Keratoconus: Eyeglass Prescription Changes and Concerns

Keratoconus and Eyeglass Prescription

Hello, Dr.
Tsai.
My girlfriend is 27 years old and has been diagnosed with keratoconus.
About 6-7 years ago, she underwent a corneal transplant at Tzu Chi Hospital.
Recently, due to significant wear on her glasses, we went to an optical shop to get new lenses.
Initially, we intended to use the prescription from her old glasses, but after measuring her vision, the shop insisted that we change the prescription and suggested gradually increasing the power over 2-3 months.
I am concerned because her ophthalmologist has not recommended changing her glasses prescription during her quarterly check-ups.
Is there a reason for this? Will increasing her glasses prescription negatively affect her eyes?

A Jun, 20~29 year old female. Ask Date: 2017/09/10

Dr. Cai Wenyuan reply Ophthalmology

Hello, the physician at your quarterly follow-up did not request a change in your glasses prescription.
There may be reasons for this.
It might be a good idea to discuss this matter with him and hear his opinion.
Wishing you peace and good health.
Sincerely, Dr.
Wen-Yuan Tsai, Director of Ophthalmology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/09/10

More Info

Hello! Thank you for your question regarding keratoconus and the management of eyeglass prescriptions for your girlfriend. Keratoconus is a progressive eye condition that affects the shape of the cornea, causing it to thin and bulge into a cone-like shape. This abnormal shape can lead to significant visual distortions, including blurred vision and increased sensitivity to light.
Given that your girlfriend underwent a corneal transplant about 6-7 years ago, it is crucial to monitor her eye health closely. After a corneal transplant, the cornea may still be susceptible to changes, and keratoconus can sometimes progress even after surgery. Regular follow-ups with her ophthalmologist are essential to assess the stability of her cornea and the overall health of her eyes.

Regarding the eyeglass prescription changes, it is not uncommon for individuals with keratoconus to experience fluctuations in their vision. This can be due to the irregular shape of the cornea, which can change over time. The recommendation from the optical shop to adjust her prescription more frequently (every 2-3 months) may be based on their assessment of her current vision needs. However, it is essential to consider the advice of her ophthalmologist, who is more familiar with her specific case.

If her ophthalmologist has not recommended changing her prescription frequently, it could be due to several reasons. One possibility is that her vision may be stable enough that frequent adjustments are unnecessary. Additionally, over-correcting her prescription could lead to discomfort or visual distortions, which might exacerbate her symptoms. It is crucial to strike a balance between providing adequate correction for her vision and avoiding over-correction that could lead to further complications.

In terms of the potential impact of increasing her eyeglass prescription, it is essential to approach this cautiously. While adjusting the prescription to improve her vision is important, doing so without proper guidance from her ophthalmologist could lead to issues such as eye strain or discomfort. If the prescription is too strong, it may cause her to experience headaches or visual fatigue, especially if she is not accustomed to the new strength.

I recommend that you and your girlfriend discuss these concerns with her ophthalmologist during her next appointment. It would be beneficial to ask about the rationale behind the current prescription and whether there are specific reasons for not changing it more frequently. Additionally, you can inquire about the potential risks and benefits of adjusting her prescription and how to best manage her vision needs moving forward.

In summary, while it is essential to ensure that her eyeglass prescription meets her visual needs, it is equally important to do so under the guidance of her eye care professional. Regular monitoring and open communication with her ophthalmologist will help ensure that her vision remains stable and that any necessary adjustments are made safely and effectively.

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