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A few years ago, Ravens defensive tackle Brandon Williams learned he has a degenerative eye condition called keratoconus. He worried it might be career-shortening, but he's optimistic after undergoing a new procedure called cross-linking to strengthen his corneas.
A few years ago, Ravens defensive tackle Brandon Williams learned he has a degenerative eye condition called keratoconus. He worried it might be career-shortening, but he's optimistic after undergoing a new procedure called cross-linking to strengthen his corneas. (Kenneth K. Lam / Baltimore Sun)

Brandon Williams sat in his usual seat near the back of the Ravens’ meeting room, but something was wrong. The dry-erase board down front had dissolved into a blur of colors and squiggles. Williams squinted and blinked furiously but couldn’t bring the image into focus.

“Like I got sand in my eye almost,” the Ravens defensive tackle recalls.

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Like many elite athletes, he had been able to count on near-perfect vision for most of his life. But seemingly overnight, he could not achieve this most basic of physical functions.

Williams finally went to his doctor and after a round of tests, learned he was suffering from keratoconus, a degenerative condition in which the corneas weaken and eventually bulge out, leading to blurry or distorted vision.

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There was more bad news. The procedure that could slow the deterioration of his cornea — known as cross-linking — was not yet licensed in the United States. So Williams had to wait, knowing he could do little to prevent his vision from worsening. The blurriness got bad enough that if he closed his right eye, he couldn’t make out the details of a person’s face just a few feet away.

“It’s your eyes,” he says, remembering how disconcerted he felt at the unusual diagnosis. “Usually, we get injuries to legs, arms shoulders — things like that. But this is my eyes. I’ve got to see to do what I’ve got to do on the field. It kind of freaked me out a little bit, yeah.”

After two years, cross-linking became available in the United States, in time to strengthen Williams’s cornea before keratoconus truly imperiled his livelihood.

The procedure is fairly painless, though Williams said it feels odd to have your eye propped open with a device for an hour. His Washington-area surgeon, Dr. Rajesh Rajpal, treated his eye with riboflavin (or vitamin B2) drops for 30 minutes and then blasted it with ultraviolet light for another 30. Williams underwent the procedure for his blurry left eye before last season and for his right (keratoconus generally affects both eyes, though at differing paces) two weeks ago.

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“The reaction causes the bonds in the cornea to strengthen,” Rajpal says. “The real goal is to prevent the cornea from worsening, and in most patients,it flattens.”

Williams was his usual jovial self in the operating room. The day before his initial surgery, the nurses at See Clearly Vision asked him to name his favorite song. He said “Big Poppa” by The Notorious B.I.G., figuring he’d never in a million years hear it in a doctor’s office. Sure enough, the hip-hop classic was booming over the speakers when he arrived the next day.

“They did a great job making sure I was comfortable,” he says.

Cross-linking, which originated in Germany almost 20 years ago and gained approval from the U.S. Food and Drug Administration in 2016, does not cure keratoconus. But Rajpal says it’s the best way to stall the effects, which can include double vision or starbursts in aggressive cases.

“The impact could certainly be very significant for an athlete,” the ophthalmologist says.

The prevalence of keratoconus varies widely from nation to nation, but estimates in the United States have ranged from 1 in 2,000 people to 1 in 400 people.

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Like many people, Williams first reacted to his blurry vision by assuming he needed LASIK surgery. But that’s actually the opposite of what a keratoconus patient should do, Rajpal says, because LASIK further thins the cornea.

Williams, 29, is accustomed to coping with scary health conditions. When he was playing at Missouri Southern State, he faced complications from back surgery and had to be rushed to the hospital with a staph infection, spinal meningitis and a torn spinal fluid sac. He could have died had he not called the ambulance when he did.

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“Nothing’s as bad as what happened in college,” he says. “With this, I was a little scared but it was perfectly fine.”

The Ravens bet big on Williams before last season, signing him to a five-year, $52.5 million deal to serve as the long-term anchor for their defensive line. Though he missed four games because of a foot injury, he largely rewarded their faith, elevating the team’s run defense almost immediately when he returned to the field.

He wears a customized contact on his left eye, but other than that, he should be able to continue playing without worry. When he bulldozes through an opposing blocker, the ball carrier on the other side won’t be an indistinguishable blob.

“I can’t be out there only seeing blurs,” he says, laughing.

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