What Caused Your Keratoconus?

Genetics

The frequency of keratoconus in first degree relatives having the disease is much higher than the general population. Keratoconus can also be associated with other systemic syndromes such as Down’s syndrome.

The good news is that keratoconus is often not passed to children. If you have or may have children in the future, it’s only a 6% likelihood that any of your children will inherit keratoconus.

It makes sense to have your children have a baseline corneal topography between ages of 8-10 years old and have a topography every year. The subsequent topography maps can be compared to the first one to catch keratoconus early if it will be occurring. Early keratoconus can easily be “nipped in the bud” with a C3-R® treatment before it gets worse.

Quote:

“It seems that both environment and genetics play a role in Keratoconus”

-Says Dr. Brian S. Boxer Wachler, MD.

Free Radicals

All corneas, like any tissues in the body, create harmful byproducts (free radicals) of cell metabolism (metabolism is a fancy word for the activities of the cell required for it to live and do it’s thing). These byproducts are similar to a car’s exhaust that results from the car being driven. Normal corneas, like any other body tissue, have a defense system in place to neutralize the free radicals so they don’t damage the collagen.

The collagen is the equivalent of steel beams that support a building. Damage to those beams causes the building to tilt, just like damage to the collagen causes the cornea to bulge. Think of those free radicals as attacking your collagen fibers in the cornea, trying to thin it and weaken it.

The problem with keratoconus is that anti-free radical system in the cornea (called anti-oxidants) are not properly working, so the free radicals are allowed to overwhelm and wreak havoc on the collagen fibers. They bombard the cornea like mortar fire blasting into a brick wall. The free radicals damage the cornea, thin it, and ultimately allow it to bulge and steepen out. This is how your vision got worse from keratoconus.

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For more information about keratoconus visit the American Keratoconus Association

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Bobsled Driver Sees Better Things Ahead

Bobsledder- Steven Holcomb has a lot to say in this article from USA Today Written by Tim Reynolds…

———————————————————–

Bobsledder Steven Holcomb was speeding down the icy track for a preseason training run a few weeks ago, when a piece of duct tape tore off the chassis and whizzed past his helmet. His teammates weren’t bothered. They’d seen it happen dozens of times. Holcomb, though, was spooked. Until then, he’d never seen that before.

In a sport that demands razor-sharp hand-eye coordination, Holcomb excels even with a degenerative eye disease called keratoconus that makes reading a challenge – say nothing for steering a bobsled in a snowstorm. “Sometimes, I really didn’t see all that much out there,” he said.

Given his success, that’s hard to believe. Holcomb is a national champion, a World Cup star and was the top American driver at the 2006 Turin games. He navigates slippery tracks at 80 mph in a sport where tiny mistakes can lead to disaster. Yet he did all that with vision so blurry that he couldn’t read the big “E” atop an eye chart from more than 6 feet away. A $15,000 procedure may have saved Holcomb’s vision – plus could nudge him closer to gold in Vancouver in 2010.

“If he was in the top five in the world before, I wouldn’t be surprised if he’s soon to be the top in the world,” said Dr. Brian Boxer Wachler of Beverly Hills, Calif., the corneal surgeon who developed the procedure that Holcomb underwent, Holcomb would love to see that.

Keratoconus causes the cornea to bulge outward, causing blurred vision. In some mild cases, glasses or contacts can be the answer. In Holcomb’s case, neither did the trick. Lasik didn’t work, either; Holcomb tried that in 2000, but was back in glasses within a year. So after last season, he decided he’d either find a solution or retire.

“They couldn’t make contacts strong enough for me anymore,” Holcomb said. “And since it’s a progressive disease, I had to get a new prescription, a stronger prescription, every three months. Finally they said, ‘You know, we can’t make them any stronger.’ So it was the end. For a while, I thought it was the end.”

U.S. bobsled coach Brian Shimer didn’t want to see that happen. He researched options, found Boxer Wachler, and sent Holcomb to California to meet the doctor. Holcomb was deemed a candidate for Visian ICL, or Implantable Collamer Lens, a 9-minute surgery where a contact is embedded behind the iris. It’s permanent, and so far, it’s worked for Holcomb.

His vision, once as bad as 20-1000 – which gets defined as “profound visual impairment” – is now close to perfect. He sees things on tracks that he never knew were there before.

“I was part of the FDA approval study for it,” Holcomb said. “I couldn’t wear contacts the day of the surgery, so they literally had to walk me around the room. And then they did it, I got up, and just like that, I was 20-20. It’s incredible. I call it an eye-opening experience.” Pun intended, of course.

Holcomb didn’t just suffer from keratoconus, but also was extremely nearsighted. So Boxer Wachler – who has performed similar procedures before live on national television, plus has worked with other athletes, most notably Los Angeles Lakers’ guard Derek Fisher – began the process by having Holcomb undergo what’s called C3-R, something that strengthens the anchors within the cornea and minimizes the bulging effect.

It’s relatively new technology and isn’t offered by many eye doctors yet. Boxer Wachler is considered the pioneer in this sort of work. “We’ve been doing this for five years,” Boxer Wachler said. “It’s not experimental for us. We call it an off-label procedure.”

But because of the costs involved, Holcomb almost decided not to undergo any procedure. Holcomb isn’t a rich man, by any stretch of the imagination. Bobsledders don’t get into their sport for money; it’s rare to find a sled that turns a profit at the end of a season, no matter how many races a team wins in a given year. The technology is costly, the perks are few, and when Holcomb was told how much Visian ICL would cost, he initially balked at going forward.

“It was every amount of prize money I’d ever won,” Holcomb said. “So the U.S. Bobsled Federation stepped up and donated and now I hope they can collect on it.” That shouldn’t be a problem.

When the World Cup season starts in Germany in a few weeks, Holcomb will be among the favorites once again. He ended last season ranked fourth among drivers in two- and four-man bobsled, and now with his vision no longer a stressful issue, he can’t see any reason why he shouldn’t improve on the track.

Now that I can see, things are starting to click,” Holcomb said. “I already could feel out there on the track. It’s like putting a face to a name now. My eyes don’t hurt. My head doesn’t hurt. Before, I couldn’t do anything. I couldn’t even play catch before. Someone would throw me something and it’d hit me in the face. Now I can focus on what’s important out there.”

To learn more on Keratoconus visit the American Academy of Opthamology

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For more information about keratoconus visit the American Keratoconus Association

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True Testimonials: Seeing Through the Haze~ Meet Catherine Bally

Catherine has struggled for many years with the deterioration of her vision. As most Keratoconus patients do she has had a number of different corrective eye wear including Hard contacts which are many times difficult to handle creating irritation to the eyes, pain and discomfort – to having soft contacts that still don’t provide her with adequate vision.

Catherine started wearing the Hard contacts as a teen has suffered still with the problems of vision disturbances. Her Keratoconus had created a haze over things she saw making it difficult to see clear enough to make turns and walk down and up stairways while walking. Sometimes getting help with walking from her teenage children.

Catherine has gone to several ophthalmologists over the years. Receiving the same answer “We don’t know how to improve your vision.” Some requested she get a cornea transplant that even see considered but doctors were hesitant to perform. Recently Catherine did a search on treatments for Keratoconus and found Dr. Boxer Wachler.

She discovered that there were treatments that could help her with her severe nearsightedness and progressive Keratoconus. She immediately had an evaluation. Dr. Boxer Wachler performed 3 Treatments on Catherine’s eyes giving her remarkable results. In just 24 hours she stated:

Quote:

“For the first time in my life ever I can see things Clear”

Catherine is walking down the stairs without fear of falling, bending corners, and has the freedom of living a normal life again. Although see still wears glasses Catherine is very grateful for the procedures she received and to Dr. Boxer Wachler who gave her what see always dreamed…vision.

The procedures performed on Catherine where Intacs, C3-R®, and CK. These procedures can stop the progression of Keratoconus and help reverse the damage of Keratoconus on the eyes. Catherine had severe damage to her eyes so she still will need corrective lenses but her vision has improved drastically. The procedure affects each patient differently depending on the severity of the Keratoconus.

For more information about keratoconus visit the American Keratoconus Association

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True Testimonials: Anxiety Free Vision Correction~ Meeting Dorothy McDonald

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!

For more information about keratoconus visit the American Keratoconus Association

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Mapping Your Eyes: Topography & Keratoconus

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.

For more information about Pellucid Marginal Degeneration visit the American Academy of Opthamology

For more information about keratoconus visit the American Keratoconus Association

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Describing Keratoconus

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.

For more information about keratoconus visit the American Keratoconus Association

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“Nothing Ventured Nothing Gained” Seeing Through the Eyes of Kenny Atkins

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 to be the first 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 about keratoconus visit the American Keratoconus Association

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Our Eyes and How Keratoconus Affects Them

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.

For more information about keratoconus visit the American Keratoconus Association

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True Testimonials: Meeting Steve Zier

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 and decided to give him 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.

For more information about keratoconus visit the American Keratoconus Association

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Living with Keratoconus

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.kcsupport.org

KC Support- Gives assistance to patients with keratoconus

www.AmKCa.org

American Keratoconus Association – 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!

For more information about keratoconus visit the American Keratoconus Association

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         ©2019 BOXER WACHLER VISION INSTITUTE OF BEVERLY HILLS. 465 N. Roxbury Drive, Suite 902, Beverly Hills, CA 90210.                          Call: 310.594.5210  Or   Text: 424.666.8454  ALL RIGHTS RESERVED. email: info@boxerwachler.com.

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