UK Keratoconus Self-Help and Support Association

Anyone got any experince of this?
For the last several months, the vision out of the grafted eye has (apparently) been getting more astigmatic.
Once upon a time (like, last february) print was in focus at about 3-4".
Then the almost-vertical lines started getting into focus further and further away, while the alomst-horizontal lines stay in focus about 4" away.
It's been getting quite hard to read out of it again recently.
I gather this is called astigmatism.
For all this time, the close-focus lines have been those going from about 9.30 to 4.40 on a clock face, and those in focus further away have been those running 12.30 to 6.30. Approximately.
Then on the tube this morning I picked up a copy of Metro and tried the Clockword (a sort of circular crossword puzzle).
The lines in focus furthest away are now those going 11.30 to 5.30 and the close-focus ones are now those going 2.30 to 8.30. Approx.
Close focus at about 4", far focus about 6" away.
This has happened in the last few days... certainly in the last wekk.
Is this usual??
Is this likely???? - that the "axis" should move that suddenly?

Also: the vision just seems blurrier. I don't mean misty, it just seems harder to read, like nothing is in focus all that well.
COuld this just be the astigmatism changing?
Has anyone experienced it moving like thisso rapidly??
(Yeah, I spend all too much time doing crosswords, sudokus, etc so a lot of time with grids of vertical/horizotal lines and trying to get them in focus.....)
Alterntively......
Could the blurriness be anything to do with (changes in) the high IOP?
- or, could it be the start of a cataract growing?
I gather the latter is a common effect of the anti-rejection steroid drops.
ANyone who's had a cataract post-graft think this is familiar?
Does anyone know, once a cataract has started, does it just keep growing, or will it stop where it is if the trigger steroid drops are stopped?
And:
Can anyone who's had a cataract op post-graft tell me what eye drops they get put on after the cataract op? - or are used during the op, for that matter?
Sorry to sound really down about this.... I do know that cataract ops are really routine now.... but after my experiences, another op does NOT appeal! - and there's always the possibility some of the drugs will set everything off again.
Rosemary

Rosemary,

The only time I have experienced what you describe is after stitches were taken out in that the astigmatism axis would change significantly.

Have yuo been to the hospital yet to see what they think?

After my post-graft cataract operation I was back on Dexamethasone and Chloramphenicol.

Andrew

My graft was done a year ago and looks like maxidex drops caused a cataract. The vision is badder after stitches was removed and also there is double vision. I see my doc next year in January and then probably line up for a cataract operation (although I'm only 27!)

I also see vertical lines a little bit better and more focused than horizontal lines...but have to say I cant correctly focus anything with my grafted eye.

I think that prolonged exposure to topic steroids is a common cause of cataracts. Still, if my experience is anything to go by, the remedy is simple and straightforward.

All the best

Andrew

Thanks for the replies.
Andrew, can you remember how many dexamethasone eye drops and for how long, after your cataract op? - I'm guessing you meant, an increased dose from what you were on prior to the cataract op for anti-rejection.
My trouble would be, if they wanted to do that with me, it probably means a cataract op is impossible, at least ofr the foreseeale future.
Because an increase in the dexa. is likely to set off all the hallucinations again. Yup, I'm that sensitive to steroids now!!!! Well, maybe four a day would be OK for a while, but I'm not sure.....
Gareth, I haven't been to the hospital recently - it was only yesterday I noticed the axis appeared to ahve shifted. (I've been trying to discipline myself to read the paperwork I've got before I pick up any more free papers on the tube! - but yesterday, the clockword just called......)
My last appointmnet was the end of October and I said then that the power seemed to be changing, and indeed got escorted round to Refraction for an eye test. I still have the prescription (for specs) that resulted. Glad I didn't get it made up if it's changing like this now.
I've got three more in early January (contact lens (I think), corneal consultant and glaucoma clinic) all onthe same day.
Don't feel inclined to go back there till then at current state. Have been to A&E four times in last few months, and been told to go home I'm being paranoid twice...... trouble is, the grafted eye spends most of its time feeling sore from the anti-glaucoma drops I might be in there ever other week at least, and told to stopbeing paranoid...
Will, needless to say, be trying to have full and frank discussion with glaucoma guy about this next apptmt!
Now, if I had definite evidnce there were something markedly worse than usual, that mght be different. But it always is a bit sore.
Meanwhile, could do without spending a large chunkk of a day sitting around in a waiting room again..
..... and I really hate having to go to That Place - stresses me out walking in the door by now.
Rosemary

Hi Rosemary,

I too have developed a cataract after graft. I was on Maxidex for well over yr and half post op.

Got fitted with a lens in grafted eye by optician back in September. He recommended that as long as I am getting decent vision with the lens, I should delay getting the cataract removed. Have hospital appointment on Tuesday, hopefully consultant will recommend the same. I know it will need to be removed one day, but i'm happy just now.

Dont know if thats of any use or help to you.

Sarah

PS I have just been diagnosed with blepharitis in my grafted eye - anyone else suffer with this?

First of all, let me say that my ophthalmologist told me BEFORE either of my grafts that a possible outcome was the development of a cataract. There were other potential negative outcomes, but as I have yet to encounter any of them I begin to hope that my cataracts were the only distaff side results of my post surgical management.

Steroids are extremely useful anti-inflammatory medicines. They are used routinely after eye surgery to minimize the inflammation in the eye that follows the insult caused by the knife.

Following my graft I was on a fairly high frequency of Dexamethasone for over a year. After my cataract the dose was far lower (initially four a day, then dropping to two, to one and then off) and the duration was no more than a month or two.

Sorry I can't be more precise.

Andrew

I have noticed in the past 20 years surgeons have moved to a prolonged use of steroids that 12 months is the norm. I have been told it slows the healing process but makes for a better graft and significantly reduces rejection problems in the first year. Trouble with this, over the past 2 years I am hearing more about cataracts occouring within 5 years post graft.

When I had my grafts the steroid drops were only used for three months and I know my graft healed quickly and within six months the vision change had settled enough to wear glasses. It did continue to change slightly after that and when all the stitches were out after 12 month no steroid dros, just an antibiotic cream to use for a week. I know we did not have the internet back when I had my grafts, but I wonder how many developed cataracts in that period.

Unfortunaty I do ot know enough about rejections and catarats to say which is the lesser of the two evils. On the face of it though it does appear to me we have become over relient on the steroids.

Hi Rosemary - if it's any comfort, I was having to change my glasses every few months after my grafts because the vision kept changing as the graft 'settled'. I spent a fortune! After the sutures came out, the vision finally stabilised and has remained virtually stable ever since (apart now from the effects of ageing kicking in!) I didn't develop cataracts - and having followed this forum over the years, my impression is that the majority of people with grafts don't.
Anne