[Fmpro] KC , Eczema and Shiftwork

[K. Jeremy Gibbons]

Hello 

My name is Jeremy Gibbons . I was diagnosed with KC in
my early 30's. I've probably noticed subtle changes in
my vision ( particularly night vision) in my late
20's. I have always been significantly myopic and my
astigmatism has always been monitored. I began wearing
soft contacts in my late teens ( as opposed to
glasses) because of my athletic lifestyle ( soccer,
track and field)  

I have 2 questions. 

Firstly, I have suffered from severe eczema ( contact
dermatitis ) since birth particularly in the creases
of my joints ( behind knees, inside elbows,  fingers
etc...  ) and occasionally on my face ( especially
when I travelled outside of North America). I am now
38 years old and since I have been diagnosed with KC (
currently wearing RGP's in both eyes) my eczema has
completely  disappeared. The areas where flare-ups use
to occur have totally healed and are no longer
discoloured. During the last 2-3 years I have also
become a bonafide seasonal allergy sufferer requiring
antihistamine relief: REACTINE. I'm curious to know if
anyone has any insight to the disappearance of my
eczema and the emergence of KC. It is my understanding
that these disorders fall under the auto-immune
sequelae. To add more fuel to the fire I required a
splenectomy         ( removed spleen)  when I was 20
years old to correct acute idiopathic autoimmune
heamolytic anaemia (I acquired an auto-antigen lining 
my red blood cells which my immune system considered
foreign). 

My second question concerns the incidence of KC among 
shift-workers. My KC is more than likely genetic
however I often wonder if environment could also play
a role. I'm a sleep disorders technologist and as such
my sleep-wake schedule is quite erratic. I have been
in this profession for nearly 13 years. During the
beginning of my career I used to moonlight quite a bit
working 3-5 night shifts a week then switching back to
days for 1-3 days depending on my various schedules.
During this time I was constantly wearing soft
contacts   rarely switching to glasses. My contact
lens fitter at the time never advised that I should
wear my glasses more often. After wearing my lenses
for up to 36 hours at a time I would often have
prolonged bouts of "eye-rubbing". My contact lens
fitter would enquire as to how often I would rub my
eyes but she never indicated whether or not this was
an issue ...etc. I can no longer see with my glasses.
Only my RGP's allow for proper vision. I'm still a
shift-worker ( 2 night and 2 days /week with weekends
off). Is there any evidence that wearing RGP's
overnight may exacerbate KC? I was once told by a
colleague ( retinal specialist) that I should  monitor
ocular pressure as well. Does anyone have any insight?

Thanks

Jeremy Gibbons BSc RPSGT
 from Toronto Canada. 




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