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The Advanced Eye Procedures Helping Patients with Keratoconus, According to Dr. Neda Shamie

Dr. Neda Shamie

Ophthalmologist and Specialist in Advanced Eye Surgeries

Dr. Neda Shamie, an ophthalmologist and specialist in advanced eye surgeries in Los Angeles, sees patients for a wide variety of eye conditions, including keratoconus, a condition in which the cornea thins, leading to blurred vision and light sensitivity. For many years, doctors were unable to do anything for patients with keratoconus, but the advanced surgical options that Shamie helped pioneer offer fresh hope. “Now when I see a keratoconus patient, I don’t have this gloom-and-doom feeling like this patient is going to need a corneal transplant before the age of 40,” Dr. Shamie said.

Dr. Shamie was drawn to ophthalmology because of the field’s developing surgeries. “My real interest in it was the elegance of the surgical procedures, the incredible impact you can have on patients’ lives, and how quickly you can give them those results,” she said. “I could foresee the application of really advanced exciting technology.”

Achieving milestones

With her eye on advanced surgical options, Dr. Shamie became the first person in the Midwest to offer artificial corneal transplantation. “I flew out to watch the surgeons who had done the most of those types of surgeries,” she said. “I learned from them and then taught myself in the laboratory setting and then we ventured into the surgery.”

Dr. Shamie said it was her patients that inspired her to become a pioneer in advanced eye surgeries. “I was motivated by the responsibility I had to them to give them the best care possible,” she said. “I didn’t intend to be the first, actually at the time I probably didn’t even realize I was going to be the first. I just knew what was right for the patient.”

Future of treatment

Corneal transplant is typically a last resort procedure for patients suffering from keratoconus, but new procedures are helping prevent keratoconus from advancing to the point where a corneal transplant is required. “Keratoconus diagnosis management has completely shifted in the last decade and a half,” Dr. Shamie said. “We started off looking at keratoconus as a relentless condition that we really couldn’t stop from progressing. We would just watch these patients, many of whom were young, gradually losing their vision, becoming more and more dependent on glasses and contacts, and then ultimately would need a corneal transplant.”

In the last 15 years, however, new therapies have developed, such as collagen cross-linking, a minimally invasive procedure that helps strengthen the cornea by creating new links in the collagen fiber. “Collagen cross-linking has caused an absolute paradigm shift in the way that we manage keratoconus,” Dr. Shamie said. “The success of this has been incredible. Corneal transplant rates where the indication was keratoconus have plummeted.”

Additionally, Dr. Shamie believes in genetic testing as an effective advanced diagnostic tool for keratoconus. “[It] will pick up at-risk patients that have that genetic predilection for keratoconus, and when we have a less invasive collagen cross-linking procedure, it could be a quick in-office treatment where even before a patient is symptomatic we could potentially stop the disease in its progression,” she said. “Imagine if we could come up with something like that for cancer or heart disease, but we’re very close to it with keratoconus. We’re almost there.”

Check vision early

Dr. Shamie encourages people to have their eyes checked from a young age. “If a younger patient has keratoconus and they wait to get a proper eye evaluation, they’re not going to know they have keratoconus until it’s too late,” she said. “It’s critical that we change our culture and our mentality to not ignore the eyes because isn’t vision one of the most important senses we have?”

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