The patient in the photo with me lives in the Bahamas and first visited our office in 2008. This patient suffers from a very rare form of keratoconus known as "Superior Pellucid Marginal Degeneration." This type of corneal ectasia affects the upper half of both of his corneas. Note in the photo below the protrusion or bulging of the upper portion of this cornea. Both corneas have the same appearance. When this patient first visited our office, his visual acuity was 20/800 in each eye. Over the years he visited a number of major eye institutions and clinics throughout the United States trying to get help. A number of doctors told him that his only option was to have corneal transplant surgery in both eyes. Over these years he tried many different types of contact lenses without success. He was also unable to obtain functional vision with eyeglasses. In 2008, we fit this patient with GVR Scleral lenses which have provided this gentleman with 20/20 vision in each eye. Every year this patient has returned to our office for yearly examinations, the latest being today. His vision has remained at 20/20 with his GVR lenses. In addition he has been able to wear his lenses every day with all day lens wear comfortably. This patient will never need to undergo corneal transplant surgery.