Major Leaguer Tommy Pham Plays Through Keratoconus

March 9, 2018: By Jon Swedien

Tommy Pham
(Source: Johnmaxmena2/Wikimedia Commons)

Tommy Pham believes he is the only major-league baseball player with keratoconus.

Pham, 30, a center fielder for the St. Louis Cardinals, recently spoke with media outlets about his battle with keratoconus, the crosslinking surgery he underwent to save his vision, and how he manages to see deceptive pitches and track fly balls while living with the disease.

“I’m the only (major league) baseball player with keratoconus,” Pham told 101ESPN during a March radio interview on the Bernie Miklasz Show. “They all look at me as a miracle because this isn’t supposed to happen.”

Pham, who is coming off a breakout year, was diagnosed with keratoconus in 2008, he told Bleacher Report’s Scott Miller, who wrote a profile on Pham for the website.

Pham told Miller that before he was diagnosed he once hit a home run on what he thought was a fastball, only to find out from teammates that the pitch was actually a slider.

At the time he was diagnosed, Pham was playing in the Cardinals’ minor league teams. A team official had encouraged him to get his eyes checked because while he had a good swing, he struck out often.

Pham feared the diagnosis might threaten his chance to play major league ball, especially after glasses proved ineffective and contacts were very uncomfortable.

As Miller explained, glasses did not help Pham because he needed to look through the center of the lens to benefit his vision, but that’s not possible for a ball player who is tracking a pitch with his eyes while keeping his head still in his proper hitting stance.

As for contacts, Pham said he found several models were painful and some caused his eyes to water and blur when he ran. Fortunately, through experimentation over the years, Pham found contacts that work well for him.

Pham broke into the majors for the first time in 2014, although he would still spend time in the minors before becoming a full-time starter last season.

After his diagnosis, however, Pham learned that he had more than contacts to worry about because his early-stage keratoconus could get worse and further threaten his vision and career.

That was the message he heard from Brian Boxer Wachler, MD, who contacted Pham a couple years after his diagnosis regarding a cross-linking surgery that the well-known Beverly Hills-based ophthalmologist had developed, and which he thought could help the ball player.

Boxer Wachler named the surgery Holcomb C3-R after Olympic gold medalist bobsled driver Steve Holcomb, on whom Boxer Wachler had performed the surgery.

Pham underwent the procedure following the 2011 season, at which time no cross-linking procedure had been approved in the US. In April 2016, Avedro’s cross-linking system received FDA approval for progressive keratoconus. It remains the only approved cross-linking in the US. It has since also gained indication for corneal ectasia following refractive surgery.

C3-R differs from Avedro’s approved system. A key difference is that during C3-R the cornea’s epithelium is left on, whereas during the FDA-approved Avedro cross-linking system the epithelium is removed to allow liquid riboflavin to more easily penetrate the corneal tissue. There is a debate among ophthalmologists on whether so-called “epi-on” procedures are effective.

For Pham, the results have been good, and, so far, his disease has been held in check.

“When we look at my charts, my keratoconus has been the same for years,” Pham told the radio station.

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