A Perfect Fit For Imperfect Corneas

Specialty rigid contact lenses correct blurry vision caused by corneal disease.

Daytona Beach native Terell Riley previously worked on the cardiology and pediatric floors of a hospital. He served as a medical biller and coder and also as a medical assistant. For the past 4½ years, though, Terell has been a manager on the retail side of the medical cannabis industry, a job he fell into by happenstance.

“These lenses have changed my life.” - Terel

“These lenses have changed my life.” – Terell

“I was sending out résumés and received a call for an interview,” Terell recalls. “I thought it was some type of medical practice but then they told me it was medical cannabis. I honestly didn’t know that was a thing in Florida, so I was a bit shocked. I showed up on the first day of work and, sure enough, it was medical cannabis.

“As a manager, I make sure the daily operations run smoothly. Along with a group of colleagues, we manage a staff of 25 to 30 people. Our goals are to help people that come in find what they need to achieve pain relief and provide the ultimate customer service experience.”

When he’s not working, Terell likes to travel and cook. He’s actually been cooking since age 11.

“My mom put me in the kitchen at a very young age,” he confirms. “After I cooked my first meal, I was hooked. I really like being in the kitchen cooking.”

Recently, reading recipes and clearly seeing his computer screen at work became rather difficult. His prescription eyeglasses, which he’s worn since the fifth grade, were no longer correcting his vision effectively.

“I wasn’t seeing as perfectly as I should have,” Terell expounds. “At work, people were asking me, Why is your computer screen blown up so big? It had to be big because I couldn’t see it very well. Eventually, I went to my regular eye doctor.”

After an examination and tests, the eye doctor diagnosed Terell with keratoconus, a degeneration and thinning of the cornea, the transparent outer portion of the eye. Due to the degeneration, the cornea loses its round shape and bulges out into a cone-like form. Light hitting the misshapen cornea scatters, causing blurry vision, which cannot always be corrected with glasses.

 “He told me he would have to report me to the Department of Motor Vehicles and I probably wouldn’t be able to drive anymore,” Terell recalls. “That scared me. I thought, If I can’t commute to work, where does that leave me and my career?

About a year later, Terell went to a different eye doctor, who confirmed the keratoconus.

“I relayed what the first doctor said about not being able to drive,” Terell recounts, “and he said, No, that’s not correct. That doctor shouldn’t have frightened you. There are ways to fix that condition. Then he referred me to Premier Eye Clinic.”

At Premier Eye Clinic, Terell met with Ashley C. Royce, OD, a board-certified optometric physician. Dr. Royce has extensive experience in using specialty contact lenses for treating ocular disease, including keratoconus.

“In patients with keratoconus, eyeglasses do not always effectively improve visual acuity. In many cases, contact lenses, specifically rigid-gas permeable (RGP) contact lenses, are required to improve vision,” Dr. Royce explains. “Traditional, smaller RGP lenses would not be a great fit for Mr. Riley because he has severe corneal irregularity. A large-diameter scleral RGP lens is required to improve his vision and comfort.” 

Reservoir of Fluid

“Scleral lenses are fairly large and rigid, but they are actually quite comfortable,” Dr. Royce discloses. “Because of the way the lens gently rests on the sclera, or the white part of the eye, it creates a vaulting pattern over the cornea. As a result, a reservoir of fluid forms between the lens and the cornea.

“This reservoir of fluid is accommodating, and any irregular pattern of the cornea is corrected because the eye takes on the shape of the perfectly smooth scleral RGP lens.” 

Scleral lenses can be used to treat disorders other than keratoconus as well, such as severe dry eye disease, corneal scars and postsurgical corneal grafts, the optometrist adds. 

“Sometimes, eye physicians use scleral lenses to create a fluid reservoir on the corneal surface to help keep dry eyes moist,” Dr. Royce explains. “Scleral lenses may also be used after corneal transplants, especially if a patient’s corneas remain irregular. These patients may need a medical contact lens to further improve the quality of their vision after surgery.

“There is a surgical alternative to managing keratoconus in severe cases,”Dr. Royce continues. “It is a corneal graft, or corneal transplant, in which a damaged or diseased cornea is replaced with donated corneal tissue. Mr. Riley wanted to avoid surgery, so we opted to proceed first with a scleral lens to improve visual acuity and quality of living.” 

“Perfect Vision” 

Terell’s corneas are severely irregular and he still may need to have surgery to manage the corneal disease in the future, Dr. Royce informs. For now, the scleral lenses are effectively correcting the irregularity and greatly improving his eyesight.

“My vision is exceptional,” Terell enthuses. “I actually have 20/20 vision in one eye and 20/25 vision in the other. That’s like perfect vision. I haven’t had perfect vision since I was young.

“Thanks to these scleral lenses, I don’t have to blow up my computer screen anymore, and I can actually read very small print on the computer. I see everything now, even things I didn’t notice before. I notice everything when I’m wearing these contacts.”

Terell says it took him some time to get used to wearing the contact lenses but notes that Dr. Royce helped him make that adjustment.

“At first, I was terrified of using contacts because I don’t like playing with my eyeball,” he says. “But Dr. Royce made it a day-to-day process. She told me to put in the contacts for three to four hours one day, then take them out. The next day, I wore them for five to six hours. I continued that way until my eyes adjusted to the contacts. Now, they’re actually very comfortable, and the best thing is that these lenses have changed my life.

“I can’t thank Dr. Royce enough for all she’s done for me. She’s an amazing person and very knowledgeable. She knows what she’s doing and what she’s talking about. She definitely eliminated all my worries and fears about my condition and treatment. I love Dr. Royce.”   

© FHCN article by Patti DiPanfilo. Photo courtesy of Terell Riley. js
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