For years researchers and Doctors have been looking for effective ways to treat patients with keratoconus. In the past the options were very slim with little hope for reversals or healing the corneas. Often patients had to receive corneal transplants to get relief from diseases like Keratoconus. However now they are finding new and less invasive ways to correct the progression of keratoconus.

Keratoconus is caused by free radicals which invade the eye and create a reactive species which break down and cause weakness. The weakness causes the cornea to herniate causing keratoconus. The progression is not over night but over years and the effects of keratoconus can be debilitating for the patient leading to blindness. In the beginning of the disease there are little symptoms and patients often overlook a problem. The condition often strikes one eye first later spreading to the second eye by the time a problem is detected.

Now there is a treatment called C3-R® which can strengthen the cornea in the places that are weakened and give the reverse effect of the damage done by keratoconus. The treatment is relatively easy with only 30 minutes to apply and the cornea is strengthened over the next 2-4 months. Many patients only need one application, while more severe cases may require two.

The use of C3-R® or Corneal Collagen Crosslinking with Riboflavin has been very effective in recent years and can give tremendous improvement to the patients vision. In addition to C3-R® the doctor can use Intacs, and/or CK to additionally improve the sight of the patient.

A few symptoms of Keratoconus are:

Itchy eyes

Excessive Rubbing

visual disturbances

visual discomfort

glare halo

squinting

seeing double

For more information on Keratoconus and its treatments visit: www.keratoconusinserts.com

Many of us deal with anxiety when it comes to our eyes. The patients at Boxer Wachler Vision Institute are no exception. The key is all in how they are treated. There is a big difference in with treatment of patients at Boxer Wachler Vision Institute and other vision centers.

Meet Dorothy McDonald a registered nurse who has had to use reading glasses for the better part of her life. She is an avid reader of her local newspaper as stated she was tired of reading it with her glasses and was ready for a change.

Deciding to get vision corrective surgery is not a decision to take lightly. However she decided it was time. Dorothy decided to have CK followed by C3-R in both eyes despite her concerns and anxiety. She shares that she enjoyed the presence of staff in the room with her and listening to their voices.

She had an “Anxiety Free” experience with the CK. However during her C3-R procedures Dorothy did experience some anxiety and the staff aided her by holding her hand, talking her through the procedure and with some medication to help her through.

Dorothy stated in an interview 24 hours after the procedure-

Quote:

“I woke up this morning to read the newspaper for the first time in 5 years without my glasses.”

While her procedures went well Dorothy tells anyone who is tired of wearing glasses to read to try the procedure. She says it is painless and a wonderful decision! For many of us we fight with the decision to have procedures done; especially if they are new. However the Boxer Wachler Vision Institute offers a caring and expert staff that go above and beyond to meet your needs-Just ask Dorothy!

Intacs provide a safe and non-invasive treatment for Keratoconus. While many keratoconus patients suffer with the need for RGP or Rigid Gas Permeable Lens they are often uncomfortable and have to be changed regularly. The use of Intacs provided the patient with a option they won’t feel and gives them the option of using soft lenses. For most patients with Keratoconus this is a great relief to the options they are using now. The Intacs are not irritating and they require no additional maintenance.

Intacs are tiny segments that are placed under the patients cornea. The procedure only takes around 10 minutes and provides almost immediate improvement. Glasses or soft contact lens are likely required after the procedure but there is a great improvement in the patients vision. For patients with mild keratoconus the results can give them improvement without use of corrective lens, or contacts after the procedure. The first Intacs reported world wide was by Dr. Joseph Colin MD. From France in 1999.

Keratoconus is a disturbing condition that continues progression of vision loss in the patients who suffer with it. For many years doctors have been trying to improve the vision of those suffering from Keratoconus. Recently Dr. Boxer Wachler has used the option of Intacs with C3-R® to improve the vision of his patients.

The C3-R® gives added strength to the cornea stopping the progression of Keratoconus and reversing the effects. While the Intacs improve the vision that has already been damaged. This method has been proven effective and safe for many patients. The long term effects show great improvement and add to the options of those suffering from Keratoconus and Keratoectasia. C3-R® or Corneal Collagen Crosslinking with Riboflavin is the application of a treatment called Riboflavin to the cornea. The medicine penetrates the cornea and strengthens the collagen fibers inside the cornea. The treatment takes about 30 minutes and is usually preformed after the Intac procedure to give better results.

Below are some signs of Keratoconus:

Multiple images-”Seeing Double”

Excessive eye rubbing

Sensitivity to Light

Seeing halos

Claims of “itchy eyes”

Keratoconus is common in ages 16-25 and develops in both eyes however it occurs in one eye first. The diagnosis of keratoconus is usually after both eyes are effected because it is not usually found until than.

Keratoectasia is a diagnosis of Keratoconus after Lasik surgery. Many times patients are improperly evaluated before Lasik and develop Keratoectasia after the procedure. For more information on Keratoconus causes, signs and treatment options visit: www.keratoconusinserts.com

Keratoconus is a disturbing disease that can hinder the lives of the sufferers greatly. For many years doctors have struggled to find the cause and prevention of vision loss in patients with keratoconus. Within the last decade advancements in vision correction have found an efficient treatment for the progression of vision loss in Keratoconus and Keratoectasia patients.

C3-R® or Collagen Crosslinking with Riboflavin has been proven to not only stabilize the vision loss in patients with keratoconus and Keratoectasia but essentially stop it. There have been many studies like: Stress-Strain Measurement, Thermal studies, and Enzyme Digestion studies had been performed with astonishing results. Human studies showed an increase in strength of corneas after treatment of 328.9 % and in pigs of 71.9%.

In 2003 Dr. Boxer Wachler performed the first C3-R® procedure in North America. To date 99% of patients have stabilized after only a single treatment. A few patients with severe Keratoconus and Keratoectasia have needed a second treatment before getting all the benefits.

C3-R® or Corneal Collagen Crosslinking with Riboflavin is a simple procedure done in the convenience of the office and takes about 30 minutes. A numbing solution is placed in the eye which contains the Riboflavin and a solution called Tetracaine. With the aid of the Tetracaine the Riboflavin can penetrate the cornea without removal of the Epithelium called the “Epi-on” procedure. The Epi-on procedure does not give the patient any pain during or after the procedure. Then an Ultra Violet Light is placed over the eye for 30 minutes to activate the Riboflavin.

There is some gritty feelings or Mild foreign body sensations, and haziness during the day of the procedure which clears up the next morning. The procedure in non-invasive and stops the progression of keratoconus effectively saving the vision of the patient.

Below are a few additional conditions and procedure that have shown benefits from C3-R®:

Combined with PRK to increase stability of vision

Stabilizes eye after RK

To find out more about Corneal Collagen Crosslinking with Riboflavin or C3-R® visit http://www.keratoconusinserts.com

When deciding to have Lasik surgery one must undergo a thorough evaluation to determine if you are a good candidate. There are some complications associated with Lasik surgery that can be avoided by careful testing prior to Lasik such as corneal mapping or Topography.

Keratoconus after Lasik known as Laser in situ Keratomileusis is a condition known as Keratoectasia. The occurrence of Keratoectasia after Lasik is .04-.6%. In 2004 over 50% of doctors reported at least one patient with this condition. Most instances occur in patients with Myopic Lasik or Lasik for nearsightedness.

Some risk factors before Lasik are:

Thin cornea

Young age with high prescription

Amount of myopia that is treated

Depth of treatment

Pre-operative inferior steepening on mapping

One of the biggest signs of risk to Keratoectasia after Lasik are patients with inferior steepening on the topography. Keratoectasia can also show up in patients with no risk factor and careful observation after Lasik is extremely important. All patients should have proper Corneal mapping & Evaluation before Lasik surgery or PK (photo-refractive Keratectomy).

PRK or Lasik permanently changes the shape of the anterior central cornea. The procedure is done with an excimer. Mostly preformed on myopic patients and it is said that 80% of the population are eligible for the procedure.

Some requirements are:

Normal Ocular Health

Age- 20 years plus

Optimal parameters are 1.5– 7.00 diopters of myopia

Pupil size of 6mm

Stable refraction error ( no change in the last year)

Corneal thickness greater than 450 microns.

Remember to get a thorough evaluation before any vision correction treatment this is important and be sure you understand all possible complications and a reasonable expectation of results.

One of the best ways to evaluate the cornea is through the use of Corneal Topography. There are various signs in the mapping that show the doctors signs of keratoconus and other progressive eye conditions. The topography can show irregular and steepening of the shape of the cornea. The normal cornea also has a 90 degree axes perpendicular in the cornea. In the normal cornea during corneal topographies there is a smooth and flat surface.

If the topography shows irregularities or steepening this is a sign that there are problems. Any irregularities in the cornea such as steepening and/or irregular shaping of the axies show signs of irregular astigmatisms. Raising questions for diagnosis of Keratoconus. When doctors check for Keratoconus in the Lasik evaluation they look for “ Inferior Steepening.” Corneal Astigmatism appears in the shape of a football compared to a normal cornea that is round and smooth.

Additionally Keratoconus is confused with Pellucid Marginal Degeneration or PMD. PMD was first discovered by an Ophthalmologist in 1957 named Dr. Schalaeppi. Pellucid Marginal Degeneration is a break down of the cornea creating a lobster claw pattern. PMD is also known as the peripheral form of keratoconus. While the disease is in the same family and similar there are some differentiating factors. When viewing in a corneal topography the PMD appears as a steepening from the outer margin of the cornea heading inwards and appearing to pinch the center.

Signs of Pellucid Marginal Degeneration:

No pain reported [compared to keratoconus]

Visual distortions

No vascularization of cornea

No scarring

Lobster Claw formation
In the end the best form of testing for Keratoconus is to have a baseline corneal topography, and regular testing annually. The treatments of keratoconus are advancing and progression of this disease can be treated successfully. Catching the condition early can give you a better result. Checking with your ophthalmologist and getting regular checkups is a must.

Keratoconus is a non-inflammatory degenerative eye disease. Keratoconus causes damage to the collagen fibers in the cornea causing them to grow weak. When it reaches a weak enough point in the fiber it bulges up like that of a hernia. Keratoconus causes irregular astigmatism, steeping of the cornea, and vision loss in the cornea. This significantly affects the patient’s daily life. Giving them grief when driving, reading and often completing day to day activities.

Vision loss can be mild to severe in one or both eyes. Keratoconus is diagnosed in 54.5 people out of every 100,000 in the general population. However the concentration of diagnosed patients being evaluated for Lasik is much higher, because people with keratoconus often seek Lasik to correct their poor vision. Lasik surgery is not an efficient treatment for those with Keratoconus due to its underlying risks for complications and high incidences of causing a rapid progression of the condition necessitating more surgery even possibly the need for a cornea transplant.

Many vision correction surgeons use corneal topography to map the eyes before treatment. This gives them a better view of the corneas of each patient. They use the mapping of both eyes to compare the changes and differences. The patients must be mapped in both eyes because is useful to detect and stage keratoconus this way. Over 90% of patients with keratoconus are affected in both eyes and over 6% are affected in one eye only. Keratoconus often strikes patients in one eye first and spreads to the other. However by the time the patient is diagnosed often the Keratoconus have affected both eyes.

If patients are not properly diagnosed before Lasik they can develop Lasik-induced Keratoconus or Keratoectasia. There are many symptoms of Keratoconus and proper evaluation of eyes regularly is best to catch Keratoconus or other vision problems early.

Below is a list of symptoms of keratoconus:

Glare and/or light sensitivity

Frequent prescription changes

progressive nearsightedness

irregular astigmatism

High amounts of Astigmatism

inferior steeping on corneal color mapping (topography)-red spots on mapping

It is wise to check with your eye doctor if you feel you have more serious case. Additionally finding someone who is familiar with early signs of Keratoconus is also wise as some doctors may not be familiar with them. Taking care of your eyes and vision is always a wise decision. Educating yourself can help you rule out issues in the future. Always consult your eye doctor if there are changes in your vision.

Keratoconus is a frustrating disease. It effects the lives of the patients significantly and understanding the cause can often help us understand the disease. Here are a few under laying causes of Keratoconus that can help you get started.

Genetics: Though genetics plays a part in keratoconus so does the environment. Keratoconus in a family typically effects more then one family member. The chances of keratoconus is higher in first degree relatives however it is unlikely that one will pass keratoconus to their children. There is only a 6% chance that the disease can be passed from parent to children. However there are precautions you can take to catch keratoconus in your children early. Treatments are available to help stop the progression of early keratoconus.

Generally at the ages of 8-10 a baseline mapping of the eyes or a Topography can be taken. Additional topography’s can be taken each year after to compare results. If changes are found steps to stop the progression can be made before the problem increases.

Free Radicals: Free radicals are the byproducts of the cell metabolism. Unfortunately most of our bodies tissues create byproducts and our bodies defend against them daily. There is a barrier or wall that protects against damage to your corneal fibers by the byproducts called anti-oxidants. Keratoconus develops because the anti-oxidants are not working properly to protect the cornea against the byproducts. The collagen fibers in the cornea are attacked by the byproducts breaking down the fibers like a hammer on a brick wall. As the fibers weaken you develop a bulge in the cornea that creates vision changes, and other complications.

Keratoconus generally develops slowly over time and if you are evaluated properly the damage can be minimal. With treatment of C3-R® you can help stop its progression and strengthen the collagen fibers in the cornea. It is important to find a doctor who is familiar with early stage keratoconus and obtain treatment before it gets too bad. With the new technologies and mapping you can keep ahead of the disease.

The stories of those with Keratoconus are many. Each journey of the patients is important to us all. It shapes what we know and makes us who we become. Learning each story takes time but can be done one patient at a time. The story of Kenny Atkins is one of frustration, struggle, and venture as he was a big addition to new procedures in Keratoconus. Something many of us know and suffer.

Kenny Atkins was the first patient in the United States to have the Intac procedure done on a someone with Keratoconus. This decision is not one made lightly and many of us struggle with this decision after many procedures have been done. The courage of Kenny Atkins should be remembered by us all.

This post is dedicated to him-

Kenny Atkins was a Ocean Lifeguard who struggled with his vision.

“At school I found it harder to focus on textbooks. I thought it was just the chlorine from the pool. I had my eyes checked and I was diagnosed with Astigmatism in my eye.” said Kenny.

Kenny goes on to describe the complications he had while lifeguarding.

“By late afternoon I would see double images of objects far away”. The frustration he endured using traditional vision correction contact lenses and prescription sunglasses made it difficult for Kenny to continue to do his job properly.

In 1999 Kenny heard of the new procedure of Intacs for patients with Keratoconus by Dr. Boxer Wachler and despite the fact that it had not been tested on a patient with Keratoconus Kenny felt it was worth it.

After the successful procedure Kenny started showing improvement in his eye right away and only a week afterwards he had almost equal vision in both eyes.

“It has now been eight years since I had Intacs and I still do not wear corrective lenses, I am able to pick objects out of the glare on the horizon and street signs before I need to turn.”

Kenny Atkins has opened the gate way for many other sufferers of Keratoconus. He is one of great courage and a model for us all. Kenny says:

“I can now appreciate the saying- Nothing Ventured Nothing Gained”

 For more information on Keratoconus visit: http://www.keratoconusinserts.com

The importance of vision correction to many is a important issue. Many however value greatly the precious vision they have and understand there is often risk associated with making some improvements. That is why Lynn Murphy decided to delay her procedure by a few years. Although Lynn has had issues with her vision since grade school she often worried about the advancement of the vision correction procedures like most patients do.

This created a delay in her care. Unfortunately this is often a common story. When she was interested in looking into the procedures she consulted her physician on the best surgeon to undergo the treatment. That is when Boxer Wachler Vision Institute took hold.

Lynn’s treatment went well. Correcting her 20/200 vision too 20/20 in one eye and the use of mere reading glasses for endeavors of the other. She was very pleased with the outcome and was able to see almost immediately. The truth is many Lasik procedures are shied away from simply because the patient is misinformed of the proper procedure for them. It is important that you ensure you have a good surgeon, a thorough exam, and are a good candidate for the procedure before moving forward. This will help prevent any complications after the procedure.

Lynn Murphy is doing incredible now and enjoying her new found vision. She says that:

“It was absolutely one of the best things I ever did in my life” despite her former skepticism.

Stating that her only regret was not having it done soon! Another happy patient. Vision correction though scaring can be life changing for many. The staff at The Boxer Wachler Vision Institute are taking vision care one patient at a time.