How many hours can contact lenses be worn daily?

Thanks to modern advanced lens materials and because Vision Experts works only with leading international manufacturers, many patients comfortably wear their specialty contact lenses throughout the day. Daily wearing tolerance depends on the lens material, lens design, your tear film quality, and your individual fitting profile — your specialist will confirm a safe daily wearing schedule at fitting.

How long do specialty contact lenses last?

Lifespan depends on the material and lens type. For scleral lenses, lifespan commonly ranges between two to five years for many patients with proper care and maintenance. RGP and hybrid lenses typically have similar multi-year lifespans when handled and stored correctly, while soft specialty lenses are usually replaced more frequently per the manufacturer's replacement schedule.

How should soft contact lenses be used properly?

Wash hands thoroughly before handling soft lenses. Clean lenses daily using the recommended solution — never use tap water. Follow the recommended wearing schedule and remove lenses before sleep unless specifically approved by your contact lens specialist.

How should RGP / hard contact lenses be used properly?

Rigid gas permeable lenses require daily cleaning using specialized RGP lens care systems and should remain stored overnight in the recommended disinfecting solution. Avoid using soft-lens solutions on RGP lenses, and never expose RGP lenses to tap water.

How should scleral contact lenses be inserted and used?

Scleral lenses should be filled with preservative-free saline solution before insertion while ensuring no air bubbles remain trapped beneath the lens. Insertion is typically performed with a plunger or with the fingers using a specific technique taught at your fitting appointment, and the lens should be removed and cleaned at the end of each wearing day.

How should hybrid contact lenses be used?

Hybrid lenses should be handled gently during insertion and cleaning because they contain both rigid and soft components. Use the cleaning and disinfecting solution recommended by your contact lens specialist, and follow the prescribed replacement schedule to maintain optical clarity and ocular health.

Can I swim while wearing my keratoconus contact lenses?

Swimming with contact lenses, including specialty keratoconus lenses, is generally not recommended because pool water, sea water and hot-tub water can introduce microorganisms (such as Acanthamoeba) that may cause sight-threatening infection. If swimming is unavoidable, use well-sealed swimming goggles over your lenses and discard daily disposables immediately after.

Can I cook or be exposed to heat with contact lenses?

Brief routine cooking exposure does not affect modern contact lens materials, though prolonged exposure to direct steam, smoke or open-flame heat can cause dryness and discomfort. If you experience eye irritation during cooking, blink frequently or use preservative-free lubricating drops as recommended by your specialist.

Keratoconus Treatment in Amman, Jordan — Non-Surgical Specialty Contact Lens Fitting

Quick answer. Keratoconus is a progressive thinning of the cornea that distorts vision and cannot be fully corrected with regular glasses or soft contact lenses past the early stage. It is non-curable but it is highly treatable. In 2026 there are five clinically validated non-surgical paths to clear vision — aspheric freeform glasses (early cases), custom toric soft lenses (mild irregularity), rigid gas-permeable (RGP) lenses, hybrid lenses, and scleral lenses for moderate-to-advanced keratoconus. Corneal cross-linking (CXL) is a separate procedure used to halt progression, not to improve vision. At Vision Experts in Amman, the typical patient reaches functional 20/20 or near-20/20 vision in 2–4 fitting visits across a 4–6 week window. Most cases never require corneal transplant.

Reviewed by Bilal Rawashdeh, Optometrist & Contact Lens Specialist, founder of Vision Experts in Amman, Jordan. 20+ years of clinical experience in specialty contact lens fitting for keratoconus and irregular corneas. Last clinical review: 31 May 2026.

What keratoconus is

Keratoconus (Greek: kerato- cornea + konos cone) is a corneal ectasia. The cornea — the clear front window of the eye — gradually thins and bulges outward into a cone-like shape rather than the normal smooth dome. The result is irregular astigmatism: a kind of blur that ordinary glasses cannot fully correct because the optical surface is no longer regularly curved.

Most cases begin in the late teens or early twenties. Progression is typical for 10–20 years and then most patients stabilize. A small fraction continue progressing into their thirties or beyond. The condition almost always affects both eyes, though the two eyes can be at very different stages.

Keratoconus is not contagious, not caused by anything you did, and not caused by wearing the wrong glasses. The corneal collagen has a structural weakness that prevents it from holding the normal dome shape under the constant intraocular pressure inside the eye. Over months and years, that pressure stretches the weakest part of the cornea outward.

Why it matters

Untreated keratoconus is the leading cause of corneal transplant in young people worldwide. The good news for 2026 is that the modern combination of cross-linking (to halt progression) and specialty contact lenses (to recover vision) means corneal transplant is now a very late-stage decision — most patients we fit at Vision Experts will never need one. Of the new keratoconus patients walking into our clinic each year, fewer than 1 in 50 ends up referred for corneal transplant. The other 49 see clearly with the right contact lens.

How common is keratoconus in Jordan and the Middle East

The most-cited global figure is roughly 1 in 2,000 people (Hashemi et al., 2022 for the prevalence meta-analysis). In the Middle East the prevalence runs 3–10× higher. Saudi epidemiological data reports rates around 1 in 380 in the general population, and even higher in specific subpopulations.

The reasons are not fully understood but include:

Genetics. First-degree relatives of a keratoconus patient have a roughly 5-fold higher risk than the general population.
Chronic eye rubbing. Often driven by allergic conjunctivitis, which is itself very common in the dust-and-sun environment of the Levant and Gulf.
Atopic conditions. Asthma, eczema, and allergic rhinitis are independently associated with keratoconus risk.
UV exposure during development. Strong sunlight during teenage years correlates with regional rates.
Consanguinity. Documented to amplify genetic risk in regional cohorts.

At Vision Experts we see new keratoconus presentations nearly every week. The typical patient is between 16 and 32, often comes from a family with a known case, and has been told their glasses prescription is changing too quickly. Many have been rubbing their eyes for years without knowing the link.

Symptoms — what keratoconus actually feels like

Early keratoconus often gets dismissed as “ordinary astigmatism” or “I just need stronger glasses.” The pattern that should trigger a corneal tomography examination:

Frequent prescription changes. A new glasses prescription every 6–12 months in a teen or young adult, especially with rising astigmatism.
“Ghost images” or doubled letters. The cone produces multiple focal points so straight lines appear with a halo or smear.
Difficulty driving at night. Headlights produce starbursts and glare that ordinary myopic patients do not experience.
Vision that glasses no longer fix. The astigmatism becomes irregular — glasses correct only the regular component. Patients say “my new glasses don’t feel right” even after multiple refractions.
Eye rubbing. Especially in patients with seasonal allergies.
Family history. A parent, sibling, or first cousin with diagnosed keratoconus.
Asymmetric vision. One eye notably worse than the other, with the worse eye progressing faster.

How keratoconus is diagnosed

A standard refraction will not catch early keratoconus. Diagnosis requires corneal tomography — a 3D mapping of both the front and back surfaces of the cornea, with a thickness map. At Vision Experts the diagnostic workup includes:

Case history. Family history of keratoconus, allergy/atopic history, eye-rubbing habits, prescription change pattern.
Best-corrected refraction. Subjective refraction at distance and near. Comparison to previous prescriptions.
Slit-lamp biomicroscopy. Looking for the classical clinical signs — Munson’s sign (V-shaped indentation of the lower lid when the patient looks down), Fleischer’s ring (iron deposits at the base of the cone), Vogt’s striae (stress lines), and any apical scarring.
Scheimpflug tomography (TMS-5). The diagnostic gold standard. Maps anterior elevation, posterior elevation, thinnest pachymetry (corneal thickness), and the Belin/Ambrósio Enhanced Ectasia Display. The TMS-5 also performs Scheimpflug imaging which extracts anterior and posterior corneal profiles for keratoconus screening.
Topography overlay. Standard Placido-disc topography for confirmation.
Pachymetry mapping. Thinnest point + thickness gradient — values below 480-500 microns at the cone apex are typical of moderate-to-advanced disease.
Anterior segment OCT (when indicated) for additional detail in atypical or post-surgical cases.

The diagnostic exam takes 30-45 minutes at Vision Experts. The output is a multi-parameter staging that informs both the contact-lens fitting plan and the timing question for corneal cross-linking.

The Amsler-Krumeich staging system

The internationally used framework grades keratoconus from Stage 1 (early) to Stage 4 (advanced):

Stage	Refraction	K-max	Thinnest pachymetry	Best correction
1 (early)	<-5.00 D	<48 D	>500 µm	Aspheric glasses or soft toric
2 (mild)	-5.00 to -8.00 D	48–53 D	400–500 µm	RGP, hybrid, or scleral
3 (moderate)	-8.00 to -10.00 D	53–55 D	300–400 µm	Scleral lens (default)
4 (advanced)	Cannot refract	>55 D	<300 µm	Scleral lens or transplant referral

The five non-surgical treatment options

1. Aspheric freeform glasses (early cases only)

For early forme-fruste keratoconus with mostly-regular astigmatism, modern aspheric freeform lenses with optimized progressive design can recover most of the visual quality lost to ordinary glasses. Modern freeform manufacturing cuts surfaces to about 1 micron of accuracy, enabling lenses that compensate for the patient’s specific higher-order aberration profile.

This works in a narrow window: Stage 1 keratoconus and some pellucid marginal degeneration cases. Once the cone reaches Stage 2 or higher, glass-based correction stops being competitive with contact lenses. Vision Experts fits ZEISS Individual freeform progressives and Essilor Varilux XR for keratoconus-eligible patients in this window.

2. Custom toric soft lenses (mild irregularity)

A high-modulus custom soft lens with stable rotational axis can correct mild keratoconus, especially in patients who cannot tolerate rigid lenses. The fitting set runs into dozens of trial parameters; for the right patient — typically someone in their early twenties with mild ectasia and a strong preference for soft lens comfort — this is a viable option. Vision quality is good but not as crisp as rigid lens options because the soft lens drapes over the irregular corneal surface.

3. Rigid gas-permeable (RGP) lenses

For most of the last 40 years RGP lenses were the standard for keratoconus. A small, high-Dk-permeability rigid lens (diameter typically 8.5–10.5 mm) sits on the cornea and replaces the irregular front surface with its own regular surface. The tear film between lens and cornea fills the irregularities. Vision is excellent — often 20/20 — but the lens is small enough that the cone apex is in direct contact, which can cause apical scarring over time.

RGP remains the right choice for many mild-to-moderate keratoconus cases, especially in patients who already wear them and tolerate them well. Modern aspheric, multi-curve and reverse-geometry RGP designs (e.g. Rose-K, ComfortKone) have made the fit much more refined than the spherical-front lenses of the past

4. Hybrid lenses

A hybrid is an RGP centre fused to a soft skirt. The patient gets the optical quality of the rigid centre with the comfort of a soft outer ring. SynergEyes (the dominant manufacturer) makes specific keratoconus designs (UltraHealth, ClearKone). Fitting is more demanding than soft lenses but easier than scleral. For patients who do not tolerate full-RGP comfort but need better optics than custom soft, hybrid is often the answer.

Hybrid fees at Vision Experts run JOD 500-850 for the fitting and lens supply.

5. Scleral lenses (the answer for moderate-to-advanced cases)

Scleral lenses are large-diameter rigid lenses (typically 15–22 mm) that vault entirely over the cornea and land on the white of the eye (the conjunctiva over the sclera). The space under the lens is filled with preservative-free saline. The cornea never touches the lens.

Vision is excellent because the rigid front surface is regularly curved, comfort is excellent because nothing rubs the sensitive cornea, and the saline reservoir creates a constant moisture bath that helps the dry-eye component most keratoconus patients also carry.

For moderate-to-advanced keratoconus, scleral lenses are the modern standard. The Scleral Lens Education Society has published consensus fitting protocols and the clinical evidence is now extensive — wear times of 12+ hours per day are routine, and a properly fit scleral lens can recover near-perfect visual acuity in eyes that would have been transplant candidates a decade earlier.

The fitting is more demanding than for any other lens type. Our clinic uses a fitting set of approximately 60 scleral lens parameters and the Scheimpflug Tomographer (TMS-5) to map the corneal and scleral elevation. Most patients reach a stable fit in 2–3 visits; complex cases (post-graft corneas, severe asymmetry between eyes, scleral asymmetry from previous filtering surgery) may take 4–6.

Scleral lens fees at Vision Experts run JOD 800-1,400 for the all-in fitting and lens supply — see our dedicated Scleral Lenses page for the detailed fitting protocol and cost breakdown.

Corneal cross-linking (CXL): when and why

Cross-linking is a separate procedure done by a corneal surgeon, not an optometrist. CXL uses UV-A light and riboflavin (vitamin B2) eye drops to create additional bonds between collagen fibres in the cornea — strengthening the tissue and halting progression. The American Academy of Ophthalmology’s Preferred Practice Pattern on Corneal Ectasia is the standard reference.

Important distinctions:

CXL halts progression. It does not improve vision. Patients still need glasses or contact lenses after CXL — the prescription does not improve, the cornea simply stops getting worse.
CXL is most useful in patients under 35 who show documented progression (K-max increase of ≥1.0 D over 6–12 months, or thinning of ≥10 microns).
CXL is generally not done in stable, mid-life patients. Their cornea has already stabilized; CXL adds little value.
Pre-CXL contact lens fitting may be deferred. Patients often wait 3–6 months after CXL before final contact lens fitting because the corneal shape can change slightly during healing.
Post-CXL contact lens fitting is generally easier because the cornea is more stable.

Vision Experts co-manages CXL with corneal surgeons across Amman. Our role is the diagnostic workup, the lens fitting before and after, and the long-term follow-up. The surgical procedure itself is done at partner clinics. CXL in Jordan is widely covered by private health insurance for documented progression in patients under 35.

Eye rubbing and prevention

Of all the things a patient can do to slow keratoconus, stopping habitual vigorous eye rubbing is the single highest-impact action. Eye rubbing has been documented in multiple studies as one of the strongest non-genetic risk factors for both onset and progression of keratoconus.

The mechanism is mechanical: each rub flexes the corneal collagen, accumulated thousands of times per year. Combined with the underlying biomechanical weakness, the cumulative effect is significant.

If you have keratoconus and you rub your eyes:

Identify and treat the underlying allergy. Most chronic rubbers have allergic conjunctivitis. We can prescribe lubricant drops, antihistamine drops, or mast-cell stabilizers; persistent cases need an allergist.
Switch to “press, don’t rub.” If your eye itches, press gently with the back of a knuckle. No grinding motion.
Eliminate sleep rubbing. Some patients rub during sleep. Eye shields at night work for the worst cases.
Identify and remove the trigger. Sometimes the trigger is a cosmetic product, a pet, or a household dust source.

What to expect at Vision Experts

Vision Experts has fit specialty contact lenses for keratoconus in Amman for over 20 years. The clinic positions itself as the first dedicated contact lens center in the Middle East and has fit several thousand keratoconus patients. The fitting protocol is standardized:

Visit 1 — diagnostic workup

90 minutes. Full case history, refraction, slit-lamp exam, Scheimpflug tomography (TMS-5), pachymetry, and patient counselling. The output is a written treatment plan with options, expected timeline, and cost band. If CXL is indicated we refer at this visit and pause the lens fitting until the corneal surgeon confirms stability.

Visit 2 — trial fit

60 minutes, typically 2–4 weeks after Visit 1. We fit the trial lens (RGP, hybrid, or scleral, based on Visit 1’s recommendation), assess fit dynamically, and order the custom lens.

Visit 3 — dispense + insertion training

60 minutes, 1–2 weeks after Visit 2. The custom lens arrives, we dispense it, train the patient on insertion/removal/cleaning, and send them home with their lenses + a written care protocol.

Visit 4 — one-week follow-up

30 minutes. Assess wearing time, comfort, and visual acuity. Adjust parameters if needed.

Visits 5+ — month-one and three-month follow-ups

Standard 30-minute checks at month 1 and month 3 confirm long-term comfort and fit stability. After three months most patients move to a six-month or annual cadence.

Total fitting timeline for a straightforward case: 4–6 weeks from first appointment to a settled fit. Complex post-graft or post-CXL cases can take 8–12 weeks.

Living with keratoconus

A keratoconus diagnosis is not an emergency and it is not the end of normal vision. Most patients live unrestricted lives with the right lens, wear contacts 10–14 hours per day, drive, work, play sport, and never reach a stage where transplant is considered.

Specific lifestyle notes:

Sport. Most sport is fine with scleral or RGP lenses in. Swimming with lenses is contraindicated (microbial keratitis risk). For contact sport with high impact risk, sport goggles over lenses are wise.
Driving. Patients are usually back to legal driving vision within the first fitting cycle. Night driving sometimes requires the highest-clarity lens type (typically scleral).
Children and family. First-degree relatives of a keratoconus patient should have a baseline corneal tomography at some point in their teens or twenties, even if their vision feels normal. Early detection means earlier cross-linking if they turn out to be progressing.
Hormonal changes. Pregnancy is associated with documented keratoconus progression in a subset of patients. We see post-pregnancy patients more frequently for tomography during and after gestation.
Long-term lens care. Cleaning protocols matter. Microbial keratitis remains the main avoidable complication of specialty contact lens wear. We provide explicit cleaning routines and replace solutions as we go.
Mental health. A new keratoconus diagnosis is stressful. We tell patients up front the realistic timeline, the realistic outcomes, and that fewer than 1 in 50 of our patients ends up needing transplant.

When to consider corneal transplant

Corneal transplant (penetrating keratoplasty or deep anterior lamellar keratoplasty) is reserved for advanced keratoconus where:

The cornea has significant scarring that does not improve with any contact lens, or
The cornea is too steep or too thin for any contact lens to fit safely, or
The patient cannot tolerate contact lens wear despite multiple attempts.

In our practice, fewer than 2% of new keratoconus patients reach transplant criteria within their first decade of care. Modern scleral lens technology has dramatically reduced the transplant rate compared to a decade ago. When transplant is needed we refer to corneal surgeons in Amman who perform DALK and PKP routinely.

Frequently asked questions

Can keratoconus be cured?

No, not in the sense of restoring the cornea to a perfectly regular shape. But the visual consequences of keratoconus are almost always fully correctable. Most patients reach 20/20 or near-20/20 with the right lens. Cross-linking can halt progression, and lenses recover the vision.

Do I need surgery if I have keratoconus?

Most patients do not need surgery. The current standard of care is to start with contact lenses, add cross-linking if progression is documented, and reserve corneal ring segments or transplant for the small subset of cases where lens fitting can no longer give functional vision.

How long does scleral lens fitting take?

The first diagnostic visit is approximately 90 minutes. Most patients have a working lens by the third visit, with the entire fitting process completed inside 4–6 weeks. Complex post-surgical cases or post-graft eyes can take 8–12 weeks.

Can I wear scleral lenses overnight?

No. Scleral lenses are daily-wear only. Sleeping in them is contraindicated because of the elevated risk of microbial keratitis. We dispense each pair with explicit handling, cleaning and storage protocols.

Is keratoconus hereditary?

It runs in families more often than chance would predict. First-degree relatives have a roughly 5-fold elevated risk. If a parent or sibling has keratoconus, every family member should have a baseline corneal tomography (not just a regular eye exam) at some point in their teens or twenties even if their vision feels normal.

I rub my eyes a lot. Is that a problem?

Yes — vigorous eye rubbing is one of the strongest non-genetic risk factors for keratoconus onset and progression. Treating any underlying allergic conjunctivitis (which drives most chronic rubbing) is a routine part of our keratoconus protocol.

Are scleral lenses safe?

When properly fit and properly cared for, yes. The main complications — corneal hypoxia from a too-tight fit, microbial infection from contaminated saline, and conjunctival impingement from a too-large diameter — are managed by fitting quality and patient education. We follow the Scleral Lens Education Society care guidelines and our complication rate is consistent with the published literature.

Will my insurance cover this?

Coverage of specialty contact lens fitting varies by carrier and policy. We provide itemized invoices and the clinical documentation insurance requires. Please confirm coverage with your provider before scheduling.

How quickly does keratoconus progress?

Highly variable. Most patients progress gradually over 10–20 years and then stabilize. A subset progress quickly during the late teens. Pregnancy is a documented trigger for renewed progression. The most useful predictor of progression is Pentacam/TMS-5 measurements taken 6–12 months apart — comparing K-max, thinnest pachymetry, and posterior elevation.

How much does keratoconus treatment cost?

Specialty contact lens fees vary based on the lens type chosen, complexity of the case, and any additional procedures. We provide a written cost estimate after the diagnostic visit, before any fitting work begins. Please contact us for a personalised quote.

Can I wear regular glasses if I have keratoconus?

For Stage 1 (early) keratoconus, yes — aspheric freeform glasses can work well. Past Stage 2, glasses can no longer fully correct the irregular astigmatism and contact lenses give better vision.

Can keratoconus get worse during pregnancy?

Yes. Pregnancy is associated with documented progression in a subset of keratoconus patients, likely due to hormonal effects on corneal collagen. We see female keratoconus patients more frequently for tomography during pregnancy and in the year postpartum.

Is keratoconus more common in Jordan than in Europe or the US?

Yes. Middle Eastern populations have keratoconus prevalence 3–10× higher than European populations. Saudi data has reported rates around 1 in 380 — far higher than the global average of roughly 1 in 2,000. Genetic factors, allergic conjunctivitis, and consanguinity all contribute.

What’s the difference between keratoconus and astigmatism?

All keratoconus patients have astigmatism, but not all astigmatism is keratoconus. Regular astigmatism is a symmetric curve (the cornea is shaped like the back of a spoon — steeper in one meridian than the other but smooth). Keratoconus produces irregular astigmatism — the cornea has a localized cone-shaped bulge that creates asymmetric distortion. Glasses correct regular astigmatism well but cannot fully correct irregular astigmatism past the early stages of keratoconus.

Can I have laser surgery (LASIK) if I have keratoconus?

No. LASIK is absolutely contraindicated in keratoconus. Cutting the corneal flap in an already-weak cornea accelerates progression and can cause severe vision loss. Anyone considering refractive surgery in Jordan should have corneal tomography first to rule out subclinical keratoconus — this is the standard of care.

What to do next

If you have been told you have keratoconus, or your glasses prescription is changing more often than once a year, or you have a relative with the disease, the first step is a proper corneal exam — not just a refraction. We do this at Vision Experts using a Scheimpflug Tomographer (TMS-5) which gives the posterior corneal map that a standard topographer cannot. The exam takes about 45 minutes and is the basis for every fitting decision afterward.

You can book an appointment online, send an email to info@visionexperts.net, or call +962 6 566 6122 or WhatsApp +962 77 566 6122.

We see patients from across Jordan and from neighbouring countries — many of our scleral-lens fittings come from the GCC. If you are travelling from outside Amman we coordinate the diagnostic and fitting visits to minimize trips.