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Merged Keratoconus thread

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Merged Keratoconus thread

Old 21st Nov 2000, 14:07
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GulfStreamV
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Merged Keratoconus thread

Nav1,

Found it! - Disregard above nonsense...

Keratoconus, also known as Conical Cornea, is a non-inflammatory condition of the cornea in which there is progressive central thinning of the cornea changing it from dome-shaped to cone-shaped. Keratoconus comes from the Greek word meaning Conical Cornea (Cone shaped- Cornea). The cornea is the clear windshield of the eye and is responsible for refracting most of the light coming into the eye. Therefore, abnormalities of the cornea can severely affect the way we see the world, including simple tasks such as: driving, watching TV, or reading a book.

Keratoconus is not a blinding disorder, per se, but does result in a greatly increasing near-sightedness (things far away are out of focus) and irregular astigmatism (things look tilted) that can significantly distort your vision.

It is almost always bilateral (affecting both eyes). It is a slowly progressive disorder, taking years to develop, and may halt at any stage from mild to severe.

Check out:-
http://www.kcenter.org/Keratoconus/w...ratoconus.html


Good luck

GV
 
Old 2nd Jan 2001, 10:42
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BadMan
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Angry Eye Surgery

Be greeted fellow aviators.

You think bad vision is a problem, try this a year ago I had a corneal transplant and have been grounded since.19 december 1999 ! The doctors and the medical board keep inventing new excuses to keep me on the ground. After all if they say I should go and fly again and I wipe out a mountain it it is their danglies on the block. Is there any body with a similar problem or with any advice ?
By the way I am a Keratoconus sufferer for the last 9 years.
 
Old 5th Apr 2001, 17:18
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4 & 5 year post op patients are now returning in worrying numbers to laser clinics across Europe and the US. One of the main areas of concern is corneal ectasia developing into keratoconus. Ther are many others such as the incidence of scleral and retinal detachments due to the high vacuums required for the micro-keratomes to cut the corneal flap.

My remarks are based on fact. Numerous papers have been presented on subjects such as these at national and international ophthalmological meetings.

The procedure is non-reversible and carries serious potential risks. This is my point. The decision to undergo refractive surgery should not be made lightly. Many patients have enjoyed tremendous results, but the long term effects are not thoroughly understood and do not let anybody tell you otherwise.

Best regards
 
Old 7th Apr 2001, 12:14
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Rogaine addict
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Cool

Blindside: You do sound very knowledgable on the subject so I checked your profile, no occupation listed. Optometrist? opthamologist? I did pose the question of higher incidence of corneal extasia and keratokonus for LASIK/PRK patients vs. general public to the National Keratoconus Foundation (NKCF). I'll share their reply when I receive it. RA
 
Old 27th Nov 2001, 03:24
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Probably the best advice at the moment is to wait. A new proceedure is in development that will probably do away with most laser techniques. It is called corneaplasty and according to the Doc who is developing it, the final product will involve using eye drops to soften the cornea then a special hard contact lens to reshape the cornea and finally another set of eyedrops to return the cornea to its original firmness.

Here I have copied more detailed info.
What is Corneaplasty
Corneaplasty, is a non-surgical procedure that changes the shape of the cornea (the front part of the eye) using modern Ortho-K contact lenses as corneal molds, in conjunction with certain medications to prepare and final-set the cornea. This is a mechanico-chemical procedure.
Corneaplastytm is essentially a 3-step process. First, the cornea is “prepared” by applying a proprietary (ACS-005 enz) concentration of the human enzyme, hyaluronidase, which absorbs into the cornea, making it softer and more “malleable” for a period of time, says Hampar Karageozian, senior vice president of research and development at Advanced Corneal Systems. The drug temporarily alters the molecular bonds between proteoglycan molecules in the cornea. This enzyme has a long history of safe use in ophthalmic (eye-related) and other applications. Second, the “prepared” cornea is then molded to the desired shape with custom fitted AOK contact lenses worn during the treatment period. Thirdly, a proprietary cross-linking agent “fixative” drop is administered to “set” the cornea in its optimum shape. It effectively “glues” the collagen fibrils until they re-grout naturally.

Moreover, the procedure is reversible, i.e. it can return the cornea to its pre-altered state if desired; and, it (the cornea) is alterable indefinitely throughout life, so the procedure is repeatable. You can “fix,” “reverse” or “alter.” There is no ablation or cutting of tissue. There is only a bending of the cornea and a migration of corneal epithelium.

The term “Corneaplasty,” as determined by the U.S. Department Of Commerce Patent And Trademark Office, is merely a conjunction of the two descriptive words, “cornea” and “plasty.” Corneaplastytm (both REFRACTIVE CORNEAPLASTYtm and THERAPEUTIC CORNEAPLASTY), are marks sought after by the founding company, Advanced Corneal Systems, and are defined as follows:

REFRACTIVE CORNEAPLASTY: Goods and services to non-surgically change the deficient vision in a healthy eye by changing the shape of the cornea in individuals suffering from refractive error including myopia, hyperopia and astigmatism.

THERAPEUTIC CORNEAPLASTY: Goods and services to non-surgically change the shape of a damaged or diseased eye in individuals suffering from optic diseases such as ocular herpes, keratoconus, or extreme astigmatism resulting from corneal transplant surgery or cataract surgery.

The Attorney for the Trademark Trial and Appeal Board (T.T.A.B.) contends that the word “refractive” is a descriptive adjective that refers to correcting refractive errors of the human cornea. The applicant’s (ACS, Inc.) “pharmaceutical preparations” have a refractive purpose, because they are used to correct refractive errors of the eyes. So, for now, we have a new non-surgical category of refractive correction, know as “corneaplastytm,” which may or may not undergo a future semantic change.

The Procedure:

This is the probable case scenario.

The treatment period lasts approximately 2 weeks with 5–7 patient visits.

Day 0: Patient examined, then trial fit with AOK lenses, then enzyme administered and patient sent home.

Day 1-3, or when cornea is prepared: Patient returns and lenses are dispensed. This procedure will most likely be a Nightwear, End Result Ortho-k (NERO, a term coined by Roger Tabb, O.D.) or worn daytime and removed at night. Expect 4-5 diopters change from 8 hours to a few days. 1-3 diopters can change in a matter of hours.

Day 4-10: Stabilizing drops or gel is administered by the patient QID (4 times a day) in conjunction with a custom contact lens retainer.

Day 11-14: D/C stabilizing drops and lenses when stroma is altered and “set” to new desired contour.

Since the procedure deals with altering the stroma, greater degrees of refractive change are possible, as compared to Ortho-K, which only deals with about a 50 micron layer of epithelium.

The procedure can apparently be repeated, if necessary, throughout one's lifetime of refractive changes, without any damage done to the cornea. The tissue is said to remain pristine, as the hyaluronidase only temporarily alters proteoglycen bonds between the lamellae to soften the tissue, and does not actually affect the collagen lamellae themselves.

Who started Corneaplastytm?
Corneaplastytm is the brainchild of Advanced Corneal Systems (renamed ISTA Pharmaceuticals, Inc. in July 2000), Irvine, CA 92618; (949) 788-6000; (949) 788-6010 fax., the proprietary company seeking patents and marks initiated circa 1994. Introduced to the international community, circa 1995, lectures by Ortho-K pioneers such as Don Harris, OD, Charles May, OD and Stuart Grant, OD, presented materials and unpublished information at UAB and NERF conferences. At that time, mathematical functions for corneal molding, including tear layer plots, design comparisons, and computational methods were also discussed by such notable optometrists as Jim Day, Roger Tabb, the Roger Kame, and Joe Barr.

Where Is The FDA Investigational Status?
In the off-shore clinical trials that started in January 1994, phase I and II have been completed in 1997 and 1998 and yielded exceptionally good results. Expected in the first quarter of 2000, large scale clinical studies will enter 3rd phase in US and so far, right on track. Optimum lens design as well as dose/response studies are ongoing. A new stabilizing agent has been added to the trials that dramatically shorten the time from months to weeks to stabilize the cornea after it has been reshaped. Reducing the recovery time should also limit noncompliance.

When Will Corneaplastytm Be Available?
The large pharmaceutical company, Sandoz, is helping Advanced Corneal Systems, through the FDA clinicals. They expect approval (from what I have been led to believe) within a year or two. They are also working on an alternative drug delivery systems such as a "needle patch," to try and keep this procedure totally within the scope of optometry.

Why is Corneaplasty So Significant?
Extremely low complication rate, especially when compared to refractive Surgery. Corneaplasty is a Non invasive, non-surgical, procedure. The cornea is never cut and no tissue is ablated. There is no pain, no risk of infection, haze, starbursts, double vision, glare, ghosting, etc. associated with laser or other refractive surgeries. Anthony B. Nesburn, MD, director of Ophthalmology Research Laboratories at Ceders-Sinai Medical Center and clinical professor of ophthalmology, Jules Stein Eye Institute, University of California, states, “The beauty of this technique is that Bowman’s layer remains intact.” His studies indicated that the collagen fibrils themselves are untouched, just the substance that holds them together is affected. Nesburn added that the clarity of the cornea is unchanged pre- to post-treatment.

An additional noteworthy benefit is that the new corneal surface is more pristine than ever before. That is to say that the corneal molding smoothes out the natural anatomical undulations found on the cornea and facilitates an improvement in VA to 20/10ths (i.e. two lines better than 20/20) in some cases. The treatment zone with Corneaplasty is bigger and better than LASIK.

How Much Will This Procedure Cost?

The cost for this procedure is significantly less that LASIK and PRK because there are no laser, facility or royalty costs. However, just like all new procedures, the cost will be in line with what the free market allows. It will probably range from $750.00 to $1,250.00 per eye to begin with, roughly half the cost of LASIK. Enhancements and further alterations will carry modified fee schedules.

The major deterrent to LASIK is both cost and fear related. Corneaplasty is safe, effective and relatively inexpensive. It is destined to become more main stream than the invasive surgeries existing now. As it becomes more commodity-like and delivered in a more ubiquitous fashion, costs will seek a lower level.
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Old 21st Mar 2002, 02:38
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Arrow

don't rub your eyes too much ..it could distort the cornea and distort vision by causing a condition called keratoconus.
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Old 10th Apr 2002, 23:56
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Wink

in myopia , your eye balls is longer than usual so things are out of focus. but mypoia is generally stable .
keratoconus is weakeness of the cornea of the eye ..and the cornea being thin bulges and becomes irregular. ...the cornea is the clear window that you see outermost in the eye...... or rather , becoz it is transparent ..you don't see !
the problem with keratoconus is that it may progress. it behaves differently in people . in most in progresses and then stops ...but in some it goes on progressing.
many can be corected with contact lenses , but some will need a corneal transplant.

you can join some of these friendly email discussion groups dealing with keratoconus:

http://groups.yahoo.com/group/keratoconics/


or send an email to these friendly and focussed groups .... each dealing with an specific aspect of keratoconus ...

[email protected]

[email protected]

[email protected]

Last edited by gas_man; 10th Apr 2002 at 23:58.
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Old 11th Apr 2002, 00:05
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keratoconus resources

if you have keratoconus ....some places to visit ....



http://groups.yahoo.com/group/keratoconics/


or send an email to these friendly and focussed email discusion groups .... each dealing with an specific aspect of keratoconus ...

[email protected]

[email protected]

[email protected]
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Old 29th Jul 2002, 20:42
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Sorry but have to ask !

I know this has come up before, but the search did not come up with anything conclusive.

Basically I have today been told that I have a mild form of Keratoconus in my left eye, which can be corrected by wearing contact lens. Can anyone please shed any light as to how this will affect my current medical 1 status.

Your help and advice will be appreciated

ox
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Old 9th Dec 2002, 09:50
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gas_man, did you get your licence back.

I am an ATCO that needs this treatment following 13 years of keratoconus.
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Old 11th May 2005, 15:29
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Keratinous / Keratoconus

Hi there!

Is there a chance to pass the medical with this eye disorder? (FAA or even JAA)?

Last edited by Ka8 Flyer; 11th May 2005 at 17:56.
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Old 23rd Dec 2005, 18:25
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I found this on the CAA website,

The proposed changes are that:

Refractive error limits for class 1 initials – will become +5 to –6 dioptres.

Refractive error limits for class 2 initials – will become +5 to –8 dioptres.


Near esophoria limit for class 1 initials - will become 8 dioptres.

Keratoconus for all classes - will no longer be disqualifying for initial class 1 if the applicant meets the visual acuity requirements. Additionally at revalidation/renewal the frequency of follow-up will be at the discretion of the AMS.

Visual field defect for all classes – applicants may be considered fit if the binocular field is normal.

Ambylopia - The visual acuity in the other non-amblyopic eye should be 6/6 with or without correction. (Previously the 6/6 acuity had to be achieved without correction)
http://www.caa.co.uk/default.aspx?ca...90&pageid=4764

Yet to be approved I presume but a step in the right direction
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Old 24th Mar 2006, 22:35
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KERATOCONUS

I am in my late 20's and fly for a major U.S. airline. I recently was diagnosed with mild-advanced Keratoconus. I was fitted for RGP (Gas Permeable) contacts, but could not tolerate those when duty days were between 10 - 15 hours. I opted to have whats called the intacs procedure and my vision although not a whole lot better has improved and now I am able to wear soft contact lenses. This condition is rare and it happens to 1 out of every 2000 people. Just curious to see if any one else is in this elite club, and would like to share their thoughts.
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Old 5th Mar 2007, 16:18
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Keratoconus

Hello all,

I am 26 years of age and an Air Traffic Controller. I have keratoconus in both eyes for the past 7 years approx. I don't wear correcting lenses and the condition is relatively stable. I am wondering if there is anyone out there who has this condition and is either a pilot or controller. I would be very interested to know your experience with medicals etc.

Many thanks
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Old 4th May 2007, 16:09
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The dreaded "K" (keratoconus)

Hi all,

I am 27 years of age...an air traffic controller and have keratoconus for the past 7 years. I don't wear correcting lenses, however, i do have my medical at the end of the month and may be asked to get some!! I am waiting to go to Germany for Crosslinking treatment to stop the progression. I am desperately trying to find someone who has this eye condition so as I can get their experience of it as eithera controller or pilot.

Many thanks
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Old 10th May 2007, 22:33
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I had keratoconus - successfully treated, although that was back in the early eighties. I have PM'd you.

(PS: I'm not a controller or a qualified pilot - although I've had some lessons recently - but it's quite a rare condition, so you might not find anyone with it who is...)

Last edited by Blues&twos; 10th May 2007 at 22:54.
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Old 14th May 2007, 17:31
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Hello, I also have been suffering from keratoconus and I am a pilot. I pretty much have given up on flying because I could only get 20/25 to20/30 in my left eye. I also am desperately seeking advice as far as what can I do to have this condition under control. I just have had the C3R treatment (collagen crosslinking) done about 4 months ago. I was also fitted with RGP lenses about a few days ago and my right eye was just fine with 20/20, even reading most of the letters from the 20/15 line. But my left eye just will not give up. The best result that I am currently able to achieve is 20/25 in my left eye and that’s with missing a few letters. Could you also PM me or email me at [email protected] as far as what can I do to get 20/20 in each eye. THANKS a BUNCH
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Old 17th May 2007, 06:40
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Hello, I am a pilot and I also have been suffering from keratoconus. I wear a correcting lense on my right eye althought I usually don't wear it because I wear it with difficulty. What is the C3R treatment ? Does it give good results ? Is this treatment allowed by a civil aviation authority ?
I intend to convert my ICAO commercial licence into JAR licence (British CAA). Did someone experience a class 1 medical check in CAA with a keratoconus ?

Many thanks
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Old 18th Jul 2007, 19:22
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cross linking for Keratoconus

Hello Everyone:

I have recently been diagnosed with Keratoconus so you are certainly not alone guys! I have discussed the possibility of undergoing collagen cross-linking (C3-R) with my ophthalmologist. After doing a full set examinations, she thinks that I could be a very good candidate for this treatment especially as the corneas in both of my eyes still have enough thickness. I am in real need of feedback from those of you who have had this treatment and/or recommendations for a specialist in cross-linking who I can go to. As I am pressed for time (my health insurance expires soon) I would appreciate feedback from anyone as I need to have the treatment done as soon as possible. Many thanks in advance!
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Old 19th Jul 2007, 17:53
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collagen corsslinking for keratoconus

Hello Everyone:

I have recently been diagnosed with Keratoconus so you are certainly not alone guys! I have discussed the possibility of undergoing collagen cross-linking (C3-R) with my ophthalmologist. After doing a full set examinations, she thinks that I could be a very good candidate for this treatment especially as the corneas in both of my eyes still have enough thickness. I am in real need of feedback from those of you who have had this treatment and/or recommendations for a specialist in cross-linking who I can go to. As I am pressed for time (my health insurance expires soon) I would appreciate feedback from anyone as I need to have the treatment done as soon as possible. Many thanks in advance!
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