Help at Work II

[Sajeev]

Andrew,

That link don't come up with the study? There has not been any study on the prevalance between the Indian sub-continent and Europe.

I searched for the study and I copy it below... it was talking about Saudi Arabia! which is in the middle east!

"Incidence and severity of keratoconus in Asir province, Saudi Arabia
A A Assiri1,2, B I Yousuf2, A J Quantock1 and P J Murphy1
1 Cardiff University, School of Optometry and Vision Sciences, UK
2 Asir Central Hospital, Department of Ophthalmology, Saudi Arabia


Correspondence to:
Abdullah M Assiri
Cardiff University, School of Optometry and Vision Sciences, Redwood Building, King Edward VII Avenue, Cathays Park, Cardiff CF10 3NB, UK; assiria@cf.ac.uk



ABSTRACT
Aim: To assess the incidence and associated signs and symptoms of patients with keratoconus in Asir Province, Saudi Arabia.

Methods: 125 new keratoconus patients (51 male, 74 female; mean age 18.5 (SD 3. years; range 8–28 years) were recruited from referrals to the department of ophthalmology, Asir Central Hospital, over a 1 year period. Age, visual acuity, and keratometry were recorded along with clinical signs and symptoms.

Results: The incidence of keratoconus in Asir Province is 20 cases per 100 000 population. Also, the disease severity is high, as indicated by an early mean age (17.7 (3.6) years) with advanced stage keratoconus. Visual acuity, with either spectacles or rigid contact lenses, was 6/12 or better in 98% of eyes measured. Just over half (56%) of patients had atopic ocular disease. 16% of patients had a positive family history of the disease and 16% had atopic dermatitis (eczema and/or vitiligo).

Conclusion: The incidence and severity of keratoconus in Asir Province, Saudi Arabia, is high with an early onset and more rapid progress to the severe disease stage at a young age. This might reflect the influence of genetic and/or environmental factor(s) in the aetiology of keratoconus."

So it says "20 cases per 100 000 population" was reported in Saudi Arabia... so thats one in 5000??? (when in the west its said to be usually one in 2000, and contact lens are used there more in the west like you was saying) That means what they was reporting on was the Incidence AND severity of keratoconus... not that the incidence was more...

There was a study which said that the pakistaini community has more KC in the uk, that could be due to the way that culture marries with in their extened family, which increases all sorts of disorders, or with KC envirnomental factors also tiggering it.

I posted the colour of eye/hair poll more than a year ago, which showed very roughly the dispersal more.

What is clear is that it is not a blue eyed, blond haired sort of disorder as much as it is a dark eyed and dark haired one... and if it was then I think things would have moved more quickly with break throughs in Keratoconus.

[Andrew MacLean]

We;;, for the sake of your study, I am grey eyed and grey haired

I am sorry about the link. I must have got them mixed up. I'll try again later.

Andrew

[Sajeev]

No worries at all Andrew, its just brillant to be able to communicate like this with my genetic relativies

[Alison Fisher]

I've been following this thread with much interest.

I suppose I'm being pessimistic but if a connection between contact lens wearing and KC was confirmed would anyone take any notice? It would be swallowed up and forgotten amongst the myriad of other 'don't do x,y and z as it is bad for your health' warnings. Would non-KCers who much prefer lenses to glasses stop wearing lenses because of a very slight chance they might get an eye condition whose name means nothing to them? Given the general population's attitude to all the other health warnings we are constantly bombarded with I doubt it very much. I can't imagine the lens companies not wading in with their own studies proving that lenses don't cause KC either.

That said I would love to know what causes KC. Typically for a mother not for myself but to make sure I can minimise the chances of it happening to my daughters.

For the record I'm brown haired, brown eyed and had never worn lenses before diagnosis.

[Andrew MacLean]

I think that, even if it were demonstrated that wearing lenses (I only started after KC had been identified) had contributed to the advance of my KC, I should still think that it was well worth while.

There were no alternative therapies apart from a graft when I started on this road.

There are two big questions for those starting out now: are there risks associated with lens wear? and are there risks associated with any of the other available therapies?

If the answer to the first question is "yes", then how are these risks quantified.

If the answer to the second question is "yes", again how are the risks quantified.

When you have all the alternatives you can make your choice. In the meantime I would think that the advantages of lens wear far outweigh the althernative which, for many of us, would have been legal blindness at a much earlier stage.

Andrew

[Sajeev]

I think its not ALL contact lenses which may be "bad" for KC... there are better ones for fit and better materials need to be found to tackel this for KC. Then, there are scleral lenses which there is a school of thought that they should be used earlier in KC as it vaults the cornea. Education and research is needed and is the key I think.

In the KC newsletter it says that Moorfiels are looking in to a three point touch lens etc. in how they preform.

[jayuk]

so have we got a cure yet?

Group Hug!

[Barney]

In the meantime I would think that the advantages of lens wear far outweigh the althernative which, for many of us, would have been legal blindness at a much earlier stage.

Andrew, you are presumably referring to the advantages of lenses for those with KC. Alison may be referring to the wider use of contact lenses as an alternative choice to glasses or even for cosmetic reasons e.g. coloured lenses.

I began wearing lenses at 17 when I began to drive and wanted the best possible vision. I hadn't worn glasses before that and rode motor-bikes at 16 without glasses. I could have got along fine without lenses.

If I had understood that there was even the most remote possibility of lenses triggering the KC I have now I hope I would have had the sense to have got specs or have done without rather than taken that risk.

Of course, as a 17 year old I may not have had that sense or have appreciated what a pain in the butt extreme KC can be. My lenses cost me a month's wages and it was never mentioned to me the time that there was any concern about the lack of oxygen to the cornea associated with the PMMA lenses that were used up to about 1980.

In retrospect I think there was fairly early awareness by the industry which was why RGP lenses were developed. They weren't developed to increase comfort. The old PMMA lenses were more comfortable than the newer RGP lenses because they didn't dry out or cloud and it was easy to wear them for 16+ hours. I hope the industry would be more honest today than I think it was then.

Now that I have KC the position is very different. Now I've little to lose and couldn't see without contact lenses. If I had healthy corneas and lenses weren't essential I'd want a cast-iron assurance before I wore contacts and certainly the 30 day continuous wear ones.

[Alison Fisher]

When I was first diagnosed (very early 80's) I'm pretty sure I was told that lenses could well halt or at the very least slow down the progression of my KC. I had so much trouble and pain wearing them that if I had known that they might be making it worse I would have gladly thrown them away, even though without them I would not have been able to carry on with my normal daily routine.

Like you Andrew the only things open to me were lenses or grafts. Sitting here with my two successful grafts I feel incredibly lucky. If I were confronted with the variety of treatments and all the associated 'maybe' risks that people have to decide between today I'm sure I would feel overwhelmed and nervous of making any decision for fear of making the wrong one.

[Alison Fisher]

Oi you lot, you're writing faster than I am.

Yes Barney I was thinking of the wider use of lenses and preventing many more people developing KC in the first place, but of course it does have an impact on lens wearing KCers.

No cure yet jay, but I'm always up for a group hug.