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Keratoconus

Keratoconus→ Keratoconus, Scleral Lenses, 

Keratoconus Specialist in Los Angeles & Santa Monica

If you’ve been told you have keratoconus, “irregular astigmatism,” or a thinning, cone-shaped cornea, you need more than a basic eye exam. You need a keratoconus specialist who can:

  • Diagnose the condition accurately with modern imaging

  • Monitor for change over time

  • Coordinate corneal cross-linking when needed

  • And design specialty contact lenses (especially scleral lenses) to give you the best vision possible
     

At Cohenmehr Optometry in Los Angeles, right on the border of Santa Monica, we provide comprehensive, long-term keratoconus care for patients throughout Los Angeles, Santa Monica, Brentwood, and the Westside.

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What Is Keratoconus?

Keratoconus is a condition where the clear front window of the eye (the cornea) becomes:

  • Thinner and weaker, and

  • Starts to bulge forward into a more cone-like shape
     

Instead of being smooth and round, the cornea becomes irregular and distorted, causing:

  • Blurry, smeared, or doubled vision

  • Ghosting or “shadow” images

  • Halos and glare around lights, especially at night

  • Frequent prescription changes that never feel quite right
     

Keratoconus often starts in the teens or twenties, can run in families, and is more likely to progress in people who rub their eyes or have allergy or atopy.

How We Diagnose Keratoconus in Our Los Angeles Office

At our Los Angeles / Santa Monica keratoconus clinic, diagnosis is not just “you have it” or “you don’t.” We want to know:

  • How advanced it is

  • Which zones of the cornea are involved

  • Whether there are signs of active progression
     

To get this level of detail, we use:

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1. Corneal Topography

This creates a color map of your corneal shape. It shows:

  • Areas of steepness and irregular curvature

  • Asymmetry between the top and bottom or nasal and temporal areas

  • Early subclinical or “forme fruste” keratoconus that may not show up on a basic exam
     

2. Corneal Tomography & Pachymetry

Tomography and pachymetry give us:

  • A 3-D view of the cornea, not just the front surface

  • Corneal thickness maps to identify thinning and its location

  • Posterior corneal changes that help differentiate true keratoconus from simple high astigmatism
     

3. Refraction & Visual Function

We also measure:

  • Best-corrected vision with lenses

  • Amount and axis of astigmatism

  • How unstable your prescription has been over the last few years
     

This combination of topography, tomography/pachymetry, and detailed refraction lets us stage your keratoconus and build a plan.

Ongoing Monitoring: Watching for Change and Progression

Keratoconus is not a “one-and-done” diagnosis. In our Los Angeles office, we:

  • Establish a baseline with your first round of imaging and measurements

  • Compare every future visit to that baseline to look for progression, including:
     

    • Increased corneal steepening

    • Increased irregular astigmatism

    • Thinning in key zone

    • Worsening best-corrected vision
       

  • Adjust follow-up intervals based on age and risk:
     

    • Younger patients and those with rapidly changing maps are seen more frequently

    • Stable adults may be monitored annually once things have quieted down
       

If we see signs that your keratoconus is changing, we do not wait and watch casually—we start a conversation about corneal cross-linking.

Corneal Cross-Linking (CXL) – When We Refer and How We Co-Manage

Corneal cross-linking (CXL) is a procedure performed by a corneal surgeon that uses vitamin B2 (riboflavin) and ultraviolet light to strengthen the cornea and help halt progression of keratoconus.

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We don’t perform CXL in our office, but we routinely co-manage with trusted corneal specialists in Los Angeles.

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When We Refer for Cross-Linking

In our keratoconus clinic, we typically consider referral for CXL when:

  • There is documented progression on topography/tomography

  • The patient is young (higher risk of progression

  • There is a family history of keratoconus

  • There is ongoing eye rubbing or poorly controlled allergy that increases risk
     

Our role is to:

  • Provide the surgeon with complete imaging and clinical data

  • Explain the CXL process to you in plain language

  • Help you decide if and when cross-linking is appropriate for your situation
     

What Happens After Cross-Linking

After you undergo CXL with a corneal surgeon:

  • We see you back in our Los Angeles office for ongoing follow-up and imaging

  • We monitor the cornea to confirm that it is stable over time

  • Once healing is adequate and the cornea has settled, we focus on optimizing your vision, usually with scleral lenses or other specialty lenses
     

CXL is about protecting your cornea; scleral lenses are about seeing your best. We manage both parts of that equation with you and your surgeon.

Vision Rehabilitation: Scleral Lenses and Other Specialty Contact Lenses

Once we’ve addressed the question of stability vs progression, the next step is to get you seeing clearly and comfortably.

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Why Scleral Lenses Are Often Our First Choice for Keratoconus

Scleral lenses are large, custom-designed contact lenses that:

  • Rest on the white part of the eye (sclera)

  • Vault over the irregular cornea, never touching the cone

  • Are filled with sterile saline before insertion, creating a smooth liquid surface between lens and eye
     

For keratoconus, this design:

  • Masks the irregular corneal shape, reducing ghosting and distortion

  • Provides sharp, stable vision that does not fluctuate with every blink

  • Often feels more comfortable than traditional small rigid gas permeable lenses
     

We may also discuss:

  • Custom soft keratoconus lenses (for mild or earlier cases)

  • Rigid gas permeable (RGP) lenses

  • Hybrid lenses (rigid center with soft skirt)
     

But for many moderate to advanced keratoconus patients in Los Angeles and Santa Monica, scleral lenses provide the best combination of comfort, clarity, and corneal protection.

Led by Dr. Brandon Cohenmehr — Keratoconus & Scleral Lens Expertise

All keratoconus and scleral lens evaluations in our office are personally overseen by Dr. Brandon Cohenmehr, OD.

  • Dr. Cohenmehr has advanced training in specialty contact lenses and scleral lens design, with a particular focus on keratoconus and corneal ectasia.

  • He authored a scleral lens case report, “An A+ Solution to Triple A Syndrome: Scleral Lenses,” showing how scleral lenses restored comfort and function in a patient with a rare condition causing extreme tear deficiency.

  • He has been recognized with the SUNY Chancellor’s Award for Excellence, the highest student honor in the SUNY system, for his commitment to clinical care and innovation.
     

This combination of training, research, and hands-on experience makes Dr. Cohenmehr a trusted keratoconus specialist in West Los Angeles and Santa Monica.

Our Keratoconus Care Pathway

To keep things clear, this is what keratoconus care typically looks like in our Los Angeles office:

  1. Baseline Diagnosis & Imaging
     

    • Full eye exam

    • Topography, tomography, and pachymetry

    • Staging of keratoconus and risk discussion
       

  2. Monitor for Change
     

    • Regular imaging at appropriate intervals

    • Watch for documented progression
       

  3. Cross-Linking Referral if Indicated
     

    • Coordinate with trusted corneal surgeons in Los Angeles

    • Provide all data, answer questions, and support you through the process

    • Resume follow-up care and imaging after CXL
       

  4. Vision Rehabilitation with Specialty Lenses
     

    • Design and fit scleral lenses or other specialty lenses

    • Fine-tune comfort and clarity through follow-up
       

  5. Long-Term Protection & Education
     

    • Ongoing monitoring to keep the cornea stable

    • Counseling on eye rubbing, allergy control, and eye protection

    • Regular updates to your lens design as your eyes and life needs change

Keratoconus Treatment in Los Angeles / Santa Monica

If you’re looking for a keratoconus specialist in Los Angeles or Santa Monica who can:

  • Provide advanced diagnostic imaging

  • Monitor for progression year after year

  • Coordinate corneal cross-linking with top surgeons

  • And design custom scleral lenses to give you the best vision possible
     

We’d be happy to help.​ Book a Keratoconus and Scleral Lens Consultation in our West Los Angeles office (on the Santa Monica border) and let us build a long-term plan to protect your corneas and maximize your vision.

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