Fleisher rings and KC

[John Smith]

Hi Mojdeh,

I'm not an expert, but as far as I understand it, Fleischer Rings are very common in people with KC. Indeed, the presence of the rings is thought of as an indicator for KC.

[Andrew MacLean]

Mo

Kayser-Fleischer rings are dark rings that appear to encircle the iris of the eye. The rings, which consist of copper deposits where the cornea meets the sclera, in Descemet's membrane, first appear as a crescent at the top of the iris. Eventually, a second crescent forms below, at 6 o'clock, and ultimately completely encircles the iris. In later stages, the brownish rings can be seen with the naked eye. In earlier stages, an opthamologist's slit lamp reveals the golden brown or greenish-yellow crescents.

Yes, I did have this symptom at one time, and I understand that they are characteristic of eyes with KC. For all I know, I may still have them!

Andrew

[Andrew MacLean]

Mo

I wouldn't worry about this. The rings are used by ophthalmologists as a sign that they are looking at keratoconus. I was given no medication for this symptom; it did not worry me, it does not worry me now.

The problem with the internet is that we can get a whole load of confusing information, all at the same time, and become quite anxious and worried.

If I were you, I'd make a note of any questions I had and when I next saw the ophthalmologist I'd ask all the questions I had saved up. Let us know what he says.

If you want to read about secondary keratoconus, I found this article.

http://www.pnas.org/cgi/reprint/102/46/16795.pdf

Andrew

[John Smith]

Hi Mo,

I'm sure I've typed this before, but perhaps I forgot to his "Send"!

Chad Rostron is my consultant, and he performed by unusual DALK graft back in August. He can do a graft with freeze-dried tissue as he has his own eye bank!

I know that he's excited about C3R and C3R with orthokeratology, and he certainly seems to be very patient whenever I see him.

I'm sure you'll be in good hands.

[Andrew MacLean]

Mo

I have just finished reading the article to which I posted a link (above). I am really excited about the possibilities it suggests: a Medical, rather than surgical, therapy for KC.

By looking at the molecular basis of KC (in which the study of Fleischer rings and Fleischer-like rings that are present in Keratoconus is a critical element of the research), they believe that it may be possible to develop other therapies.

A little health warning: nothing moves fast in this field. The product of this enterprise may not begin to benefit the KC community for a generation or more, but in the meantime there are all sorts of things that can be done for us.

Thank you for setting me on this road. I'll keep you up to date with what I find out, and hope you will do the same!

All the best.

Andrew

[Andrew MacLean]

Mo,

Of course I don't mind you asking.

I have lived with KC all my adult life. I was offered bilateral grafts (grafts in each eye) many years ago, but decided to keep my eyes intact and join a programme that was being run in Glasgow to assess the effectiveness of long term contact lens use for the management of Keratoconus.

When I was 53, after going through almost the full range of contact lenses, styles, materials etc I became unable to tolerate lenses in my right eye, although my left eye was still able to take a scleral, but only for a very short time each day.

I had a PK graft into my right eye in December 2003. I had a bad reaction to the steroid that was prescribed and because of this my sight in the right eye did not really recover until September 2005. This was unusually long.

My driving license was restored!

In 2006 my ophthalmologist offered a DALK graft into my left eye. This procedure was performed in October last year.

Over the first four days of 2007 I suffered a relapse in the sight in my right eye. I became effectively blind again. On February 14 (a date that suited me) I had further surgery to my right eye. Among other things, this replaced my own lens with an implant; I had developed a Posterior Subcapsular Cataract, possibly as a result of steroid use.

The upshot is that I can now see very well again. The sight in my left eye continues to improve and within the next four weeks I expect to have a prescription for glasses that will correct any residual myopia in my right eye. When sutures have been removed from my left eye I expect to be able to start wearing a contact lens again in that eye!

Andrew