Blepharoptosis Associated With the Wearing of Hard Contact Lenses in Keratoconic Eyes

Keratoconus is a condition that causes progressive thinning and anterior protrusion of the cornea. Because of its irregular astigmatism, mild to moderate keratoconus is corrected with hard contact lenses (HCLs), but blepharoptosis due to the long-term wearing of HCLs is often a problem. In this study, we investigated blepharoptosis in HCL wearers with keratoconus. Thirty-seven keratoconic eyes were enrolled and divided into several groups according to their wearing history or age. Eyelid margin distance (EMD), margin light reflex distance-1 (MRD-1), and levator function (LF) were measured using a distantometer or anterior segment optical coherence tomography (AS-OCT). The EMD decreased with years of wear but showed no correlation with age; the MRD-1 decreased with years of wear and with older age; the LF showed no relationship with either years of wear or age. In the classification of ptosis, there was no severe ptosis in the present sample. The long-term wearing of HCLs is likely to cause blepharoptosis even in keratoconic eyes.