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Keratoconus Specialist in Middle Village, New York

Keratoconus is a rare, progressive disease that affects the cornea, which is the clear, transparent layer at the front of the eye.

Meet Our Keratoconus Specialist in Middle Village, New York

Maria Bosco OD

Maria Bosco O.D.

Languages: English, Spanish, Italian

Dr. Maria Bosco was born and raised in Brooklyn, NY. Currently she is a resident of Long Island and has lived there with her family for the last 16 years. She is conversational in Italian and Spanish.

Dr. Bosco earned her BS in Biology at Binghamton University and her Doctorate at the Pennsylvania College of Optometry. She completed a residency at the Brooklyn VA Hospital. She is a Fellow of the American Academy of Optometry and a Diplomate of the American Board of Optometry. She previously worked as an attending at the VA Hospital in Brooklyn for 15 years. There she focused on the treatment and management of ocular diseases and primary eye care in the veteran population; As well as the clinical teaching of optometry students and residents.

She has co-authored several posters on various aspects of the diagnosis and treatment of glaucoma and other ocular diseases.

Dr. Bosco is especially interested in the treatment and management of glaucoma, retinal diseases and the ocular effects of systemic diseases.

Since joining the 20/20 eye care team, Dr. Bosco has expanded her scope of care to include myopia management and has recently become MiSight certified. MiSight is the first soft contact lens system FDA approved for myopia control in children. She also employs prescription eyeglasses and eyedrops to manage myopia progression in children and teenagers.

Dr. Bosco is passionate about sports, especially baseball, and is an avid Yankees fan. She is also a Disney enthusiast and enjoys vacationing to Disney World when she can with her family. She volunteers much of her time at her children’s school and is an active PTA Board member. Her primary goal is to always provide the best quality eye care for all patients and to manage any ocular diseases and conditions they have.

Contact us today to schedule your next exam!

Melania Napolitano, O.D.

Melania Napolitano, O.D.

Dr. Melania Napolitano is a native of Brooklyn, NY who spent a large part of her childhood in Napoli, Italy. She is multilingual, speaking Spanish and Italian fluently, which benefits her in her professional life. Dr. Napolitano earned her Bachelor of Science Degree at Queens College, NY, and completed her Doctorate at SUNY State College of Optometry. Dr. Napolitano is committed to her patient's care, providing management, treatment, and diagnosis of eye conditions & diseases, such asdry eye, cataracts, glaucoma, diabetic retinopathy, and macular degeneration. During her comprehensive eye exams, she spends time with each patient, reviewing their eye health & ways to maintain their vision & total wellbeing. She loves seeing patients of all ages and has developed a special interest in myopia management or myopia control. At the forefront of optometry & eye health research, we now have various methods to help children & teenagers retain their natural, healthy vision and prevent their vision from worsening! Not only does keeping a child's prescription at a very low level help their vision stay clear, but it drastically reduces the risk of eye diseases like myopic maculopathy, retinal detachment, and glaucoma. We encourage parents to contact us and ask about myopia management so we can preserve our sight for a better future. Dr Napolitano also is trained in specialty contact lens fittings for patients with keratoconus or corneal disease. Our primary treatment to help patients with corneal disease is scleral contact lenses as they provide amazing vision & comfort without compromising the cornea. Dr. Napolitano is passionate about giving back and improving optometric care, and this is clear in her activities outside of her practice. Her volunteer time includes community lecturing and free vision screenings for seniors and children in the community. Her goal is to raise awareness for sight-threatening conditions. Contact our office today, and schedule an appointment for your eye care needs!

Our Doctor Can Diagnosis and Treat Keratoconus

Your cornea is the transparent, outer lens of your eye, and it typically has a smooth dome shape. Keratoconus describes a condition in which the corneal structure isn’t strong enough to maintain a healthy ball shape.

Meet with our Keratoconus Specialist in Middle Village, New York to define your eye's condition and ways for treatment.

As a result, the cornea bulges outward into more of a cone. Our professional optometric team at our eye care clinic is knowledgeable about how to diagnose and treat keratoconus.

Keratoconus is rare, with an estimated one person out of every 2,000 having the condition. It generally appears in the teenage years and can progress slowly or rapidly.

Keratoconus also runs in families, so if you or your children are at risk, it’s advised to contact us for a thorough eye exam.

Causes of Keratoconus

Your cornea is held in place by very small collagen fibers. When they are weakened and too fragile, they aren’t able to preserve the round shape of your cornea.

A reduction in the protective antioxidants of your cornea, which act to destroy damaging by-products made naturally by corneal cells, is what causes keratoconus.

In addition to genetics, some types of eye injuries may increase your chance of being diagnosed with keratoconus.

Specific ocular diseases, such as retinitis pigmentosa, vernal keratoconjunctivitis and retinopathy of prematurity, as well as some systemic conditions (Down syndrome, Ehlers-Danlos syndrome, Leber's congenital amaurosis and osteogenesis imperfecta) are also associated with this corneal abnormality.

Our Keratoconus Specialist in Middle Village, New York has years of experience identifying the various levels of keratoconus and other corneal conditions.

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Symptoms of Keratoconus

When the shape of your cornea begins to bulge, it alters your eyesight in two different ways. As the cone shape forms, your normally smooth corneal surface becomes wavy, called irregular astigmatism. Additionally, as your cornea expands, vision becomes increasingly nearsighted. Focusing becomes impossible without eyeglasses or contact lenses. Usually, the problems begin in one eye and develop later in the other eye too.

Typically, patient’s eyeglass prescription will change often as the vision becomes worse and contact lenses will be difficult to wear due to discomfort and improper fit.

When keratoconus become more severe (which usually takes a long time however on occasion can happen rather quickly), the cornea can begin to swell and form scar tissue. This scar tissue can result in even further visual distortion and blurred vision.

Altogether, these changes can create the following symptoms:

  • Blurred vision
  • Streaking of lights
  • Halos around bright lights at night; glare
  • Sudden change of vision in only one eye
  • Objects appear distorted, both near and distant
  • Double vision from just one eye
  • Triple ghost images

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How We Diagnose Keratoconus

Our eye doctors will inspect carefully for the signs of keratoconus during your comprehensive eye exam. It’s critical to inform us of any symptoms that you’ve been experiencing. To diagnose the condition, we’ll measure the shape of your cornea. Computerized Corneal Topography is used for this procedure, which takes a picture of your cornea and analyzes it instantly.

Treatment for Keratoconus

The first line of treatment is usually new prescription eyeglasses. If this solution doesn’t help you achieve good vision, then contact lenses will be tried. Rigid, gas permeable lenses are typically prescribed.

As the disease progresses, however, glasses and soft contact lenses may no longer correct vision and soft lenses may become uncomfortable. This is when other forms of vision correction will be recommended.

Gas Permeable and Scleral Contact Lenses

At the more advanced stage of keratoconus rigid gas permeable (RGP) contact lenses, scleral or semi-scleral lenses may be used for increased comfort and visual acuity. Since they are more rigid, RGP and scleral lenses are able to create a smooth, round shape around the cornea, creating a smoother surface for better vision.

Scleral or semi-scleral lenses have a larger diameter which covers the entire cornea and reaches over into the white part of the eye, which is known as the sclera.

Many patients find these more comfortable than regular RGPs and find that they move around less when the eyes move. The main disadvantage of these rigid lenses is that for some, they are somewhat less comfortable than soft lenses and they must be continually refitted as the shape of the eye changes.

Whether it is glasses or contact lenses being used to correct vision, patients will likely have to undergo many tests and prescription changes as their vision needs to change.


Intacs are small, surgically implanted plastic inserts which are placed on the cornea to flatten it back to shape. Usually they are able to restore clear vision, with the continued use of glasses. Intacs are often recommended when contact lenses and eyeglasses are no longer able to correct vision adequately. Intacs take about 10 minutes to insert and can delay the need for corneal transplant.

PTK for severe keratoconus

Severe keratoconus may lead to extreme scarring, due to overstretched collagen fibers. If the back of your corneas tears as a result, swelling may occur. It can take months for the swelling to go down, and a large scar is generally created. PTK, a specialized procedure, can smooth out this scar, thereby enhancing contact lens comfort.

Cornea collagen crosslinking

Cornea collagen crosslinking is another therapy that has shown to be effective in slowing the progression of keratoconus. An alternate remedy is called intacs, which are semicircular implants inserted under the surface of the cornea to flatten the bulging cone shape and give better vision.

Cornea Transplant

As a last resort, a cornea transplant may be performed. During this procedure, the center of your cornea will be removed and replaced with a donor cornea. The new cornea is stitched into place, and you’ll need to wear contact lenses for adequate vision after the surgery.

Dangers of LASIK and Keratoconus

LASIK can potentially weaken the cornea of anyone who suffers from keratoconus, making it a dangerous procedure. If this happens, your vision will become substantially worse. Even if your keratoconus is mild, LASIK is not an option.

Our Keratoconus Specialist in Middle Village, New York is happy to meet with you for a 1-on-1 consultation to get you back on the path to reaching clear vision.

Meet with Our Keratoconus Specialist in Middle Village, New York

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