Can it be made worse ?

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Can it be made worse ?

Postby TommyC » Thu 13 Oct 2011 5:24 pm

Hi Im Tommy i just got diagnosed today im 18 and not too worried after looking at all the help and treatments available out there.

I didnt get chance to ask my doctor but was wondering if looking at computer screens and tv's and video games can put stress on the condition and worsen it ?
Also i was wondering if apart from rubbing your eyes there is anything you should avoid to slow down it worsening ?
Also because im not at the stage were glasses dont work for me im finding myself squinting quite alot is this going to just make the condition worse ?

Would be greatfull for any help Thanks :)

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Andrew MacLean
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Re: Can it be made worse ?

Postby Andrew MacLean » Sat 15 Oct 2011 9:01 pm

Hi Tommy, welcome to the forum. I have moved your post to the General Discussion Forum; it will attract more attention there.

Every good wish.

Andrew MacLean

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Keratoconus: Yes, I have KC
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Re: Can it be made worse ?

Postby longhoc » Sun 16 Oct 2011 9:38 am

Hi Tommy

Thanks for your post – you ask some straightforward questions which are very interesting. Interesting not just because they affect many people (I think the vast majority of us do some sort of screen based work at least some of the time these days) but also because they bring up some conundrums with rare conditions like Keratoconus.

I work with statistical models and risk management so I get asked all the time things like “how likely is this- or that- scenario to happen”. In order to answer accurately you need two key things. One is a good set of data on the event you’re trying to model. That’s the easy part – so long as you can get the data and it’s reliable. The other is an awareness that there’s no hidden interactions between seemingly unrelated events which you might be tempted to overlook. People do, I find, have short attentions spans and wish to grasp simplistic – dare I say dumbed-down ? – rationales for complex and dynamic situations... alas... Move on Chris, otherwise you’ll start a rant... :)

You mention eye rubbing so let’s look at that first. Eye rubbing, as you might have been told be the clinician you saw, is clearly implicated in the development or progress of Keratoconus. It’s probably one of the best established correlations. However, even this fairly well demonstrated effect isn’t quite as simple as it seems. For example, I was, I’m sorry to say, a habitual eye-rubber until I was finally told of it’s possible ill effects on people with Keratoconus and also looked at the clinical evidence. So for a long time, I rubbed my eyes, sometimes quite hard. However, although I rubbed both eyes equally in terms of time, and equally firmly, the Keratoconus developed to a significantly more advanced degree in the left eye compared to the right one. So clearly, there’s a little more to it than simply rubbing your eyes. Because otherwise, I’d have been expected to exhibit the same degree of Keratoconus progression in both eyes if it was simply down to eye rubbing.

When you look for evidence in clinical studies about eye rubbing, what you find isn’t an established, repeatable causal factor. All you find is a strong correlation. Now, if anyone ever tries to sell you “correlation” as “proof” of something then please send them to me for a good beating with a hard-backed copy of “Statistics for Dummies”. In this instance, not rubbing your eyes is good advice because the correlation is as I say strong, and it’s a pretty easy thing to avoid (well, not that easy sometimes... but you can do it without too much hassle) so it’s a no-brainer.

Turning to your actual question about whether doing screen based activities with Keratoconus will exacerbate the condition. Or whether squinting will make things worse. I wish I could say “oh, well, look at this study here where it says that screen based work makes Keratoconus worse” or “here’s one that shows a control group of squinters had no material change in their Keratoconus compared to non-squinters”. Unfortunately such evidence doesn’t exist, as least not that I’ve seen.

What has been shown is that the cells in the corneas of people with Keratoconus have demonstrably less viability than normal corneas. So anything that stresses the eye is going to have a disproportionately greater impact on a Keratoconic cornea. Whether that impact would make any different to the progression of the disease process is an open question. I’ve a hunch (and here’s I’m descending into speculation) that what will eventually emerge is that Keratoconus is susceptible to trigger factors such as genetic predisposition, environmental elements, mechanical stresses, changes in body chemistry etc. etc. and that there’s a subtle interplay in these different factors at work in initially triggering Keratoconus and then influences the progression of it once triggered.

Until more research is done, we don’t therefore know the exact mechanism(s) at work. So for me, I have a simple principle that “if it’s hurting, it isn’t doing me any good” and “if it seems to help, then it might be a good thing to keep doing”. in other words, trust your instincts about what to do for the best.

And anyway, as you rightly said, there’s a good range of treatments out there and you can’t spend all your time worrying. So I do on occasions stare too long at my iphone, read when I’m tired or go out in the sun without my sunglasses on because just for a while I want to live “normally” and if that means having a good old squinting session, then so be it. Then again, I’ll also follow my own whack-job theories about what helps as well. For me, it’s all about trying to find the right balance.

If there’s any evidence from professionals that is pertinent to what Tommy’s asked, be interested to read it.

Best wishes, thanks again for the questions. Anything else you need to know, chuck us a post.



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Keratoconus: Yes, I have KC
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Re: Can it be made worse ?

Postby RichardC » Sun 05 Feb 2012 10:18 pm


I've used computer screens for 5-12 hours for each working day of my life to date - across 20 or so years, without this damaging my eyes. After developing keratoconus in both eyes from the age of 10 or 11, I had a full thickness corneal transplant in my right eye at the age of 15, and the left at the age of 18. My left transplant is still going strong after 22 years and my right transplant did well for 15 years until it was badly badly damaged in an accident, and was subsequently replaced.

One suggestion I would have is that if your eyes have a tendency to feel dry after pro-longed use of computer screens is to take a break and consider lubricating eye drops. I remember that before having the corneal transplants, the contact lenses I had become pretty unstable, so were problematic when playing sport, but this was remedied upon having the transplants and becoming able to receive better fitting contact lens.

The other thing I learnt through experience was if playing contact sports it is worth considering protective eye-ware.

I think your outlook is spot on. From my perspective having severe keratoconus hasn't caused me any great problems and I count my self lucky I live in an era when effective intervention is available - and as you allude to, there are treatments available now that have been recently developed, and no doubt there's further advancements on the horizon.



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