Keratoconus: Tauranga patient diagnosed after failing eye test when renewing driver’s licence

An eye test is carried out by the optician. Photo / Unsplash

Failing an eye test when renewing his driver’s licence in January was a “blessing in disguise” for Tauranga man Reuben.

Reuben, whose surname the Bay of Plenty Times agreed not to publish, learned soon after he had keratoconus − a condition that causes loss of vision.

Reuben has had treatment on each eye in September and November respectively at the Rotorua Eye Clinic by ophthalmologist Dr Colin Parsloe.

Parsloe hopes to introduce an annual national screening programme for keratoconus for intermediate and high school children through his charity, Keratoconus Limited.

He launched a pilot programme on November 25 and screened all students at Mokoia Intermediate and Rotorua Intermediate schools.

Reuben said establishing a national screening programme in schools was “a great idea”.

“There isn’t enough knowledge ... if you can get the youth to be aware of these kinds of things, then they know what to look out for and when to go and get things checked.”

‘Bearable but very painful’

Reuben, in his 30s, was referred to an optometrist after failing his eye test when renewing his driver’s licence.

The optometrist confirmed he had keratoconus in both eyes, the left being more serious than the right.

In hindsight, Reuben said he had noticed a “slight blur” in his left eye but had not got it checked.

When using his phone, he had to “zoom in more” or bring it closer to his eyes to read it.

Reuben was referred to Parsloe for cornea cross-linking treatment which he said was “fairly daunting”.

Dr Colin Parsloe - who wants to introduce a national screening programme for keratoconus - works at the Rotorua Eye Clinic. Photo / Stephen Parker

Reuben had treatment on his left eye in September and the right eye in November.

The first treatment was “bearable but very painful”.

He stayed in a “dark room” with the curtains closed for two to three weeks until it healed.

The treatment on his right eye was “way more painful”, he said.

A post-treatment check-up revealed his left eye had improved but his right eye was still healing.

If he had not had cross-linking treatment, “the alternative wouldn’t have been too good for me”.

What is Keratoconus?

Parsloe explained the cornea had collagen fibres held together by “little linkages”.

He said keratoconus weakened the ability of the collagen to hold itself together in a certain structure.

Parsloe said the eye had to be “pumped up to a certain pressure” to be stable.

For patients with keratoconus, the pressure could be “too much” on their eyes.

“That weak spot that’s between those collagen fibres allows the fibres to slip. They slip and the first thing that happens is the cornea starts to thin and then it bulges a little bit.

“Very early on, patients may not even notice this happening.”

Rotorua ophthalmologist Dr Colin Parsloe.

He said keratoconus often started in one eye. The patient could become aware of it and get glasses, which would be fine to compensate for the “small change”.

If a patient needed different glasses in six months, “it’s likely that your cone is bulging more”.

If the bulge progressed, someone might need a soft or hard contact lens. Eventually, someone might need a scleral contact lens.

“Ultimately, if it continues to thin and spread ... the inner layer can rupture, fluid gets in and they get this really intense pain initially for a few days.”

This caused scarring and the only way to overcome that was to get a donated cornea, he said.

What are the symptoms?

Parsloe said the “strongest” sign of keratoconus was rubbing your eyes.

Others were “constant squinting”, bringing something closer to your eyes to see it, and needing to update glasses every six months.

Parsloe also advised people to be aware of their family history of unexplainably losing vision in one eye.

If people had symptoms, he advised asking an optometrist specifically about keratoconus as optometrists did not always look for it.

Parsloe said keratoconus could stop people from being able to drive, doing “well-paid” jobs and working on computers.

“The earlier we get the patients, the earlier we treat them, the less loss of vision.”

Parsloe said it was difficult to say how common the disease was because “there’s no real great statistics or data”.

He said a study done among high school students in Wellington showed one in 45 Māori had keratoconus. Overall, one in 191 had it.

How is Keratoconus treated?

Parsloe said if keratoconus was picked up early, there was a “one-off” 30-minute treatment called cornea cross-linking which stopped it from progressing.

This involved soaking the eye with Vitamin B and shining a blue concentrated ultraviolet light on it for 10 minutes. This “superglues” the strands together.

After it healed, “that’s it for the rest of their life”.

Parsloe said natural ultraviolet light also “tightens those linkages”.

He said not everyone with keratoconus would “get it the full way”.

Some of his patients started developing a bulge “and then it stops at a certain point”.

Giving people ‘independence’

Parsloe was inspired to start his charity in August after seeing many patients in New Zealand with keratoconus.

Before moving to Rotorua in 2020, Parsloe was living in the UK where he “hardly” saw patients with keratoconus.

“My whole reason I get up in the morning is to give people independence.

“I can stop it from getting worse, but by then they’ve already lost their careers ... their income, they’re never going to be able to provide for their children the way that they should have been able to, and that was frustrating for me.”

Cone.org is a screening programme the charity runs.

Mokoia Intermediate School students were screened for keratoconus as part of Dr Colin Parsloe's pilot programme. Photo / Andrew Warner

During the pilot programme at Mokoia Intermediate School, “at least three” students would be referred for cornea cross-linking.

Next year, the charity planned to screen all students at Rotorua, Kawerau, Whakatāne, Taupō, and Ōpōtiki high schools.

In 2026, he planned to screen students in Tauranga, the Western Bay of Plenty, and Hamilton.

His ambition was to introduce an annual national screening programme for intermediate and high school children in New Zealand.

People could donate on the cone.org website.

Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.