT sound like K-conus it sounds like contact lens induced irregular astigmatism. With leaving the contact out the cornea usually returns to its normal shape in 1-3 months.

JCH III MD

[John C Hagan III, MD, FACS, FAAO]

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[Kaelub]

Thanks for the advice.  I wish my Optometrist knew that.  I told him what you told me and he said it was a long shot.  Thanks again!

[John C Hagan III, MD, FACS, FAAO]

Yes, you are wrong. I have seen quite a few cases of irregular corneal astigmatism due to soft CTL especially those worn as extended wear.

It is more common in GP CTL. (gas permeable)

JCH III MD

[Kaelub]

I heard contact lens induced irregular astigmatism only occurs when you are using hard contacts.  I'm I wrong?  I was using Acuvue 2 before this all happened.  Thanks for the help