Saturday 23 September 2017

How this nurse was shocked to find she had a rare eye condition after years of troubled eyesight

Even though she is a nurse, Ethel Wallace was unable to find out why her eyesight was so poor. But, she tells our reporter, following a visit to a Dublin specialist, she did get a diagnosis, and, better still, she got a cure

Ethel Wallace got a diagnosis and cure for her condition. Photo: Steve Humphries
Ethel Wallace got a diagnosis and cure for her condition. Photo: Steve Humphries

Joy Orpen

For many years, Ethel Wallace (38), struggled to get a clear picture of the world around her. She says that even though health professionals did their level best to get to the bottom of her problem, they were unable to pinpoint exactly what was wrong with her eyesight.

Ethel grew up in Dysart, Mullingar. During her early teens, she began to experience problems with her vision. "In class, I'd struggle to see the writing on the blackboard," she says. "And when I was playing football or camogie, I'd lose sight of the ball as it was coming towards me. I think my parents thought I wanted to be like my sister, who wore jam-jar glasses. But at times, I genuinely couldn't see. So, it was very frustrating, and I began to seriously doubt myself."

Naturally, Ethel's parents made every effort to resolve her problems. So, over the years she was seen by many opticians. Through her teens and early 20s, she wore glasses and contact lenses to cope with short-sightedness. But even so, she continued to experience major difficulties. "If I met you in the street I probably wouldn't recognise you," she says. "I'd be cross-eyed trying to focus. Unfortunately, some people got the idea that I was stuck-up. But I wasn't; I genuinely couldn't see them."

After school, Ethel trained to be a nurse in Sligo. She then spent four years in Dublin, working at two major hospitals. A vibrant, pretty young woman like her should have been having a great time in the metropolis, but she wasn't - her social life was being wrecked by eye problems.

"By then, I'd been prescribed contact lenses," she explains. "Every Friday and Saturday night, I ended up with red, sore eyes, and mascara running down my face. The lenses irritated my eyes horribly. Inevitably, the glasses went back on, while the contact lenses ended up in the bin. And by then, I'd have lost all interest in going out."

However, in time, Ethel returned to Dysart, and married Brendan Wallace, whom she has known since they were toddlers. They have three children - Aaron (seven), Michelle (five) and Luke (three).

In 2007, Ethel's sister decided to have laser eye surgery. "She is a perfectionist, so having researched the options, she decided to go to the Wellington Eye Clinic in Dublin," explains Ethel. "She had her surgery, and came back with 20/20 vision. I decided to go there myself."

In January 2008, Ethel arrived at the clinic and had various tests. She was then told that a colleague was being asked to give a second opinion. "I thought, 'Here we go again'." Ethel had encountered this situation during previous visits to various opticians.

"A colleague of some sort would be called in, and they'd see a 'shadow' or there'd be a discrepancy," says Ethel. "But then I'd be told there was nothing to worry about, so off I'd go." She also recalls a time when her eyes were so problematic, she ended up being examined by two opticians in quick succession, and was given different prescriptions at each practice. When she questioned this, they were unable to explain the anomaly. But in time, that discrepancy would be explained.

Enter Dr Arthur Cummings, consultant eye surgeon at the Wellington Clinic, and head of the Department of Ophthalmology at the Beacon Hospital. "He studied the results of the tests, which included pressure tests, mapping, and examining the inside of the eye," says Ethel. "And he told me I had a progressive degenerative disease called keratoconus."

According to Dr Cummings, this is "a little-known condition, which affects about one in every 2,000 people. It involves a progressive thinning of the cornea, leading to it developing a cone-like bulge, rather than its usual round shape. It's something that can be missed by optometrists during regular eye checks. Excessive eye-rubbing is a risk factor for developing keratoconus, and ophthalmologists urge parents of children who constantly rub their eyes, to have them checked."

Ethel was both stunned and somewhat relieved. She and her mother, who had accompanied her, were shocked to learn that if this condition had not been diagnosed in time, she would probably have needed a bilateral corneal transplant within two years. "My mother was devastated," she says.

Ethel describes her personal experience of having keratoconus: "Because it caused my corneas to become cone-shaped, it distorted and reduced my vision. Sometimes, when I looked at someone, there'd be no problem. But at other times, there were severe distortions, because my head was at a different angle," she says.

Ethel says while the diagnosis was a shock, there was also a sense of relief that she wasn't "crazy" after all. It also helped that from the outset, she felt she could trust Dr Cummings implicitly. "So, when he told me they were trialling new surgery, I was prepared to try it, even though it hadn't yet been approved by the US Food and Drug Authority," she says.

According to Ethel, Ireland takes its lead from the US, and if a drug or a procedure is not yet approved by them, medical insurance in Ireland won't pay for it. "It cost me €5,000, even though I was so close to needing corneal transplants," she says.

"At that stage, I was a nurse, who was also qualified in ENT and ICU, working full time, paying my taxes. If I'd become blind, I'd have become a total liability on the State. Transplants would have cost about €20,000 an eye."

In March 2008, Ethel had her left eye done under local anaesthetic. Dr Cummings, (who recently published a textbook on the topic) reshaped the cornea using a laser, to improve vision, and undertook a procedure called corneal cross-linking, to halt the progression of the keratoconus.

About six months later, Ethel had the right eye done. She says as long as she wears her prescription glasses, her vision is now perfect.

It is suspected that Ethel's condition is genetic, so her children will be tested when they are older. In the meantime, she is an avid runner, who did the Mullingar half-marathon recently. "I can't wait for those long nights, when no one wants Mammy," she says, "Then I can go running in the rain. It's wonderful to be able to see where I'm going and to see what's coming at me."

See wellingtoneyeclinic.com

'Corneal Collagen Cross Linking', co-authored by Dr Arthur Cummings and Professor Mazen Sinjab, is available on Amazon

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