I saw my former ophthalmologist today for a corneal topography, which is the gold standard in diagnosing keratoconus (KC). My optometrist had diagnosed me with the disease on July 13, 2012, roughly 9 months after my vision started to fail. That was a Friday, so I suggest not going to a doctor on Friday the 13th.
General information on keratoconus can be found here.
My ophthalmologist is a corneal specialist and I feel comfortable putting my eyes in his hands, so to speak. I only wish I had not been shifted around in his practice, as I feel I would have gotten a diagnosis earlier and before my vision progressed to its current state. I ended up seeing him after killing myself—body and eyes—doing online research non-stop following the initial diagnosis last month. Forget the worst-case scenarios out there unless you have advanced KC. I discovered a procedure known as corneal collagen cross-linking (CXL) that is awaiting FDA-approval in the U.S.
CXL is approved everywhere but the U.S., per usual. This procedure stops the progression of keratoconus by strengthening the cornea and has been available in the EU (European Union) since 2007. After I discovered this, I had to find a way to get the procedure without flying to Europe since disability does not allow for the jet-set lifestyle. I scoured the internet and came upon some posts from people who were getting the procedure via clinical trials. I figured I would have to go to L.A., but to my surprise my former ophthalmologist was participating in a clinical trial and my prayers were answered.
If you are searching for a clinical trial for CXL near you, the U.S. government site is here.
So, today I not only went in for the official diagnosis, but also for the screening process to see if I am a candidate for the trial. I should also mention that since this is a treatment trial, there is a charge of $2,500 per eye, but each trial is different it appears. Well, what are my options really? The other bad news is that my doctor is not sure if I am a candidate as they still do not have clear exclusionary guidelines from the FDA, but he thinks my chances of being approved are at about 80%. There is a waiting period of 45 days per the guidelines and considering the fact that my vision is progressing for the worse so rapidly, we have decided to do the CXL—if I am approved—on my worse eye and I will be getting surgically implanted rings (2 semi-circles) called Intacs in my better eye. This will flatten my cornea and allow me to have better vision with glasses for now.
Due to my insurance, I need to fail a pair of contact lenses before I will be approved for Intacs surgery. So, I go back to the optometrist later this week to get fitted for contact lenses and then next week I see my ophthalmologist’s optometrist to get measured for Intacs.
If all goes well after I fail the contact lenses—my severely dry eyes will make me toss them in a day, the plan is to get CXL in the better eye after FDA-approval as Intacs will disqualify that eye from the trial. In other words, I will get CXL in my right (worse) eye to stop the progression and Intacs in my left (better) eye to improve my vision temporarily until I can get CXL in that eye once it is approved, covered by insurance, and the trial restrictions are a none-issue. If you are confused, so am I, but the bottom line is that I should be getting Intacs in my left eye within a month if I can get through the insurance loopholes in a timely manner.