When he was in 7th grade, Charlie McMahon knew the school eye exam wasn't going well, when objects in the screening machine looked blurry. But when the school nurse told him and his mom Susan that he needed to see an eye doctor, no one knew he was at the beginning stages of developing keratoconus, a condition that progressively thins out the cornea, causing it to change shape and bulge, potentially leading to blindness over time.
Susan thought Charlie must be nearsighted, so she brought him to OCB for a comprehensive eye exam. She had worked for the OCB affiliated Boston Eye Surgery and Laser Center since 1997 and knew that her son would be in the best hands with the doctors she had come to know and trust.
An Early Diagnosis Leads to Hope
Doctors at OCB use specialized equipment, including topography, which maps the cornea and can detect even the most subtle changes in its shape. They were able to diagnose Charlie with keratoconus before it took a serious toll on his vision. The bad news was that at the time of his diagnosis in 2013, there were no approved treatments that would stop it from getting worse. In the traditional management of keratoconus, patients are fitted with special contact lenses to help improve their vision. Those lenses would have to be continually refitted as the shape of the cornea worsened. Cornea transplant is offered in cases that become severe.
However, the good news for Charlie was that he came to the right place at the right time. At OCB, Cornea Specialist Michael Raizman, MD, was leading clinical trials into a breakthrough treatment called corneal collagen crosslinking that could stop keratoconus from progressing.
Susan immediately enrolled Charlie, who, at 12 years of age, was at the minimum age required to participate in the trials.
"I was so fortunate to have brought Charlie to OCB where I know how great the doctors are and they had the special equipment that could detect this condition. I am fairly certain that if I brought him anywhere else, it may not have been detected until his symptoms were more severe, and that could have been when he was in his twenties," she says.
A Test in Perseverance
Over a three year period, Dr. Raizman led five clinical trials at OCB, a leading study site for crosslinking. Crosslinking works by strengthening the structure of the cornea, which is weak in those with keratoconus. During the procedure, eye drops containing vitamin B2 (riboflavin) solution are applied to the cornea. A special device that delivers ultraviolet light activates the crosslinking process, increasing the bonds that strengthen the collagen fibers, preventing the cornea from bulging.
The procedure naturally sounded a little scary to Charlie. And he was disappointed to learn that he was initially placed in the placebo group, which meant he would have to attend follow up exams even though he was not getting the treatment.
"That was a little hard, but they promised me I would get the treatment after a six month period," he recalls. "During that time I was noticing my vision getting a little worse. When I was in the back of the classroom the blackboard looked blurry."
When the six months had passed, Charlie was ready.
An Excellent Result
"I was nervous at first, but Dr. Raizman made me feel encouraged that the treatment was going to work. I thought the procedure was going to be a lot worse than it was. For most of the time, I was just lying down below the ultraviolet light which was focused on my eye, so it wasn't difficult at all. I felt some discomfort afterward, but that went away in a few days."
The results were better than expected. Crosslinking not only stopped the progression of Charlie's keratoconus, but his vision improved following the therapy; improvement is known to occur in some patients. Now a 16-year-old student at Boston College High school, Charlie no longer needs to squint when sitting at the back of the classroom to see the blackboard. He only needs to wear glasses to drive.
"I was told my vision might improve, but that it doesn't always happen, so I am just very grateful that my mom works with these doctors and was able to connect with them so that we were able to catch this early," he said.
Crosslinking now FDA approved and available at OCB
Crosslinking was approved by the Food and Drug Administration in 2016 and OCB is one of the few locations in Massachusetts to offer the treatment. The procedure is performed at our Waltham location in OCB's Laser Suite, and is offered by Dr. Raizman, Ann Bajart, MD, Daniel Hu, MD, Nicoletta Fynn-Thompson, MD, Audrey Chan, MD, and Peter Rapoza, MD. Patients may be evaluated at any of OCB's nine practice locations by one of our cornea specialists.