Expanded eye services help to diagnose more patients

Sam Odrowski

Cousineau Eye Centre’s recent renovation, expansion, and integration of eye-care services has allowed it to provide an improved level of service to its patients.
This expansion means more people are getting diagnosed for ocular eye issues like cataracts, glaucoma, macular degeneration, keratoconus, and diabetic retinopathy.
A couple of weeks ago, I visited Cousineau Eye Centre on Scott Street to learn about its recent expansion of eye services and eye-screening technology. At the time, my last eye doctor visit was just six months previous (prior to my move to Fort Frances), so I assumed there wouldn’t be any significant changes in my eyes or prescription.
During my visit, I allowed Dr. Thomas Cousineau to do various screenings on my eyes to show me how the machinery worked and I was shocked by what he discovered.
After screening my eyes with an autorefractor and reviewing the keratometry reading, he said the amount of astigmatism found in my eyes didn’t coincide with the prescription I had in my glasses.
Dr. Cousineau later used a retinoscopy and corneal topography machine, which is also available at Lidkea Optometry, to confirm his suspicions.
He determined I have a corneal ectasia and it’s likely the beginning stages of keratoconus–a progressive eye disease where the cornea begins to thin and bulge into a cone shape.
The thinning and bulging of the cornea makes light deflect on its way through the cornea, causing visual distortion.
Keratoconus can cause a rapid loss of vision in those affected and sometimes is treated with a corneal transplant surgery as a last resort.
My corneal ectasia was never diagnosed during my eye test before I moved here because the office I visited didn’t have a corneal topography machine.
Had I never visited Dr. Cousineau, my eye disease likely would have remained undiagnosed until it got more advanced, which could have caused a permanent loss of vision.
“It would be much more difficult to treat and your best corrected acuity may not be as good,” Dr. Cousineau explained.
“The longer you leave it, the more difficult it is to deal with,” he stressed.
The corneal ectasia in my eye is off-centre, making it more difficult to diagnose and possibly is one of the reasons why it initially was overlooked, although it’s not rare for a corneal ectasia or keratoconus to not be central in the eye.
Dr. Cousineau said he sees it all the time.
“Keratoconus is way under-reported in the population,” he noted. “If you look at a lot of older journals, they’ll say it’s maybe one in a few thousand people.
“But now the instance of keratoconus is higher than what was traditionally thought.”
Some estimates indicate the current rate of keratoconus could be as high as one-in-400.
In light of current research, Dr. Cousineau makes every effort to do extra screenings such as topography on first-time patients or those who may be at risk for a genetic eye issues.
“Currently, we pick and choose people that we think are the most appropriate to do it on, such as contact lens wearers or anyone with an unusual astigmatism,” he said.
“We also do it on every surgical patient, if they’re looking at Lasik laser surgery, or anything we do topography on–anybody with high astigmatism or high myopia.
“But also particularly with families of patients with keratoconus,” Dr. Cousineau said. “Now we’re screening the children and even though the child’s vision may be 20/20, we still do topography because it could be like yours where it’s off-centered.
“But it seems like the range of people we’re doing it for is expanding constantly,” he added.
In the near future, Dr. Cousineau plans on replacing his current topographer with a more advanced model that will become a part of regular screenings for most patients, including those with dry eye disease.
Dr. Cousineau said he doesn’t think the instances of keratoconus or other corneal diseases is more prominent here. But when people look for it, they’ll be surprised by what they might find.
In early January, I’ll be visiting a cornea specialist in Toronto, where they will view my cornea through a pentacam to evaluate if the corneal ectasia is keratoconus–and if it needs to be treated immediately or just monitored instead.
Dr. Cousineau’s said he believes it most likely will be diagnosed as keratoconus and that I will be monitored regularly to see if the condition is progressive or stable.
I was very fortunate to have visited Cousineau’s Eye Centre and potentially saved myself from further damage to my corneas.
It should be noted that Lidkea Optometry here also offers corneal topography and houses all the same state-of-the-art equipment offered by Dr. Cousineau’s practice.
Had I visited that practice instead, I would have received the same diagnosis.