Jan Q

A self protrait of Jan Q, my 18-year old nephew. He was diagnosed with Keratoconus, a progressive, noninflammatory disease of the cornea, last week. The family is devastated, his younger brother wept with their grandfather, his teenage cousins cried over the phone while telling other relatives of his condition. Jan Q is trying to be cool as most 18-year olds are but I know he's worried about his condition. The probability of blindness is no joke, even to an 18-year old.

We have never heard of Keratoconus until last week. Jan had been treated for an eye infection a couple of times since childhood, was given prescription glasses, but nobody diagnosed it correctly until he was seen by an Ophthalmologist in PGH last week. His eyes were examined and scanned through a corneal topogram and he was directed to another Ophthalmologist who can fit him with corrective lenses. The challenge with Keratoconus is that it deforms the cornea to a more conical shape than its normal gradual curve. Because the cornea is irregular and cone-shaped, glasses do not adequately correct the vision of patients with this condition. Jan's eyesight was restored to 20/20 when fitted with rigid contact lenses (rigid gas-permeables, or RGP) but because of his conical cornea, the lenses fell off. RGP lenses provide a good level of visual correction, but do not arrest the progression of Keratoconus. The Ophthalmologist quoted P60,000 (or about $1,300) for a pair of Rose K lenses with a 2-year warranty. The lenses will be specially designed to the shape of Jan's corneas. Rose K lenses are imported and there are no local distributors.


We went to another Ophthalmologist, a cornea specialist, yesterday for a second opinion, also hoping for a better price for corrective lenses. The doctor agreed to the diagnosis from PGH and referred Jan to another Ophthalmogist in Greenhills for RGP fitting. The second Ophthalmologist told us that there are only a few doctors here who do contact lenses for Keratoconus patients, it's possibly the reason why the lenses are so expensive.

From various articles I read in the net, no one truly knows the cause of Keratoconus. There have been many theories like a genetic predisposition, deficient collagen crosslinking caused by free radicals but there are no scientific evidence to support such theories. The doctor we've seen yesterday mentioned that vigorous eye rubbing causes the progression of the disease. Jan may have an untreated eye allergy that causes his eyes to itch. The doctor also stressed that about 25% of Keratoconus cases will progress to a point where corneal transplantation (or penetrating ketatoplasty) becomes necessary. I pray that Jan's condition will not progress to that point. For now, Jan applies 2 kinds of eye drops to treat his eye infection. We're going to see the doctor in Greenhills on Monday, and hopefully, Jan Q will have clearer vision soon and can go back to school. 


Photo: a "conical cornea" that is characteristic of Keratoconus