A Grateful Keratoconus Patient, Resiliency, and a Top Doc
By the time Janice Evans met Mark Mifflin, MD, in 2013 at the John A. Moran Eye Center, she had dealt with a long history of eye problems.
Diagnosed with keratoconus at age 11, the now-70-year-old Evans drew on her years of experience and gratitude for her preserved vision to respond to the (NKCF) call for Top Doc nominations.
"I've had four cornea transplants, three in my right eye," she says. "Dr. Mifflin performed the third transplant in my right eye. And he performed both cataract surgeries on my eyes. He is so careful. I recommend him frequently, and my friends are always grateful."
Thanks to her story, the NKCF named Mifflin, director of Moran's Cornea and Refractive Division, head of Surgical Services, and associate medical director of the Utah Lions Eye Bank, its 2022 Top Doc.
"The doctors who get nominated tend to be those who don't talk down to their patients but spend the time addressing patient concerns without appearing rushed," said NKCF director Mary Prudden.
"A common phrase in these nominations is, 'I feel like I am his only patient.'"
Evans would agree.
"I liked Dr. Mifflin right away," she says. "Since it was my third time with that eye, I asked him, 'How many at-bats do I get?' He was so kind and direct. Without missing a beat, he told me he has one patient who's had six. I felt confident with him; he really eased my anxiety. You're awake when they do the surgery, so I could tell he was a solid leader working with a great team."
A Long and Winding Road to Good Vision
Evans' keratoconus diagnosis did not come as a surprise. Her father and half of her siblings also have some form of the condition.
Keratoconus causes the cornea, the clear, dome-shaped window in front of the eye, to slowly get thinner and develop a cone shape over time, affecting one in every 2,000 Americans. Because the cornea focuses light into the eye, the condition causes light rays to go out of focus, blurring and distorting vision. It makes daily activities, such as reading or driving, difficult.
For Evans, she couldn't see with eyeglasses and has worn some form of hard contact lenses for nearly 60 years. Before her diagnosis, Evans loved playing softball and basketball. But as her keratoconus slowly progressed and her vision "went south," she couldn't play sports anymore.
During college, she worked editing news film and eventually as a broadcast news producer at KSL-TV News in Salt Lake City. By age 21, fuzzy vision in her right eye made reading impossible, and she had her first cornea transplant.
Six years later, she needed a cornea transplant in her left eye and had to turn down an offer from CBS News. The network waited for her eye to heal and hired her to work as a producer in the Chicago bureau, where she stayed for two years. She worked in the Washington, D.C. bureau for four years and then returned to KSL.
Cornea transplants can fail for various reasons, including rejection of the donor cornea. By 2009, Evans had a second cornea transplant in her right eye. By 2013, she needed a third and final one.
Today, she wears rigid glass scleral contact lenses, lives independently, can drive, and enjoys cooking and reading.
Keratoconus Requires Resiliency
"Keratoconus requires patients to be adaptive and resilient," according to Mifflin. "It often starts in the late teens or early-20s, but symptoms slowly progress over 10 to 20 years. We can often correct a patient's vision with glasses or hard contact lenses, and the cornea will stabilize. Still, 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 occurs, we may need to do a cornea transplant."
Mifflin has been helping patients with keratoconus for more than 30 years.
"It is truly an honor to receive this award from the NKCF, but I would be remiss if I didn't also credit my healthcare team members, those who taught me, and perhaps most importantly, eye bankers and the donor community," says Mifflin.
"Like many corneal diseases, keratoconus spans almost all decades of life, and I have greatly appreciated my long association with patients and families."