Dealing with vision can be difficult and if you are a person who is required to wear glasses or contact lenses it can be down right frustrating. There are several things that we can do to correct our vision or make it a little easier on a day to day basis. Many eye surgeons are faced with frustrating decisions on a regular basis of paths of treatment for their patients. Finding the best ways to improve the patients vision as well as give them a satisfying non-invasive treatment is no piece of cake.

First you should find an eye doctor or surgeon you are comfortable with. The area of the eyes is quite sensitive to several people and it is important that the doctor you choose is understanding, and will listen to their patients.

Available Treatments:

Visian ICL-

The Visian ICL is a implanted Collamer lens that was designed by the Staar Surgical Company. They designed an implantable contact lens that forms to your specific vision needs. These Contact lenses are special because they do not need maintenance but additionally they are made of Collamer a special material that makes them life like and making them bio-compatible, which means they are safe for a lifetime. Some of the benefits of Visian ICL are they provide high quality vision (like an HD TV screen), a small entry site is used to insert the lens, they are removable in the event that your vision changes, and they are more durable than other ICL’s.

Lasik Surgery-

Lasik Surgery is a benefit to those with mild to moderate nearsightedness, some degrees of farsightedness, and varying degrees of astigmatism. It is become more and more of a trend and surgeons are moving much further along is improving this treatment. Some patients are using the new “Wave front Lasik” which provides the doctor with a guided hand in the procedure. Through use of a computer doctors can now pin-point exactly where the irregularities are patient by patient making the procedure much more efficient and can provide a better quality of vision.

INTACS-

INTACS are small insertable lenses that have no maintenance. The use of INTACS are often for those suffering from Keratoconus or mild nearsightedness. INTACS cause no permanent changes or damage to your eyes; if your vision changes or you no longer want these inserts they can be removed. So many find this treatment helpful. The importance of them being removable are nice for those who suffer with Keratoconus. As it gives them more options later down the road.

INTACS with C3-R-

Many patients are also using the technique of INTACS with C3-R which allows patients with Keratoconus to benefit more from the INTACS treatment. The C3-R treatment has been found to stop the progression of keratoconus within 3 to 4 months.

Though these are just a few of the great benefits available to those looking into vision correction you can see there is a wide variety. Choosing which method is best for you is up to you and your doctor.

The treatment of C3-R® or Corneal Collagen Crosslinking with Riboflavin is a common practice. While there are several doctors that perform such a procedure not all of them believe that it can be done with the epithelium intact. However when the epi is removed it can cause pain and damage to the patient that may just very well be unnecessary.

The procedure -

Corneal Collagen Crosslinking with Riboflavin or also known as C3-R® is a procedure that involves using Riboflavin or Vitamin B2 to strengthen the corneal stroma in patients with Keratoconus, Corneal Ectasia, post-RK and some irregular progressing astigmatism. The procedure generally takes about 30 minutes. The doctor sometimes removes the Epithelium to help the drops get through to the stroma. Then a UV light is placed over the eye for around 30 minutes to activate the drops for effectiveness.

The Conflict-

Eberhard Spoerl Ph.D, From the University Eye Clinic of Dresden in Germany and Theo Silverman MD, at the Institute for Refractive and Ophthalmic Surgery in Switzerland have made a large impact on the procedure allowing it to gain Scientific research and studies. Their procedure involves what is called Epi-Off, this is when the Epithelium is removed to gain access to the corneal stroma. However Dr. Brian Boxer Wachler prefers to do the surgery free of removing the Epithelium giving the patient less pain hence the conflict. Dr. Boxer Wachler’s technique involves disrupting the epithelium and pre-soaking the cornea for 5 minutes to allow penetration of the Riboflavin to the stroma prior to applying the UV light to activate the Riboflavin. Some doctors say that the procedure without removal of the Epithelium is not as effective. However studies have shown that after 30 minutes the drops have fully absorbed and are activated by the UV light with the epithelium still attached. Dr. Boxer Wachler has been successfully treating patients with the Epi-on technique since 2004. 98% of patient’s have needed on treatment and have had stabilization of the cornea with his Epi-on technique.

Quote:

“ When we and others have analyzed Epi-on vs. Epi-off C3-R® results, there was no difference. It’s no necessary to remove the epithelium if the doctor uses the technique of allowing the Riboflavin solution to penetrate through intact, but loosen the epithelium.” says Dr. Boxer Wachler.

The epi-on procedure allows the patient less discomfort afterwards, as well as avoids the scaring or hazed risk and the need for steroid drops after the procedure. It doesn’t cause the side effects that the epi-off procedure does. Although there are still studies being conducted on this procedure it have been very effective in the Boxer Wachler Eye Institute. Just as Dr. Pinelli of the Italian Refractive Surgery Society or(SICR) who has visited the Boxer Wachler Eye Institute. He viewed the Epi-on procedure and preformed his first procedure on January 12th 2006. After his successful completion he has conducted multi-studies on the effectiveness of the Epi-on versus the epi-off procedure of the C3-R®.

Over the years Dr. Brian Boxer Wachler has continued to perform the epi-on versus the epi-off as he has made an oath to give is patients the best care possible and do no harm. He believes the Epi-off procedure could do harm by unnecessarily increasing the risk of scarring. To read more on the epi-on procedure visit: http://www.keratoconusinserts.com.

The Cornea-

The cornea contains a clear dome which lies on the surface of your cornea. It is the most important part of the eye known as the focusing lens. The cornea must be smooth and well shaped to give your eye good focus. Keratoconus gives the lens a irregular shape and over time makes it difficult to focus.

Though in many people the possibility of developing Keratoconus is present from birth. The ratio is only 1/2000 born. Others can develop this over time. The progression of Keratoconus is frustrating to say the least. And many people start out with mild impaired vision. Usually needing to wear glasses or contacts. The progression of Keratoconus can be slow developing over 3 to 4 decades. Glasses often won’t be enough and many times there is one eye worse then the other.

Keratoconus Vision Loses:

The loss of vision on a keratoconus patient can happen in one of the following two ways:

Form 1: Distortion in the Cornea-

Have you ever looked through a camera with a distorted lens? I am sure you were not able to see all you wanted. Keratoconus is much the same way. The images you are getting back are distorted. The focus you have on the images are blurred and seem out of focus.

Form 2: Scarring of the Cornea-

The cornea is scarred or swollen this makes the images show up blurry and foggy in view. Have you ever looked through a windshield that was foggy in certain parts but not in others? Not a pleasant experience. This form the over all picture is blurred.

Keratoconus is a large part of vision problems in the overall vision care field. Determining if you have Keratoconus is done by a series of tests. There is help for those with keratoconus. Though there is no cure there are some things you can do to stop progression and improve your overall quality of vision.

Many patients with Keratoconus are frustrated by the difficulty of seeing in everyday activities such as driving. Talk to your ophthalmologist for further details or visit: www.kertaconusinserts.com

I had the wonderful pleasure of speaking with Steve Zier a recent patient of Dr. Brian Boxer Wachler. Dr. Brian Boxer Wachler performs several Corrective surgeries in the Los Angeles area for patients around the world. This remarkable doctor is one of the kind. I am writing this week to share with you this patients experience at the Boxer Wachler Vision Institute.

Steve Zier was diagnosed with mild Keratoconus. In many states doctors feel it is difficult to work on patients with Keratoconus some don’t try, others do with complications. In Steve’s case it was difficult to locate a doctor that would attempt it due to his condition.

“None of the other surgeons would touch me with a 10 foot pole” He said sounding a bit frustrated.

Searching the Internet as so many of us do Steve happened upon Dr. Boxer Wachler’s website www.boxerwachler.com and decided to give it a try.

Steve was pleased with the incredible service that the Boxer Wachler Vision Institute had to offer.

“The service was great from the receptionist to the doctors” he said.

Steve Zier had a PRK treatment and C3-R directly afterwards. His total procedure time was less than one hour. Steve reports that he was a little sore afterwards but didn’t need any pain relievers. Additionally his vision was a bit blurry but cleared up within a week. Now he it is four weeks later and he is amazed at the results. Steve had 20/200 vision in the right eye- after treatment 20/20

Results:

Right eye- Before procedure 20/200

Right eye- After Procedure 20/20

Left eye-Before Procedure 20/60

Left eye- After Procedure 20/40

Steve says he only needs a soft contact in one eye now to help him see. His Keratoconus is currently stable and his new quality of vision is great “It was worth every penny!” he says.

Look for True Testimonials next week and hear the story of another patient…

Keratoconus is a serous and frustrating disease. Many are fearful when diagnosed and worry about the loss of sight associated with keratoconus. The truth is there are many procedures and treatments in modern medicine that can help control the progression of this disease. We often see the discouragement on the faces of those suffering; finding a doctor who can communicate easily with you as well as specializes in keratoconus can help you better adjust.

Though many people await a cure there are several ways you can be helped now. Aside from the medical problems of keratoconus, we often face difficulty personally as well as in our family lives. Many find it hard to do some activities. As the disease progresses and becomes more evident it is harder and harder to continue in our social circles. The search for answers becomes clearer and seemingly harder to find. The truth is a specialized doctor is best for these situations. A doctor specializing in Keratoconus can give you more definite and truthful answers.

There are several resources that you can find to assist you with support and information. Contacting a local ophthalmologist will give you more information. It will also provide options for treatment you can choose from. Below are a few links to support groups available to assist patients, family, and friends with people diagnosed with keratoconus:

www.keratoconus.org

www.kcsupport.org

KC Support- Gives assistance to patients with keratoconus

www.nkcf.org

National Keratoconus Foundation- Provides assistance, information, and events for those suffering from keratoconus.

Www.kcglobal.org

The Global Keratoconus Foundation- Provides support for families, friends, and patients with Keratoconus.

New studies are proving that C3-R has benefits for those who suffer from Keratoconus. The procedure C3-R will help build and strengthen the cornea of the eye. It will help not only strengthen but it has also stopped the progression of Keratoconus in many patients.

The diagnosis of Keratoconus doesn’t mean you life is over. It doesn’t even mean your alone. There are several places you can get help and treatments to help slow and even stop the progression of this disease. Though there is not a cure yet…there definitely is hope!

Suffering from Keratoconus can be a difficult thing. Many people worry greatly about the progression of Keratoconus and although there is no definitive cure for Keratoconus there are treatments that can greatly improve your vision. Helping you have a much better quality of life. Laser surgery is not an options for individuals with Keratoconus, but Intacs may be a possibility. There are many benefits of using Intacs.

Below are a few reasons:

• Intacs are removable, which make it easier to adjust if you have visual changes later in life.
• No tissue is removed from your cornea when Intacs are used.
• If you decide to change the method you are using from Intacs to another the option is still open.
• Intacs are maintenance free. you can just enjoy your improved quality of vision instead.

When you have laser surgery they are changing the shape of your cornea by removing tissue with the laser. With Keratoconus this can cause problems, even making things progress and worsen quicker. With Intacs you can treat your disease with little complications.

The results of Intacs are much more exciting. The goal of INTACS is to help normalize the irregular cornea curvature, which has lead to decrease quality of vision. Over 90% of people with Intacs have an improved quality of vision with glasses or contact lenses. Additionally more than 50% of patients have better than 20/20 vision after the procedure with their glasses or contact lenses, which is a miracle for many who have had loss of vision over the years from this disease. Finally this can be a great choice for those with Keratoconus and mild nearsightedness. At times these people experience such a dramatic improvement they rarely need glasses or contacts.

Quite often we dream of good vision and for those of us who have been suffering with vision problems all our lives there is hope. The chance to finally have something that doesn’t require lots of maintenance or excessive checkups is a true blessing. Intacs can give it too you!

There are several things you can do if you feel you are suffering from Keratoconus. The professionals will help not only evaluate your physical status but also take a thorough examination of your medical history.

The Ophthalmologist or Optometrist will also give you tests to check your visual acuity. This means reading letters from an eye chart much like a general eye evaluation. It can also include measuring the curvature of the corneas using a topographer. Having an irregular curvature could mean possible Keratoconus.

One additional test that is often performed is a cornea ultrasound(Pachymetry). This will measure the cornea thickness. A thin cornea can be a sign of Keratoconus.

Another test examines your cornea with a slit lamp(Microscope). More advanced cases can be determined right away with this test, because of the yellow-brown or olive-green rings or a (Fleischer ring)

Fleischer Ring-

Seen in 50% of patients with Keratoconus. Also caused by Iron Oxide Hemosiderin that is deposited in the Corneal Epithelium.

Vogt’s Striae- These are fine lines or (stress lines) caused by stretching and can be seen on the front of the cornea.

Munson’s Sign- is another give away of Keratoconus. This is a V-shaped indentation and sometimes seen in the lower eyelid when the sufferer moves their line of sight in the downward direction. Most signs are detected before this stage and is seldom used for diagnosing keratoconus.

It is important to get a definitive diagnosis for keratoconus. Many times it requires several tests to make an absolute confirmation. There are numerous other conditions that have similar symptoms of keratoconus. Make sure you are being seen by a specialist in diagnosis of keratoconus and ask questions if you do not understand your diagnosis. After all it is your health at stake.

Though we have not walked a mile in your shoes there are certainly many who have. Meet Margret Puchjoe- Recently a patient at Boxer Wachler Vision Institute Margret has a real story to tell. Margret was treated with Lasik in 2002 on the East coast and experienced many complications. The surgeons treating her could not give her an accurate diagnosis and disturbingly enough would not answer her many questions.

She then followed up with 2 corrective procedures in the left eye and 1 in the right eye in a 6 month time span. After which her vision improved for some 4 years. Recently she has experienced some disturbing complications. She has had distorted vision- the inability to read comfortably or focus on an image. After exhausting all her possibilities on the East coast Margret found Dr. Brian Boxer Wachler.

*Quote-

Margret says: “ They got me in right away, I saw Dr. boxer Wachler on a Monday and he gave me options.”Margret has currently undergone C3R. Or Corneal Collagen Crosslinking with Riboflavin. This procedure involves the application of drops on the epithelium, The drops are then activated by exposure to UV lights for about 30 minutes. The procedure is virtually painless and can slow down or stop the progression of Keratoconus.

Margret is very pleased with her services and has hope for a great recovery. Although it will take a few months for the full effectiveness of the procedure to kick in she has a positive new light she didn’t have before. We will keep you updated on her progression.

Understanding that Keratoconus is a progressive disease and causes stress on the patients should be important to your health care provider. The use of our vision is something we often take for granted until something like this happens. Although we learn the signs, symptoms, and treatment for Keratoconus the medical side of the disease is not the only area we need to manage.

As human beings we are emotional. Our feelings and emotions can play a big part, especially if the disease progresses and how we take care of our disease. Learning to cope with Keratoconus and not let it break us down in our daily life is equally important. We need to know how this can effect us at home and where to look for help.

Below are a few tips to help keep you focused and cope:

Tip 1: Remember we are not alone- There are several places that provide support Online and off to Keratoconus patients. The Keratoconusinserts.com is a great resource for ways to fix Keratoconus. The National Keratoconus Foundation provides lots of support and information on this disease. Also the Global Keratoconus Foundation provides support groups and activities to help Keratoconus patients. Turning to family and friends to support you and talk to you also helps relief the stress of this progressive disease.

Tip 2: Enjoy yourself- Spend some time pampering yourself. Doing the things you enjoy doing. If you aren’t as able to do the things you have always done…remember you can always try some new ones. Finding activities to occupy your time will help you focus on the happy times and deal with your situation with a clear mind….remember you must not dwell on what can’t be changed.

Tip 3: Participate in your treatment- One thing we take for granted is that we can be our own advocate. You can learn more about your options, ask questions, and decide who your doctor is going to be. The important thing is to make sure you are comfortable with them. That they have your best intentions at heart.

Know that you are not alone. That there is help for you and others going through the same things you are. Reach out for them…share your experiences you maybe able to ease someone else’s pain while you are at it. Keratoconus is progressive but there is help and remember to take it one day at a time!

Corneal Collagen Crosslinking with Riboflavin or (C3-R) is a relatively new treatment. In past decades surgeons would have to perform a corneal transplant to improve the vision of Keratoconus patients. Now they have developed a new treatment that helps strengthen the cornea and stop the damage that Keratoconus patients could suffer from this progressive disease.

The Treatment Application-

C3-R is directed under the epithelial cell layer. Located on the surface of the cornea. The surgeon will apply anesthesia drops on the surface of the eye. Then disrupt the epithelial cell layer. So the Riboflavin eye drops will penetrate the stromal portion of the cornea, which is the layer under the epithelium. The Riboflavin drops are then placed on the surface of the cornea.

A small UVA light is shone over the eye for about 30 minutes to activate the solution. The procedure is relatively comfortable if the epithelium layer is only disrupted rather than removed. Some surgeons removed the layer, which makes the first week of the procedure uncomfortable. Be sure to check with your doctor to see if they perform the epi-on or epi-off technique.

There are several benefits of Corneal Collagen Crosslinking below are a few:

Strengthens the cornea with less evasive procedures- The solution will improve the strength of the cornea over 3-6 months after treatment. It only requires a one time application. And there are less risks associated with C3-R as appose to corneal transplant.

Can be combined with INTACS to reverse damage to the cornea- C3-R treatment can be mixed with INTACS reduce the cone shape of the cornea. After the 3 year follow up doctors found that it stopped the increase of cornea curvature values and flattened the mean cone.

C3-R Stabilizes Progressive Ectasia- C3-R can give some relief from Progressive Ectasia. It has been proven to stabilize progressive Ectasia. While it is not a complete cure there are high hopes for further treatments of Ectasia.

The benefits of C3-R many. Surgeons are further studying and researching C3-R and INTACS. Without question medical sciences are growing rapidly. And each day we are improving the treatments for Keratoconus and other troubling diseases. There is no need to suffer with Keratoconus. Patients now have a wide array of treatments to help them with the progression of this condition.