My appointment wasn’t for six months and I started to worry, so I saw a specialist privately, who said I had keratoconus in my right eye, which was also beginning in my left. He explained that a normal eye is round so the cornea – the transparent front part – focuses light onto the retina, the lining at the back of the eyeball. In keratoconus, the cornea becomes stretched and thin near its centre. The thinned part bulges outwards and the cornea becomes rugby ball-shaped with a pointed end. Your sight becomes blurred, as though you’re underwater, because the light isn’t falling on the back of the eye properly. I was told it usually progresses gradually and can be corrected by contact lenses or glasses. I was prescribed rigid lenses that would press on the pointy tip of the eye to keep it in shape. Butut they didn’t sit properly and made my eyes feel as though they were full of sand. I tried different types, but couldn’t wear any for more than ten minutes. Over the next few months my sight got rapidly worse. I struggled to read and watch TV. Then I heard about a new operation for keratoconus called INTACS (Intracorneal Ring Segments), where they put a clear ring of plastic, like a doughnut, into the cornea to force it to flatten out. The ring builds up the sides of the cornea; the pressure this puts on the cornea then flattens the central, pointy bit. I saw a private specialist who said I couldn’t have this on my right eye because the disease had developed fast and I needed a corneal transplant.
By that point, my sight was so bad I had to give up my job. I had the corneal transplant on the NHS in December 2007. For two days, the pain was immense. Even after the transplant, my sight was blurred. The specialist, Mohammed Muhtaseb, recommended INTACS for my left eye, though he warned I might still need glasses. I had the operation a few months later. When I woke from the anaesthetic and took off the eye patch, I could see the INTACS. It was like a shadowy semi-circle in my eye. But within a day or so, I got used to it and simply didn’t see it anymore. A week after the op, I could see every detail on the TV from the other side of the room. Now, I can watch my seven-month-old son Sam smile, read him stories and drive him to playgroup. It’s just wonderful. The Surgeon Mr Mohammed Muhtaseb, consultant eye surgeon at Singleton Hospital, Swansea, and FOCUS Laser Vision in London, says: Keratoconus is a weakening of the cornea – the clear window at the front of the eye – causing it to bulge. This changed shape means that instead of light being projected onto the retina for best focus, it is scattered, so sight becomes blurred. The condition affects one in 2,000 people, for reasons we don’t fully understand, though we know it can run in families and typically develops in the late teens and early 20s. In the early stages, it can be corrected with glasses or contact lenses. But because the cornea becomes pointed, fitting lenses is difficult. For many years, the only other option for patients with severe keratoconus was a corneal transplant – 20 per cent of patients have needed one. But this carries the problems of any organ transplant, including risks of infection and rejection. Finding a donated cornea can be problematic and after surgery it takes between nine and 18 months to settle down. It’s practically impossible to stitch a cornea into position accurately and it will never be as good as your own. But this exciting development means we can restore good vision to keratoconus patients. INTACS involve putting one or two C-shaped plastic rings into the sides of the cornea to correct its shape (each is the size of this letter ‘C’). This thickens the sides of the cornea, which forces down the top of the cornea so it flattens, and refracts light properly. As the cornea is damaged, most patients will need glasses or contact lenses. But contact lenses will now stay on. The operation takes 15 to 20 minutes under a local or general anaesthetic. First, I make a 2mm incision in the side of the cornea, cutting through 75 per cent of its thickness, before creating a semi-circular pocket where the INTACS semi-circle will sit. Then I slide the ring gently into the pocket, which I leave for the cornea to heal around. We protect the eye with a hard contact lens for a few weeks so the ring doesn’t move. Patients have combined antibiotic and anti-inflammatory drops for a month. After that, they can visit a specialist optician for glasses or contact lenses to fine-tune their sight. In some cases, the implants may work loose or not work at all, in which case they can be removed. However, this operation is successful for around 70 to 80 per cent of patients who would otherwise need a corneal transplant. Because keratoconus affects you only until you are in your 20s, the disease will have run its course. The implant will go on working for life.