A sight-sparing procedure approved less than a year ago along with a well-established form of surgery are providing the technological aid to help a Rockville Centre woman pursue a dream career.
Danielle Meacham wants to be a photojournalist, but during her teen years developed a condition called keratoconus, a disorder that was robbing her vision in both eyes.
“I really couldn’t see out of my right eye,” said Meacham, 24, who noted that she struggled in school and college to see what was written on the board. Unless she was seated in the first row, the teacher would be out of focus — a blur.
“It wasn’t all of sudden,” she said of her failing eyesight. “It was gradual and got worse over the years. The left eye wasn’t as damaged as my right eye.”
Keratoconus is a degenerative eye disorder that generally strikes young people, emerging during the teen years through about age 25. Unlike glaucoma or most cases of cataracts, which occur in older people, keratoconus inflicts its damage in the prime of life. It produces warping and bulging of the cornea that leads to severe visual distortion, doctors say.
The cornea, the clear “windshield” of the eye, takes on a cone shape in the disorder. In advanced cases, like the kind of damage on Meacham’s right eye, the condition can leave the cornea irrevocably scarred.
“Keratoconus is asymmetrically progressive,” said Dr. Ira Udell, chairman of ophthalmology at Long Island Jewish Medical Center and North Shore University Hospital, two campuses of the Northwell Health system.
“That means it can progress more in one eye than the other because each eye has its own life,” said Udell, who was not involved in Meacham’s case. “It starts to slow down when patients are in their 30s.”
But Udell said the disorder leaves patients with marked astigmatism, myopia and thinning of the cornea.
The National Keratoconus Foundation estimates that one in every 2,000 people in the United States is affected by the condition.
Worried about her daughter’s challenges, Meacham’s mother, Gwynne, sought out armies of doctors over the years who prescribed corrective lenses, but the unyielding condition continued to steal more and more her daughter’s eyesight.
Gwynne Meacham, who is employed in the human resources department at Mount Sinai Hospital in Manhattan, started asking whether doctors there might be able to help. Her inquiries led her to cornea surgeon Dr. Emily Waisbren at New York Eye and Ear center, a division of Mount Sinai Hospital.
“It’s an underdiagnosed condition,” Waisbren said of keratoconus, “and it can be associated with other conditions like Down syndrome and eczema.”
Though genetic and environmental influences may play a role, she added, the root causes of the disorder remain elusive.
She found that the condition was so advanced in Danielle’s right eye that a corneal transplant was the only solution. For the left eye, a new technique approved by the U.S. Food and Drug Administration last April likely would stabilize her sight in that eye.
The transplant, performed in November has already brought her vision to 20/20, the doctor said. The new technique performed a week ago is called “cross-linking.”
“It’s new to this country but it had been used in Europe for quite a while,” said Waisbren, who was specially trained in the technique, which was developed in Germany.
Cross-linking also has been widely used in Canada and Mexico to treat keratoconus, she and Udell said.
The procedure involves the application of riboflavin, or vitamin B2, on the affected eye and then exposing the eye to ultraviolet-A light. The treatment is not a cure but it stops the progression of the disease, Waisbren said.
Meacham said she is ready to return to Nassau Community College having stopped her studies a few years ago because of her failing eyesight.
“I love photography. I have always loved photography,” Meacham said about the career choice, noting that her brother was her inspiration. “He kept saying ‘You can do it.’ Not having sight was a problem. But I know that I can do it now.”