Keratoconus Treatment
& Management

Specialized care for keratoconus patients, providing advanced solutions for improved vision and quality of life.

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What Our Patients Say

Read how our expertise has helped patients improve their vision and quality of life.

"Dr. Alexander Bonakdar is amazing! He took the time to explain everything to me and made sure I understood my options. His attention to detail and patient care is outstanding. I couldn't be happier with the results!"

Sarah M. - Keratoconus patient testimonial for Dr. Bonakdar

Sarah M.

Satisfied Patient

"After years of struggling with various treatments, Dr. Bonakdar provided solutions that actually worked for me. His approach is thorough and personalized. The results have been life-changing, and I'm so grateful for his expertise."

Robert K. - Scleral lens patient at EYECARE CENTER OF ORANGE COUNTY

Robert K.

Long-term Patient

"My experience was exceptional from start to finish. The staff always takes the time to address all my questions, and Dr. Bonakdar's expertise has made such a difference. I now have confidence that my eye health is in good hands."

Jennifer T. - New keratoconus patient review for EYECARE CENTER OF ORANGE COUNTY

Jennifer T.

New Patient

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Keratoconus Treatment Success

Understanding Keratoconus

Keratoconus is a progressive eye disease that causes the cornea (the clear front surface of the eye) to thin and bulge outward into a cone-like shape. This abnormal shape prevents light from focusing properly on the retina, resulting in distorted vision. Typically your cornea is round and dome-shaped, but in keratoconus it becomes more cone-shaped, causing vision distortion as light is no longer focused correctly onto the retina.

Symptoms of keratoconus include blurred or distorted vision, increased sensitivity to light and glare, difficulty driving at night, eye redness or swelling, frequent changes in eyeglass prescriptions, and inability to wear contact lenses comfortably.

Keratoconus typically begins during puberty and progresses through the 30s and 40s, usually stopping around age 40. The rate of progression varies significantly from person to person, which is why early diagnosis and treatment are crucial for preserving vision. While it usually progresses slowly over a period of 10-20 years, it can sometimes advance rapidly, leading to corneal swelling and scarring.

At the Eyecare Center of Orange County, Dr. Bonakdar specializes in diagnosing and managing keratoconus with advanced techniques and personalized care plans.

Dr. Alexander Bonakdar - Keratoconus and Scleral Lens Specialist in Orange County

Keratoconus Treatment Success

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Advanced Diagnostic Technologies

Comprehensive Keratoconus Diagnosis

Accurate diagnosis is crucial for effective keratoconus management. At the Eyecare Center of Orange County, we utilize advanced diagnostic technologies to precisely map your cornea and monitor changes over time.

Our Diagnostic Procedures Include:

  • Corneal Topography: Maps the surface curvature of the cornea, creating a detailed 3D model that can reveal irregularities not visible during standard eye exams. This technology can detect keratoconus in its earliest stages, sometimes before symptoms appear.4
  • Corneal Tomography: Provides comprehensive mapping of both the front and back corneal surfaces, measuring pachymetry (corneal thickness) across the entire cornea, which is essential for detecting early keratoconus.
  • Anterior Segment Optical Coherence Tomography (AS-OCT): Creates high-resolution cross-sectional images of the cornea, allowing us to measure epithelial and stromal thickness with micron-level precision.
  • Wavefront Aberrometry: Measures how light waves travel through your eye, precisely identifying the optical aberrations that cause visual distortions in keratoconus.

What We Measure

Our diagnostic technology measures several key parameters:

  • Keratometry (K) readings: Measure the steepness of the cornea in different meridians
  • Pachymetry values: Map corneal thickness across the entire surface
  • Posterior elevation: Crucial for early detection as changes often begin on the back surface of the cornea
  • Higher-order aberrations: Optical distortions that significantly impact vision quality
  • Progression indices: Track changes over time to determine disease stability or advancement

These comprehensive measurements allow Dr. Bonakdar to detect keratoconus at its earliest stages, precisely monitor progression, determine the optimal treatment approach, and customize contact lens designs for the most challenging cases.

Our Treatment Options

Scleral Lenses

Scleral lenses are large-diameter gas permeable contact lenses that vault over the entire corneal surface and rest on the sclera (the white part of the eye). These specialized lenses create a new optical surface to replace the irregular cornea, providing dramatically improved vision for keratoconus patients.

Benefits include superior vision correction for irregular corneas, comfortable all-day wear, protection of the corneal surface, and reduced symptoms of dryness and irritation.

Corneal Cross-Linking (CXL)

Corneal cross-linking is a minimally invasive procedure that strengthens the corneal tissue to halt the progression of keratoconus. The procedure uses riboflavin (vitamin B2) drops and controlled UV light to create new bonds between collagen fibers in the cornea, both stabilizing and strengthening it.1

This FDA-approved treatment (approved in 2016) has shown success in stopping corneal thinning and preventing further irregularity. Clinical studies demonstrate that corneal cross-linking is effective in halting progression in over 90% of cases, with many patients experiencing improved vision and corneal flattening.2 Long-term studies show results remaining stable for 5-10 years after the procedure.

Unlike other treatments that only improve vision while keratoconus continues to progress, CXL addresses the underlying condition itself. It can also be combined with other treatments and has been shown to reduce the need for corneal transplants by up to 50% in appropriate cases.3

Intacs Corneal Implants

Intacs are tiny, clear inserts placed in the periphery of the cornea to reshape its surface. These micro-thin prescription inserts help flatten the cone-shaped cornea and improve vision in patients with keratoconus.

The procedure is quick (taking about 10 minutes) and minimally invasive. The implants can be exchanged or removed as needed through additional procedures, making this a reversible option. While Intacs won't stop the progression of keratoconus like corneal cross-linking, they can significantly improve vision and may delay or prevent the need for corneal transplant surgery.

Specialty Contact Lenses

In addition to scleral lenses, we offer other specialty contact lens options for keratoconus patients, including:

Hybrid lenses: These combine a rigid center with a soft skirt, providing the vision correction of a gas permeable lens with the comfort of a soft lens. They're often more comfortable than traditional rigid gas permeable (RGP) lenses and less of a hassle than piggybacking.

Custom soft keratoconus lenses: Specially designed soft lenses with increased central thickness and unique geometries that can work for mild cases of keratoconus. Examples include KeraSoft® IC and NovaKone® lenses.

Rigid Gas Permeable (RGP) lenses: These rigid lenses can "vault" over the cornea and provide better vision than soft lenses by creating a new optical surface that compensates for corneal irregularities. Modern RGP materials offer excellent oxygen permeability for corneal health.

Piggyback lens systems: This involves wearing both a soft contact lens and a gas permeable lens—one on top of the other. The soft lens is placed in the eye first for comfort and protection, and then the rigid lens is put on top for optimal vision correction. This approach is particularly useful for patients with corneal sensitivity or irregularities that make single-lens options uncomfortable.

Corneal Transplant Co-Management

For advanced cases of keratoconus, a corneal transplant (also called penetrating keratoplasty or PKP) may be necessary. This surgical procedure involves removing the irregular corneal tissue and replacing it with healthy donor tissue.

While this is typically considered the last course of action after other options have been explored, Dr. Bonakdar works closely with top corneal surgeons to co-manage patients before and after transplant surgery, ensuring continuity of care and optimal outcomes. Even after a corneal transplant, patients often still need prescription eyeglasses or contact lenses for optimal vision correction.

Ongoing Monitoring & Management

Keratoconus requires lifelong management. We provide comprehensive monitoring using advanced technology like corneal topography and pachymetry to track changes in your cornea over time and adjust your treatment plan accordingly.

Scleral Lenses for Keratoconus

Clear vision with scleral lenses for keratoconus treatment
With Treatment
Distorted vision caused by keratoconus corneal irregularity
Before Treatment

How Scleral Lenses Work

Scleral lenses are specially designed to vault over the cornea, creating a fluid-filled reservoir between the lens and the corneal surface. This design offers several advantages: the fluid layer compensates for corneal irregularities, creating a smooth optical surface; the lens rests on the less sensitive sclera rather than the cornea, improving comfort; the fluid reservoir continuously bathes the cornea, providing relief for dry eye symptoms that often accompany keratoconus; and the rigid material provides superior optics compared to soft lenses.

The Scleral Lens Fitting Process

Fitting scleral lenses requires specialized expertise and technology. Our process includes comprehensive corneal mapping using advanced topography, custom lens design based on your unique corneal shape, trial lens evaluation to assess fit and vision, detailed training on insertion, removal, and care, and follow-up appointments to ensure optimal fit and comfort.

Dr. Bonakdar is recognized as a leading scleral lens specialist, with extensive experience fitting even the most challenging keratoconus cases.

Scleral lens design for keratoconus patients - specialized contact lens at EYECARE CENTER OF ORANGE COUNTY

Benefits of Scleral Lenses

Scleral lenses provide dramatically improved vision quality and all-day comfort, even for patients who couldn't tolerate other contact lenses. They offer protection of the corneal surface from environmental irritants, reduced progression of keratoconus in some cases, avoidance or delay of corneal transplant surgery, and improved quality of life and ability to perform daily activities.

Why Choose Us for Keratoconus Care?

Specialized Expertise

Dr. Bonakdar is a recognized specialist in keratoconus management with extensive experience treating even the most complex cases.

Advanced Technology

We utilize state-of-the-art diagnostic equipment including Scheimpflug corneal topography, epithelial thickness mapping, high-resolution anterior segment Optical Coherence Tomography (OCT), and precision pachymetry to monitor corneal changes with micron-level accuracy. Our scleral lens fitting utilizes digital imaging technology to ensure optimal lens vault and alignment.

Personalized Approach

We develop customized treatment plans based on your specific corneal shape, vision needs, lifestyle, and disease progression.

Comprehensive Care

From diagnosis through ongoing management, we provide continuous care and support throughout your keratoconus journey.

Get Expert Keratoconus Care

Take the first step toward clearer vision with our specialized keratoconus treatments.

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Frequently Asked Questions

What causes keratoconus?

The exact cause of keratoconus is not fully understood, but it appears to involve a combination of genetic, environmental, and cellular factors. The American Academy of Ophthalmology reports that about 10 percent of people with keratoconus have a parent who has it too, suggesting a genetic component.

Risk factors include family history of keratoconus, excessive eye rubbing, certain systemic conditions (like Down syndrome), inflammatory conditions like allergies and asthma, and connective tissue disorders.

Can keratoconus be cured?

While there is no cure for keratoconus, treatments like corneal cross-linking can halt its progression, and specialty contact lenses can provide excellent vision correction. With proper management, most keratoconus patients can maintain good functional vision throughout their lives.

Are scleral lenses difficult to use?

Scleral lenses do have a learning curve, but most patients quickly become comfortable with insertion and removal. We provide comprehensive training and support to ensure you can manage your lenses confidently. The dramatic improvement in vision makes the adjustment period well worth it for most patients.

Is corneal cross-linking covered by insurance?

Many insurance companies now cover corneal cross-linking for progressive keratoconus since it received FDA approval. Coverage varies by provider and plan. Our staff will help you understand your coverage options and any available financing plans.

How often do I need to be monitored for keratoconus?

The frequency of monitoring depends on your age, disease progression, and treatment plan. Typically, patients with newly diagnosed or rapidly progressing keratoconus are seen every 3-6 months, while those with stable disease may be monitored annually. Dr. Bonakdar will recommend a personalized follow-up schedule based on your specific needs.