l'm medical student with keratoconus help me plz

[musa fares]

hi, am a 22 year-old man. l feel greatful to join u and to know such a website. lts really my pleasure to share u and find someones who care.
l have so many problems and questions to say so am so sorry for saying it all.
first of all l have to say am really get frustrated and feel depressed when l first knew about my keratoconus.l was wearing my glasses for about 5 years and i only recently discovered that l have keratoconus.
i am a 5th year medical student and this is the big issue.l was thinking that my vision is reduced like any other people so l was only changing my glasses every then and now without knowing the reason.
in that 5 years in medical school i was thinking that l have astigmatism only because l didn't know any thing about keratoconus.
only about 2 weeks ago l discovered tha l have keratoconus just after when l finish my ophthalmology course.
when l was practicing in ophthalmology clinic l have told one of my senior doctors that my vision is getting worse in the last months specially in my right eye and my glasses are not doing benefit any more.
then l have told him l have astigmatism but when he examined me he surprised me when he told me : u have kearatoconus.
l find out that my rt eye i in moderat stage and the left is in early stage.
that doctor really frustrated me when he said this will be difficult for me to be a physicion with keratoconus and l felt that my all hopes in future are fading away.------------------------------------------------------------------
so plz tell me without any sympathy is it really a difficult thing for a doctor to have this.
l feel depressed when l think about my future because am one off the best students in my class so is that gonna affect my functioning level, my productivity,is that gonna affect my professional work.how can l do any micro or macro surgery,how to be involved in dignosis any disease. when l use for example aureoscope to examine the rt ear of a pateint l should use my rt eye but l can't see clearly the eardrum then l will fail to diagnos.
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what l really need is to fulfil my job in the future like any other doctor.
what l really need is to know from u the best way to tolerate this and how to deal with this problem.
do the contact lenses stop the progression of the left eye , and what to do now is it to wear contact lenses in both eyes, or only in the rt then in need l will use it in the left?
what r the recomendations to do to be away from CL complications----------------------------------
plz help me because l need support from u
thank u alot

[jayuk]

Musa

Welcome to the board!

I can understand your concerns totally. However it will be extremely hard to determine whether you can go about "busines as usual" in your chosen profession.

You mentioned Opthamology? Is that your chosen field? Or was that just a module you reffered to?...

Anyhow....As I am sure you are aware, KC is very hard to predict and determin. The fact that you have just come out of glasses and may now need to wear contact lenses is not a bad thing. In fact it MAY even be a good thing as you should get good vision at this stage.

Clearly, going ahead, and depending on your area of specialism things MAY get difficult. If you was going to be a Opthamologist with deteriorating sub-par vision than YES that will be a negative aspect..as I am sure you are aware the majority of these procedures are performed under microscope and thus you would need good vision (20/30 and above). I can understand that this cannot be easily especially as you may be at the top of your class and also invested all this time and effort.

However!..that is not to say that your KC cannot be managed and you may not even get to advanced stages!!....However I would highlight the above, and be real...and thus be prepared for also the worse case of KC.......and how you can then change your working life around that.

What I think you need to do, is to speak to someone in your profession than speak with a reputed Consultant Opthamologist and get there opinion. I do know that in medical careers there are always other areas (research etc) that you can divert into if you face obstacles such as this).

To answer your questions

a) No, contact lens DO NOT stop KC and its progression and dont let anyone else tell you different (Even Opticians!!)

b) If both your eyes are affected than its best to wear lenses in both

I hope this helps!

[Ali Akay]

Hi Musa
How much KC may or may not affect your performance as a doctor is hard to say as KC is such an individual thing but ,if it's any consellation, I have a number of optometrist colleagues and doctors with KC as my patients.One of my best friends also has KC and is a prof. at one of the main teaching hospitals in Istanbul and KC hasnt hindered his abilities as a top surgeon.It'd be fair to say that most keratoconics live very normal and fulfilling lives and only a relatively small number have major problems.Patients who get on well tend not to join forums like this one and reading the postings on the forum can give a depressing view of keratoconus (in my opinion).I hope things work out for you.

[musa fares]

thank u very much Jayuk, and u too Ali Akay----------
l wanna say that l was thinking about choosing ophthalmology as my future speciality. but with KC l'v changed my opinion.
l'm not yet in any speciality but obviously KC has limited my options.
so what specialities do u think l should not considered.
l may not even choose any surgical speciality.however l should be aware of choosing a nonsuitable speciality because l wanna be as execellent as l am and not to make somthing deviate me.
my older brother underwent corneal transplant surgery but was complicated by rejection and the other eye also has been transplanted but without any benefit in terms of vision.this increases my fear.l wanna ask about the percentage of KC people who will deteriorate to an advanced stage.
one last question is : can whatching TV or PC or even reading alot increase the progression?
and if there any factor decreses it tell me plz-------------------------------------------------------------- thank u

[GarethB]

Hi Musa,

I studied environmental microbiology and started the course after a graft in my right eye and limited sight in my left. All the practical work was done as part of my industrial placement.

Graft rejection is not the normal thing, but something you should be aware of. Post graft I wore glasses and had 20/20 in both eyes and soon after all the stiches were out, I had 20/20 in each eye for a few years. Until recently glasses gave me full 20/20 vision and has never hinderd microbial or microscopic work I have done.

KC can stabilise and contacts may be fine for the rest of your life. I met a few weeks ago somone who has worn lenses for over 20 years to correct his KC, although sight is not 20/20, it is very good with lenses and is not a problem. He also had quite good wear time.

It is only recently I have had to gibve up motor racing, but my KC has developed a rare complication!

If you were to specialise in KC, then you would have a rare insight into both the doctor and patients take on KC.

Regards

Gareth

[jayuk]

Musa

I think it would be hard for anyone to recommend which field you should go into....however as Ali pointed out, there are stories which exist whereby people have coped well with KC and havent gone through the issues as can be seen on this board.

To answer your question, NO; watching TV or looking at a PC screen does not progress KC, however whether it can affect other parts of the eye is probably up for debate.

I can understand how this must be frustrating, however do not give up just because you have KC. Just be aware of both the best case, and worse case of what MAY happen....

j

[Ali Akay]

Hi Musa
The friend I mentioned to you specialises in breast and thyroid surgery which I guess is quite intricate and he copes well. As I mentioned, I know a number of optometrists with KC as well.I guess if you aimed to be the best in your chosen field then this might be harder to achieve with some specialities than others and you may find eg general practice a lot less demanding than plastics which requires long hours of concentration.But if you have a dream, dont sacrifice it just because you have KC, dont let KC rule your life. On the subject of whether VDU work, etc make KC worse I'd like to add to Jayuk's comments that there is the link between eye rubbing and KC.Hence prolonged VDU use without adequate breaks and poor lighting etc may contribute to dry, itchy eyes and result in eye rubbing. My advice is to look after your eyes, take reasonable breaks, good ventilation and lighting to make visual tasks like VDU more comfortable.But please dont read this as "VDU is bad for your eyes !" If you suffer from ocular allergies, or have dry, itchy eyes, dont neglect it,seek help and use drops, tablets etc as advised. Vigourous eye rubbing can also precipitate hydrops which is best avoided.
Good luck

[Praveen Kushwaha]

Hi Dr.Musa
I am Praveen from India and i am diagnosed with the exact same condition as that of yours.
I just took admission in college of medicine and so i am very curious to know what road did you took in your carrier and what should i do, which field should i go for. I always wanted to be a cardiologist , can i still become what i dream of knowing that this KC can affect my carrier anytime it progresses! Please help me i need guidance.
Please if u could just let me know sir.
Your junior
Praveen
(Med-student)

[Anne Klepacz]

Hi Parveen,
I'm afraid Dr Musa hasn't visited this forum since 2006, so I don't think you'll get a reply from him. But you'll have seen that even before corneal crosslinking (CXL) became widely available, keratoconus didn't stop people qualifying as doctors and having successful careers. And now that CXL can stop keratoconus progressing, there's even less reason for it to stop your dreams. Wishing you well, whatever specialty you decide on.
Anne