The BMA's view!

[Sweet]

Hi being a nurse i guess i should say something! LOL!!

We don't use this book in work but i know exactly the one you mean. A lot of doctors do their training using it which is where most get their understanding of this condition from!

From what i can gather this book is updated every few years but sadly i think that the new treatment and options available to us now hasn't made it to this book. It is a large reference guide on every disorder known to mankind! So there is a lot to do in two years to make sure that it is up to date for the next publication. I understand that it is written by a team of doctors from around the world and that this is only their opinions and what they know about the condition at the time of press. Maybe this edition was written years before it was published, just as with other operations? Maybe if you looked up hip replacements it wouldn't be as up to date either? Science and medicine change so quickly that books and teaching sometimes struggle to keep up, especially with a book as large in covering information as the BMA.

It would be like a dictionary but whereas only small numbers of new words would make the next edition we are discovering new diseases every day. It is very hard to replace and be accurate on every word before the next edition, although i know that they are paid to do this!!

It would be good to let them know, but i would understand that being a group of doctors and ourselves not being medically trained we are as useful to them as a chocolate teapot!! Unless of course you just had late night chocolate cravings!!!

Sweet X x X

[GarethB]

Pru,

What you posted is why I think many of us that were diagnosed with KC post eye trauma found our sight had deteriorated so quickly.

The reality is that it had not, as KC progressed we adapted at the same rate.

[Andrew MacLean]

Prue is right. Transplants are just methods for managing KC.

Gareth is right. Even glaucoma specialists may not be too au fait with diesases of the cornea. This is why some hospitals (like the one I attend) have various ophthalmological specialities, including diseases of the cornea.

Trekkie who is abstaining from chocolate for lent

[GarethB]

Andrew,

Going without chocolate for lent is blafemous, I have given up alcohol hence the low alcohol beer today.

To be honest never been much of a drinker, I am daft enough without it

[Sweet]

Hehe OHHH that was why it was alcohol free!! LMAO!!! Good one!

Sweet X x X

[GarethB]

Back to the topic, which is very unlike me

Just been thinking about some of the slides from the presentation and I think the development of KC can be likend with plate ectonics and earthquakes! this would explain why people describe their KC being the result of trauma and others who say KC developed overnight.

Earchquaes are casued by a sudden release of pressure built up as two contintal plates puch against each other. At a certain pressure, friction is overcome and there is a sudden movement as one contintal plate slides over another which feel as an earthquake.

If the colllegen is breaking down and the pressure is from below, but the outer surface is still holding the corneal shape as per one of the slides. Pressure builds up, trauma will cause this sudden release of pressure. In an earthquake this has been caused by heavy mining activities and explosions.

Where KC is described as an ovenight occurance, then the friction in the layers has been overcome and there is sudden slipage so literally a sudden change in the condition. As in plate tectonics earthquakes can be frequent and then not heard of again for a long time just as in KC.

KC is ofetn ruby ball shaped or a bit like a volcano and others a bulge on the side of a hill like mount St Hellens prior to its dramatic recsculpting itself in the late '80's.

I am by no means suggesting that the eye wll suddenyl explode if unchecked

[Prue B]

Hehe I use volcano analogies a lot, because it is domant at times and has times of increased activity.

[Andrew MacLean]

Gareth

that is a really strong metaphor! There may be more mileage in it than you think.

Parts of the corneal structure do move across each other, and this movement may cause itch. Hence a relationship with eye rubbing, and the possible complex relationship that can make eye rubbing both a symptim and contributory factor the the advancement of KC

Andrew

[GarethB]

Good point Andrew and with that I have essentially generated a theory that destroys my preveous theory that eye rubbing was just a symptom that it is actually a strong case for it to be an agrevator.

Strong eye rubbing to the point the eye is left red raw is similar to minor eye trauma i mentioned in my preveous post.

[Lynn White]

Like Sweet, I think the problem with such a book is the amount of words allowed per entry. I assume they can't go into details so have to try and condense information for general use. Thus, as Alison said, it is a pretty much accurate description for some people but not others. lt would be interesting what it says about other conditions and whether people suffering from those agree with the definition or not!

I think the most frightening part of the BMA definition is the inherited part. Although genetics play a large part, it is not exactly what most people think of as "inherited" so this definition will confuse (since many people are the only ones in their extended family to have clinical KC) and frighten (as others will fear passing it on to their children).

The eye rubbing is interesting as the cornea is rich in nerves and therefore prone to sensations caused by even minor corneal changes. So I agree - eye rubbing can be both a symptom and an aggravator!

Oh and the other thing that interested me was the comments about KC people seeing better than their prescritpion would indicate. Yes, KC ers do adapt to poor vision but also their visual systems are subject to a high degree of aberrations. Thus the "normal" way of correcting vision with spectacles goes out of the window effectively. Giving higher than "necessary" prescriptions may induce aberrations that compensate for those in the cornea, thus helping vision.

For example, you often get similar "strange" effects, prescription wise, with people suffering from cataracts - in fact they can be totally confusing as you can find about three different prescriptions that all seem to work equally well. This is because the refractive error is not uniform over the pupil area.

Now you see.. you would need a entry a book length size to fully explain KC hehe!

Lynn