Understanding Keratoconus and Why Lens Choice Matters
If you've been diagnosed with keratoconus, you know that finding the right eyewear is about more than just looking good — it's about seeing clearly and feeling comfortable in your own glasses. Keratoconus is a progressive eye condition where your cornea thins and gradually takes on a cone-like shape, which causes blurred or distorted vision. According to the American Academy of Ophthalmology, keratoconus affects roughly 1 in 2,000 people, though rates are higher in certain communities, including immigrant populations in Brooklyn.
When you have keratoconus, your eye's refractive error is often irregular and significant. That means your prescription is stronger than average, and without the right lens material, you'd end up with eyeglasses that are thick, heavy, and distorting at the edges. High index lenses solve that problem by bending light more efficiently, letting you have a prescription strong enough to correct your vision while keeping your frames thin, lightweight, and cosmetically pleasing.
At Vision Palace Optical on 1723 Avenue U in Sheepshead Bay, we work with patients from across Brooklyn — Gravesend, Marine Park, Bensonhurst, and beyond — who have keratoconus and need specialty eyewear that actually fits their lifestyle.
What Are High Index Lenses and How Do They Help Keratoconus?
High index lenses are made from materials with a higher refractive index than standard plastic (which is typically 1.50). Common high index options range from 1.60 to 1.74, meaning they bend light more sharply. The higher the index number, the less material you need to bend light the same amount — so the lens is thinner and lighter overall.
For keratoconus patients, high index lenses offer several advantages. First, they reduce the bulk and weight of your eyewear, which matters when you're wearing glasses all day at work or school. Second, they minimize chromatic aberration and edge distortion — visual artifacts that can make the periphery of your vision uncomfortable or blurry, especially with stronger prescriptions. Third, they look better cosmetically, which many of our patients on Avenue U tell us boosts their confidence.
The higher the index, the more you pay, but for keratoconus, the investment often pays off in comfort and clarity. We'll work with you to find the right balance between your budget and your vision needs.
Combining High Index Lenses with Anti-Reflective Coatings
High index lenses have one trade-off: they reflect more light than standard plastic. That means you may see glare, halos, or reflections in your lenses, especially under artificial lighting or when driving at night. That's where Crizal anti-reflective coatings come in.
Crizal is an anti-reflective treatment that eliminates up to 99% of reflections off your lens surface. For keratoconus patients wearing high index lenses, Crizal is nearly essential. It reduces glare, improves contrast, and makes your vision sharper — especially in low-light conditions. If you're driving home from work on the Q train or heading to the store on your lunch break, Crizal will make your vision feel clearer and more natural.
You can apply Crizal to any high index lens, regardless of whether you choose 1.60, 1.67, or 1.74 material. We offer Crizal Sapphire (premium), Crizal Defend (with blue light protection), and standard Crizal. Dr. Sheyko and Dr. Shlivko will help you choose which works best for your daily routine.
Contact Lenses: A Keratoconus Alternative to Explore
While high index glasses are a solid choice for many keratoconus patients, you should also explore contact lens fitting as an option — especially rigid gas-permeable (RGP) lenses or scleral lenses.
Contact lenses can provide better optical clarity than glasses for keratoconus because they sit directly on your eye and vault over the irregular cornea, creating a smoother refracting surface. Many patients with keratoconus see better with contacts than with glasses alone. Dr. Sheyko is certified in specialty contact lens fitting and has fit patients with keratoconus, irregular astigmatism, and other challenging cases.
That said, contacts require daily care, regular follow-up appointments, and aren't right for everyone. Some patients prefer the convenience of glasses. The good news is that high index lenses + Crizal coating gives you excellent vision without the hassle of daily lens care. At Vision Palace Optical, we'll discuss both options during your eye exam so you can make the choice that fits your life.
Material Options: 1.60 vs. 1.67 vs. 1.74
Not all high index lenses are the same. Here's what you need to know about the most common options:
1.60 Index: A good entry point for moderate to strong prescriptions. Thinner than standard 1.50 plastic, more affordable than ultra-high index, and still reduces edge distortion. Many patients with keratoconus find 1.60 a sweet spot for value and performance.
1.67 Index: A significant step up in thinness and light-weight performance. Ideal if your prescription is very strong or if you want cosmetically thinner lenses. 1.67 also has slightly lower chromatic aberration than 1.60, so color fringing at edges is less noticeable.
1.74 Index: The thinnest and lightest option available, and the best at minimizing edge distortion. If you have a very high prescription or just want the thinnest possible lens, 1.74 is the choice. The trade-off is cost and slightly higher reflection (which is why Crizal coating is especially important).
Dr. Sheyko will measure your prescription during your comprehensive eye exam and recommend the index that gives you the best balance of vision quality, comfort, and cost.
Getting Your High Index Lenses at Vision Palace Optical
When you come in for your appointment at our Avenue U location, here's what happens. First, Dr. Sheyko or Dr. Shlivko will do a thorough eye exam, including measurement of your corneal topography (the shape of your cornea) if needed, to understand your keratoconus and any other refractive errors. Then we'll talk about your lifestyle — do you drive a lot? Work on a computer? Spend time outdoors? — so we can recommend the right lens material and coatings.
Once we've chosen your high index material, we'll help you pick frames from our designer frame collection or more affordable options that suit your face and style. We carry brands like Ray-Ban, Gucci, Dita, Prada, Tom Ford, and Silhouette, as well as practical frames at every price point.
Your lenses will be custom-made and delivered within a week or two. We'll fit them to your frames, adjust them for comfort, and make sure you're happy with the result.
Insurance Coverage and What to Expect
Most vision insurance plans, including Medicaid, Medicare, EyeMed, MetroPlus, Fidelis Care, 1199SEIU, and others, help cover eyeglasses and the cost of lens materials. Coverage varies by plan — call us or book through Zocdoc to verify your benefits before your visit. Some plans cover a portion of the lens cost; others may require you to pay the difference between standard and high index materials out of pocket. We'll let you know your out-of-pocket responsibility upfront.
If you're on Medicaid in Brooklyn, we accept your coverage and can discuss what's included in your plan. Same for Medicare Part B, which covers one routine eye exam per year for eligible beneficiaries.
Frequently Asked Questions
Will high index lenses completely correct my keratoconus vision?
High index lenses will give you the clearest vision possible with glasses, but keratoconus often causes irregular astigmatism that glasses alone can't fully correct. That's why some patients see better with specialty contact lenses like scleral lenses, or a combination of glasses and contacts. During your eye exam at Vision Palace Optical, Dr. Sheyko will evaluate which option gives you the best vision.
Are high index lenses more fragile or prone to scratching?
No, not at all. High index materials are just as durable as standard plastic. We always recommend adding a scratch-resistant coating to any lens, regardless of material or index.
How much thinner will my high index lenses be compared to standard plastic?
The difference depends on your prescription strength. With a mild prescription, you might not see much difference between 1.50 and 1.60. But with a strong prescription typical of keratoconus, moving from 1.50 to 1.67 or 1.74 can make your lenses noticeably thinner — sometimes cutting thickness in half or more. We can show you a comparison at your appointment.
Do I need Crizal coating with high index lenses?
You don't absolutely need it, but we strongly recommend it, especially with high index materials. The anti-reflective coating eliminates glare and reflections that would otherwise be noticeable with high index lenses. Most of our keratoconus patients on Avenue U choose to add Crizal because it makes driving and nighttime vision so much clearer.
Can I use high index lenses with Transitions (photochromic) coating?
Yes. You can combine high index material with Transitions Drivewear or standard Transitions lenses, plus Crizal coating, all in one pair of glasses. This gives you a truly versatile lens that adapts to light and eliminates glare.
References
- American Academy of Ophthalmology. Keratoconus: Diagnosis and Management.
- National Eye Institute — NIH. Corneal Conditions and Refractive Errors.
Ready to explore high index lenses for your keratoconus? Book your eye exam at Vision Palace Optical — book through Zocdoc or call us at (718) 998-8400. We're at 1723 Avenue U in Brooklyn, open Monday through Saturday. Dr. Sheyko and Dr. Shlivko are ready to help you see your best.