What are Scleral Lenses?

Scleral lenses are large, highly customized, rigid gas-permeable contact lenses. Unlike normal contacts, they vault completely over the bulging, irregular cornea and rest on the white part of the eye (sclera). This creates a perfect, smooth optical surface, often restoring 20/20 vision to patients with advanced keratoconus.

Keratoconus Treatment & C3R Surgery in Jaipur

Understanding the Bulging Cornea

The cornea is the clear, dome-shaped front window of your eye. It is responsible for focusing most of the light that enters your eye. Keratoconus is a progressive eye disease where the collagen fibers holding the cornea in place weaken. Unable to hold its shape against the normal pressure inside the eye, the cornea begins to thin and bulge outward into a highly irregular cone shape.

Because the cornea is no longer perfectly spherical, light entering the eye is scattered instead of being focused sharply on the retina. This causes a massive increase in irregular astigmatism and significant visual distortion. Keratoconus typically emerges in a patient's late teens or early twenties and can progress aggressively. If left untreated, the cornea can become severely scarred, eventually requiring a full corneal transplant to restore vision.

Clinical Indicators

Keratoconus is often misdiagnosed as simple astigmatism in its early stages. Seek a specialized evaluation if you experience:

• Frequent and rapid changes to your glasses prescription.
• "Ghosting" or seeing multiple images of a single object (monocular diplopia).
• Severe streaking, halos, and glare around lights at night.
• An inability to achieve 20/20 vision even with new glasses.

The Treatment Protocol: Halt and Restore

At Prasan Nethralaya, we approach keratoconus in two distinct phases: First, we aggressively stop the disease from progressing. Second, we rehabilitate the irregular surface of the eye to restore functional, crisp vision.

1. Advanced Corneal Topography (Pentacam)

Diagnosis and treatment begin with high-definition mapping. We use advanced topographical imaging to create a 3D elevation map of both the front and back surfaces of your cornea. This allows us to detect keratoconus at its microscopic inception, long before it affects your vision, and measure its progression down to the micron.

2. Halting Progression: Corneal Cross-Linking (C3R / CXL)

If topography confirms the cone is actively worsening, the absolute standard of care is Corneal Collagen Cross-Linking (C3R). This minimally invasive outpatient procedure is designed to strengthen the weakened corneal tissue and "freeze" the disease in its tracks.

During C3R, Dr. Neelam gently removes the outermost layer of the cornea (epithelium) and saturates the tissue with specialized Riboflavin (Vitamin B2) eye drops. The eye is then exposed to a calibrated, medical-grade Ultraviolet-A (UV-A) light. The UV light activates the Riboflavin, forcing the collagen fibers within the cornea to create new molecular bonds (cross-links). This massively increases the mechanical strength and stiffness of the cornea, preventing it from bulging further.

3. Visual Restoration: Scleral & Specialty Lenses

While C3R stops the disease, it does not perfectly flatten the cone back to normal. Because glasses cannot correct the extreme irregular astigmatism caused by a bulging cornea, we utilize Scleral Contact Lenses for visual rehabilitation. These large, rigid gas-permeable lenses vault entirely over the irregular cone and rest gently on the white of the eye (the sclera). The space between the lens and the cornea is filled with saline, creating a perfectly smooth, artificial optical surface. For many patients with advanced keratoconus, scleral lenses are life-changing, restoring near 20/20 vision.

Recovery & Post-Op Care for C3R

Following C3R surgery, a soft "bandage" contact lens is placed on the eye to protect the nerve endings as the surface layer heals. For the first 24 to 48 hours, it is entirely normal to experience significant tearing, a foreign body sensation, and moderate pain. We will prescribe powerful pain relievers and anti-inflammatory drops to manage this discomfort.

The bandage lens is typically removed by Dr. Neelam within 3 to 5 days. Your vision will fluctuate over the first few weeks as the cornea remodels. It is critical during this time—and for the rest of your life—to absolutely avoid rubbing your eyes, as the mechanical trauma of eye-rubbing is a primary trigger for keratoconus progression.

Cornea Specialist

Dr. Neelam Sharma

Cornea & Anterior Segment

Specializing in early topographic detection of keratoconus and advanced C3R intervention protocols.

View Credentials ↗

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Patient
Questions.

Clinical clarity regarding progression, cross-linking, and specialty lenses.

The primary goal of C3R (Corneal Cross-Linking) is to freeze the disease and stop your vision from getting progressively worse. While some patients experience slight improvements in visual acuity as the cornea flattens slightly over time, you will likely still need glasses or specialty contact lenses to achieve your best possible vision.

Yes, vigorous and chronic eye rubbing is a major risk factor and accelerator of keratoconus. The mechanical trauma further weakens the already fragile collagen fibers of the cornea. If you have itchy eyes due to allergies, you must use prescribed anti-allergy drops instead of rubbing.

The procedure itself is completely painless due to numbing drops. However, for the first 24 to 48 hours after the numbing wears off, it is common to experience moderate pain, tearing, and light sensitivity. We provide a bandage contact lens and specific medications to heavily manage this temporary discomfort.

Keratoconus typically begins in the late teens to early twenties and can progress rapidly over the following decade. It often stabilizes naturally when a patient reaches their late thirties or forties, which is why immediate mapping is crucial for young patients showing astigmatism changes.

Scleral lenses are large, highly customized, rigid gas-permeable contact lenses. Unlike normal contacts, they vault completely over the bulging, irregular cornea and rest firmly on the white part of the eye (sclera). The gap is filled with saline, creating a perfect, smooth optical surface that often restores near 20/20 vision to patients with advanced keratoconus.