The Essential Guide to Keratoconus and Contact Lenses

March 22, 2024


Can the right contact lenses truly transform how we experience the world, even with a complex condition like keratoconus? Contrary to popular belief, achieving crystal-clear vision with keratoconus isn’t a distant dream—it’s a reality for many, thanks to the precision of custom-fit contact lenses.

Let me introduce myself. I’m Damon Ezekiel, the owner and principal optometrist at Ezekiel Eyes. Over many years, I’ve had a special interest in offering unique contact lens solutions for complex eye care needs. My passion lies in transforming the way people see the world, especially those facing challenges like keratoconus. As the current President of the International Society of Contact Lens Specialists, I’m committed to pioneering advances in our field and ensuring each patient receives the highest standard of personalized care. Let’s explore how we can enhance your vision together, focusing on comfort, clarity, and a tailored approach to meet your specific needs.

Managing keratoconus not only improves your vision but also enhances your overall quality of life, allowing you to engage in activities you love without limitation. On the other hand, by not acting on the expert guidance provided, you risk missing out on the opportunity to improve not just your vision but also your overall well-being and independence.

Don’t let vision challenges hold you back any longer. If you are worried about keratoconus, book your eye care consultation with us today and take the first step towards clearer, more comfortable vision. Make an appointment with myself (Damon) or my fellow optometrist Rhiannon Richer to discuss a vision management strategy.

Curiosity is the first step towards clarity. So, if you’d like to learn more, keep reading to gather all the information you need to make an informed decision about your eye care journey.


  • Specialized Contact Lenses: For keratoconus patients, specially designed contact lenses provide improved vision and comfort.
  • Multiple Lens Options Available: Options include soft contact lenses for early stages, RGP lenses for sharp vision, hybrid lenses for clarity and comfort, and scleral lenses for severe cases and comfort.
  • Lens Fitting Techniques: Corneal topography and scleral topography mapping can be used, depending on the type of lens used in order to get a great fit for your eyes.
  • Living with Keratoconus: This means adapting your lifestyle to maintain both contact lens hygiene and eye health.

The Role of Contact Lenses in Keratoconus Management

In managing keratoconus, a condition where the cornea thins and bulges forward in a cone shape, the answer often lies in the precision and adaptability of contact lenses. I’ve seen firsthand how these tiny marvels can dramatically improve vision for individuals struggling with the condition.

Other available treatment options like glasses or surgical interventions have both benefits and limitations.

Glasses, while effective for standard vision correction, often fall short for anyone with more than mild keratoconus due to the cornea’s irregular shape, making it challenging to correct the distorted vision fully.

Surgical options, on the other hand, offer a more permanent solution but come with their own set of risks and considerations, including a significant recovery period.

Contact lenses stand out by providing a customized fit that mirrors the cornea’s unique contours, offering improved vision and comfort. Specially designed lenses for keratoconus, such as rigid gas permeable lenses, scleral lenses, and hybrid lenses, deliver crisp vision by creating a smooth optical surface over the cornea. It’s essential however, to remember that the journey to finding the perfect fit requires patience and expert guidance, emphasizing the need for a skilled optometrist familiar with the nuances of keratoconus and its impact on your vision.

Still not sure what makes keratoconus such a challenging eye disease? Watch the following video from Dr. Joseph Allen where he explains in more detail.



Exploring Contact Lens Options for Keratoconus

Let’s take a look at the key benefits, drawbacks, and suitability of each contact lens type for keratoconus.

  • Soft Contact Lenses are the gentle introduction to contact lens wear, offering unparalleled comfort, especially for those in the early stages of keratoconus. Their flexibility, however, might not be adequate for correcting vision in more severe cases, as they tend to mold to the cornea’s shape, providing less improvement in vision. These lenses shine for early-stage keratoconus or can be used in a piggyback system, layering them with RGP lenses for enhanced comfort.
  • Rigid Gas Permeable (RGP) Lenses excel in providing sharp vision by maintaining their form over the cornea, coupled with high oxygen permeability vital for corneal health. The trade-off includes an adaptation period and potential discomfort in environments with dust or wind. They’re the gold standard for a broad range of keratoconus severity, offering the clearest vision correction from moderate to advanced stages.
  • Hybrid Contact Lenses merge the best of both worlds: an RGP center for clarity and a soft lens skirt for comfort. This makes them a prime choice for those seeking the corrective power of RGPs but require more comfort. Though pricier and needing more care, they are great for moderate stages of keratoconus where both visual acuity and comfort are priorities.
  • Scleral Lenses, with their larger diameter, rest on the sclera instead of the cornea, providing stability and a high comfort level. They create a tear-filled vault over the cornea, offering relief in severe keratoconus cases. The challenges lie in their insertion and removal, their higher cost, and the need for more frequent replacements. These lenses are particularly suited for advanced keratoconus or for individuals who find other lenses uncomfortable.

Choosing the right lens for each patient depends on the keratoconus stage, lifestyle requirements and personal preferences. Each lens type offers unique benefits, and understanding these can significantly improve the quality of life for someone with keratoconus. At Ezekiel Eyes our aim is to provide you with the knowledge to make an informed decision, ensuring a solution that not only corrects your vision but also fits seamlessly into your life.

How do you pick the right contact lenses for keratoconus? Every patient’s daily routine is different. Some people might spend long hours in front of computers, while others might be outdoors, facing the elements. Your contact lenses should fit your life, not just your eyes.

Comfort is subjective; what works for one patient may not work for another. That’s why at Ezekiel Eyes it is crucial to discuss all the options and the pros and cons of each option with each individual patient, particularly for more advanced keratoconus,.

The key to a perfect fit, particularly with keratoconus, is a custom fitting by an experienced optometrist. At Ezekiel Eyes our role is to find the optimal contact lenses that correct your vision while fitting your unique corneal shape and lifestyle.


Keratoconus contact lens fitting Perth


The Custom Lens Fitting Process

Let’s break down the contact lens fitting process for keratoconus into simpler terms. Imagine your eye is like a soft, round bowl of desert jelly. Keratoconus makes part of this jelly bulge out like a cone or the top of a rugby ball. Now, if we’re going to place a small, thin disc (a contact lens) on top of this jelly, we need to ensure it sits comfortably and helps you see better. This process is known as “fitting the contact lens,”

To ensure we have the right shape lens for each individual patient we will map the shape of your cornea using a corneal topographer.

To understand more about why corneal topography mapping is so important in managing keratoconus, watch the following video by Dr. David Meyer.




If a patient requires scleral contact lenses we will scan the corneal topography shape and also the scleral topography shape.

At Ezekiel Eyes we are the only practice in Western Australia with a scleral topography instrument; this is essential in the fitting of our patients’ scleral contact lenses.

Watch the following video to understand more about how scleral topography is used in the scleral contact lens fitting process.




To ensure the lens fits just right, the process involves trying different trial lenses from our extensive trial sets within our practice fits and making suitable adjustments. As the eye’s shape changes (which happens with keratoconus), the lens might need further tweaking to maintain clear vision and comfortable all-day wear.

Living with Keratoconus Contact Lenses

Adapting to contact lenses means incorporating certain necessary care and maintenance tasks into your daily routine.

Just like brushing your teeth, cleaning your lenses should become second nature. Use the recommended solution to clean and store them, ensuring they’re free from protein build-ups and potential irritants. This not only prolongs the life of your contact lenses but also keeps your eyes healthy. Remember, a clean lens is a comfortable lens.

Our mantra at Ezekiel Eyes is clean contact lenses, clean hands and a clean case.

Another non-negotiable part of this adventure is regular follow-ups with your optometrist. These reviews are crucial for monitoring the progression of your keratoconus and making necessary adjustments to your contact lenses. Think of it as a tune-up for your car; regular maintenance ensures everything runs smoothly. Your vision is dynamic, and so should be the approach to managing it.

Living with keratoconus contact lenses means adapting your lifestyle to maintain both contact lens hygiene and eye health. With the right contact lens care practices and ongoing support from your optometrist at Ezekiel Eyes, you can navigate this path with confidence, ensuring your vision remains as clear and comfortable as possible.

Frequently Asked Questions

Can contact lenses stop the progression of keratoconus?

Contact lenses can’t stop keratoconus from advancing, but they do significantly improve the visual acuity.

Can you still get good vision with keratoconus?

Yes, it’s possible to achieve 6/6 vision or very close with properly fitted contact lenses, even if you have keratoconus.

At what age does keratoconus stop?

Keratoconus typically stops progressing by the mid-30s, though this age can vary from person to person.

Can I pass keratoconus to my children?

Keratoconus has a genetic component, so there’s a chance it can be passed to children, but it’s not a certainty.

What is the main cause of keratoconus?

The main cause of keratoconus is not entirely understood but is thought to involve a combination of genetic, environmental, and hormonal factors. The majority of keratoconus patients suffer from hay fever and allergies. Due to these atopic condition’s patients have very itchy eyes.

Does eye rubbing aggravate keratoconus?

Yes, eye rubbing is known to worsen keratoconus. At Ezekiel Eyes we inform all of our patients to NOT rub their eyes.


Custom-fit contact lenses offer a precision solution for keratoconus patients, providing clarity and comfort where glasses fall short. Ezekiel Eyes specialises in a range of contact lenses, including soft, RGP, hybrid, and scleral lenses, tailored to each stage of keratoconus for optimal vision correction.

Choosing the right contact lens involves considering your keratoconus stage, lifestyle, and comfort, with personalized fittings by experienced optometrists being crucial. Maintaining your keratoconus contact lenses with proper care routines and regular optometrist check-ups is key to ensuring ongoing eye health and contact lens effectiveness.

Alternatively, ignoring the need for specialised care can escalate to more invasive treatments, with longer recovery times and higher risks.

Don’t let keratoconus dictate your life—take the first step towards visual freedom by booking an eye care appointment with us today.

Booking an appointment is straightforward. Just give us a call at (08) 9386 3620 or click on the “Book an Appointment” button on our website. It’s a small step that could make a big difference in your life.


In addition to owning and managing Ezekiel Eyes, Damon is a contact lens consultant to various research organisations. He regularly lectures and conducts workshops in contact lens practice throughout Australia, Asia and the United States. Damon graduated from the University of NSW with a Bachelor of Optometry in 1989. He is now married with two children and enjoys running, hockey, swimming, piano, travelling and trekking.

Damon’s professional associations include:
President of the International Society of Contact Lens Specialists
Practising Fellow of the Scleral Lens Education Society
Fellow of the Cornea & Contact Lens Society of Australia
Fellow of the American Academy of Optometry
Member of Optometry Australia
Member of the Orthokeratology Society of Australia
Member of Alcon Australia advisory panel