Olympic Bobsledder Steve Holcomb Overcame Blindness on Road to Olympic Bronze

This week American Steve Holcomb broke a 62-year US drought in two-man bobsled by winning a bronze medal (with brakeman Steve Langton). This came four years after the 2010 Vancouver Winter Olympics, where Holcomb led the four-man US bobsled team to a gold-medal victory, ending a 62-year gold medal drought in US Olympic four-man bobsled competition.

But did you know that Holcomb almost wasn’t able to compete in either Olympics because he was legally blind?

Holcomb was diagnosed with a disease of the cornea (the clear cover over the lens) called keratoconus. Diagnosed with this degenerative corneal disease in 2002, over the next few years, his eyesight became increasingly worse- to the point where Steve thought it was no longer safe for him to drive a bobsled. Most eye doctors told Steve that the only option for him would be a corneal transplant (where the diseased cornea is removed, and a new cornea put in place). Recovery from this procedure can be long (and painful) and could only be done on one eye at a time. It would means taking a two year break from the sport, essentially ending his career. Holcomb went into a deep depression, leading to a (fortunately) unsuccessful suicide attempt.

But then Holcomb met Dr. Brian Boxer Wachler who offered a different solution. His procedure, called C3-R (later renamed Holcomb C3-R to “honor Steve”) uses a vitamin (riboflavin) solution paired with light to strengthen the deteriorating cornea and stop the disease. With the addition of special implanted contact lens (called INTACS) 3 months later, Holcomb vision was restored. As he told Voice of America:

“It’s amazing to live life with 20/20 vision, it’s like life in high definition”

After his gold medal run in Vancouver, Steve wrote about this journey in a book entitled But Now I See: My Journey from Blindness to Olympic Gold.  He became a staunch advocate for the procedure (which takes less than an hour, with almost no down time).

Holcomb hopes to repeat a four-men bobsled gold with his teammates this weekend.

What is keratoconus?

keratoconusKeratoconus is a progressive thinning of the cornea. Keratoconus arises when the middle of the cornea thins and gradually bulges outward, forming a rounded cone shape. This abnormal curvature changes the cornea’s refractive power, producing moderate to severe distortion (astigmatism) and blurriness (nearsightedness) of vision. Keratoconus may also cause swelling and a sight-impairing scarring of the tissue.

It is the most common corneal dystrophy in the U.S., affecting one in every 2,000 Americans. It is more prevalent in teenagers and adults in their 20s.

What causes keratoconus?

Studies indicate that keratoconus stems from one of several possible causes:

  •     An inherited corneal abnormality. About seven percent of those with the condition have a family history of keratoconus.
  •     An eye injury, i.e., excessive eye rubbing or wearing hard contact lenses for many years.
  •     Certain eye diseases, such as retinitis pigmentosa, retinopathy of prematurity, and vernal keratoconjunctivitis.
  •     Systemic diseases, such as Leber’s congenital amaurosis, Ehlers-Danlos syndrome, Down syndrome, and osteogenesis imperfecta.

What are the symptoms?

keratoconus visionThe earliest symptom is subtle blurring of vision. This blurriness typically cannot be corrected with glasses.  Over time, patients complain of having eye halos, glare, or other night vision problems.

Most people who develop keratoconus have a history of being nearsighted which becomes worse over time. As the problem gets worse, astigmatism develops. Astigmatism is an optical defect in which vision is blurred due to the inability of the optics of the eye to focus a point object into a sharp focused image on the retina. This may be due to an irregular curvature of the cornea or lens.

Keratoconus usually affects both eyes. At first, people can correct their vision with eyeglasses. But as the astigmatism worsens, they must rely on specially fitted contact lenses to reduce the distortion and provide better vision. Although finding a comfortable contact lens can be an extremely frustrating and difficult process, it is crucial because a poorly fitting lens could further damage the cornea and make wearing a contact lens intolerable.

How is keratoconus treated?

In most cases, the cornea will stabilize after a few years without ever causing severe vision problems.But in about 10 to 20 percent of people with keratoconus, the cornea will eventually become too scarred or will not tolerate a contact lens.

If either of these problems occur, a corneal transplant may be needed. This operation is successful in more than 90 percent of those with advanced keratoconus. Several studies have also reported that 80 percent or more of these patients have 20/40 vision or better after the operation.

A second option is the Holcomb C3-R treatment. Here is a video by Dr. Boxer Wachler explaining the procedure:

Research is underway to study this procedure and its long-term results. INTACS lens have been approved by the FDA, however Holcomb C3-R (although approved for use in Europe, is still awaiting approval from the FDA in the US.

For more information about keratoconus, click here to go to our Resounding Health Casebook on the topic.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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