Why Refer Your Eye Care Patients to Us?
Why, You Ask?
The health care professionals you choose to send your patients to reflects upon you as the referring physician. Ideally, you want your patients to visit a practice where they’re offered top-notch care, professionalism, and empathy. At The Camas Vision Centre Scleral Lens and Keratoconus Center, we take this very seriously and give our utmost to ensure a quality experience for all of our patients.
Dr. Robert Nicacio
Dr. Robert Nicacio received his undergraduate degree from Central Washington University in Ellensburg, Washington, and his Doctorate of Optometry from Pacific University in Forest Grove, Oregon. He strives to ensure his patients are truly cared for and receive the best possible eye care.
In addition to providing comprehensive eye exams, Dr. Nicacio has a special interest in the fitting scleral lenses. He provides custom-made scleral lenses to patients with keratoconus, post-LASIK complications, and other corneal irregularities — offering them clearer vision and greater comfort.
What Can We Offer Your Patients?
We are a referral center based subspecialty contact lens practice.
We work with Corneal Specialists to offer a continuum of care for their patients with corneal irregularities by providing advanced custom contact lens fitting for the most hard-to-fit patients.
Scleral Lenses and Their Benefits
Custom designed scleral lenses help patients with corneal irregularities achieve dramatic improvements in visual acuity and comfort. The scleral lenses’ oxygen permeable fluid-filled chamber protects the eye as it provides it with the moisture and oxygen it needs to stay healthy. This makes scleral lenses fantastic for promoting the healing of the cornea.
The many benefits associated with scleral lenses render them a popular and satisfying choice for patients with corneal irregularities desiring clear and comfortable vision.
Which Corneal Conditions Can Scleral Lenses Benefit?
- Post LASIK/RK/PRK Ectasia
- Post PK/INTACS/DMEK/DALK/DSAEK, Etc.
- Post Corneal Cross Linking
- Corneal Dystrophies, such as Fuchs’ and Map-dot-fingertip corneal dystrophy
- Severe Ocular Surface Disease (OSD)
- Aniridia, ICE Syndromes and Trauma
- Corneal scarring
To Refer Your Patient For Expert Care, You May:
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Scleral Lenses Following a Corneal Transplant
Patients with Keratoconus or corneal transplants can see clearly by wearing scleral lenses; they are the safest and best way to correct vision for irregular astigmatism. Following a corneal transplant, the cornea should not be touched with a contact lens. This makes scleral lenses the optimal solution, as they vault over the cornea without touching it directly.
John came to The Camas Vision Centre Scleral Lens and Keratoconus Center seeking a solution for his Keratoconus, which affected both his eyes. He had recently undergone a corneal transplant and had a corneal graft for his Keratoconus.
In order to improve John’s visual acuity, Dr. Robert Nicacio did the following:
- He took a topography reading of 11,000 points on each cornea and then designed the lens to individually match all 11,000 points of the patient’s corneas. Because he had a corneal transplant, it was crucial that the lens not touch any part of the graft to ensure maximum comfort.
- He used OCT images to measure the microns between the back surface of the scleral lens and the front surface of the cornea to ensure a healthy graft while wearing the contact lenses.
As a result, John was able to achieve 20/25 vision in both eyes. He now has clear, comfortable vision all day and is very pleased with the scleral lenses he was fitted for at The Camas Vision Centre Scleral Lens and Keratoconus Center.
Read Other Case Studies...
Post-LASIK Complications +
While LASIK surgery has a high success rate, some patients come out of the surgery with imperfect vision. Debbi is one of the many cases we’ve seen at our practice.
Her LASIK surgery results left her with poor vision. Her LASIK surgeon recommended an enhancement procedure to improve her vision, which led her to undergo subsequent LASIK surgeries. Unfortunately, these attempts left her with extremely poor vision in each eye, and Debbi was desperate to find a solution to her vision problems.
Debbi arrived at The Camas Vision Centre Scleral Lens and Keratoconus Center after hearing that we specialize in helping people achieve clear vision following poor LASIK results. Dr. Robert Nicacio examined Debbi’s eyes and found that she had a very high prescription and irregular astigmatism following her surgery.
Her best option was to wear scleral lenses as they would correct her astigmatism, farsightedness and were perfectly safe for her corneas, which after multiple surgeries, were scarred.
Since getting fitted for her custom-designed scleral lenses, Debbi is absolutely thrilled with how sharp and comfortable her vision has become.
Post-RK Surgery Complications +
Many patients underwent Radial Keratotomy (RK) surgery to correct myopia and astigmatism during the early stages of refractive surgery. Because of the aggressiveness of the procedure, those having undergone RK surgery can be left with some refractive error in the form of nearsightedness, farsightedness, or (irregular) astigmatism. Those with irregular astigmatism experience blurred, distorted vision loss which cannot be corrected with glasses. It is among the more serious and frequently occurring complications following corneal refractive surgery.
Matthew, a 52-year-old teacher, underwent bilateral RK surgery in 1995. Though the initial results were positive, within two years his vision deteriorated. He developed corneal ectasia, and complained of blurred vision, discomfort, and red eyes when wearing contact lenses.
The slit lamp examination revealed damaged corneas which had severe staining along the incision lines and around the cornea at the limbus. This was a result of the fit of the GP lenses he was wearing at the time. They were touching the anterior elevations of the cornea and did not allow for enough tear exchange.
Fitting a scleral lens was the best option to treat Matthew’s damaged corneas, alleviate discomfort and improve his vision.
At the one-year visit, the patient improved both visual acuity and quality. The fitting of a well-designed semi-scleral GP contact lens filled with a saline solution created a healthy environment behind the lens, which in turn allowed the cornea and limbus to heal. The scleral lenses also helped protect the RK incisions from further abrasions caused by blinking.
As this case demonstrates, patients having developed irregular corneal surfaces following refractive surgery can benefit from a customized scleral contact lens design to improve their wearing comfort and vision.