Macular Degeneration: Implantable Telescope Improves Vision

FRESNO, Calif.

Macular degeneration stole Jackie Carswell's central vision.

"I couldn't read a recipe. I couldn't work a microwave. I couldn't hardly do anything. I asked the doctor one day if there was anything else that can be done for this," Jackie Carswell told Ivanhoe.

Doctors suggested she try this miniature telescope.

"It contains lenses, or optics, that make an image magnified," Susan A. Primo, OD, MPH, Director of Vision and Optical Services at Emory Eye Center, told Ivanhoe.

Surgeons removed Jackie's natural lens and replaced it with the tiny implant that enlarges objects.

"It's a three-times telescope, which means, theoretically, it improves vision by almost three-times," Dr. Primo said.

The telescope is only implanted in one eye.

"Now, these folks are bi-ocular. The use one eye for one thing and one eye for the other," Dr. Primo explained.

It takes about twelve weeks of training and rehab for patients to master the new device. In one study, nine out of ten patients with the telescopic implant improved vision by at least two lines on the eye chart.

The telescopic implant is helping Jackie keep a lot of her independence.

"I was determined that I'd make it, and that I'd do it. Now, I have and I am!" Jackie said.

The telescope implant is FDA approved for patients 75 and older who have advanced wet or dry macular degeneration. The most common risks include inflammatory deposits on the device and increased pressure in the eye.

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BACKGROUND: Age-related macular degeneration (AMD) is a common condition and the leading cause of vision loss in people who are 50 and older. It slowly destroys the part of the eye that allows sharp, central vision needed for seeing objects clearly, known as the macula. AMD can advance so slowly in some that vision loss does not occur for a long time. In others, the disorder can progress faster and can lead to a loss of vision in one or both eyes. The vision loss associated with AMD makes it difficult to recognize faces, drive a car, read, and write. The macula is made up of millions of light-sensing cells that allow for sharp, detailed central vision. It's the most sensitive part of the retina. The retina quickly turns light into electrical signals and then sends the electrical signals to the brain through the optic nerve. The brain then translates the electrical signals into images. When the macula is damaged, fine points in the images become unclear. (Source: www.nei.nih.gov)

STAGES: There are two forms of AMD: dry and wet. Both forms can advance and cause severe vision loss. The dry form is more common and it occurs in about 90 percent of the people with the condition. It also has three stages: early, intermediate, and advanced. It occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision. The wet form is considered advanced AMD and can be more severe. It happens when new blood vessels under the macula leak fluid and blood. All people who have the wet form had the dry form first. (Source: www.nei.nih.gov

NEW TECHNOLOGY: There is no cure for End-Stage AMD. It is uncorrectable by drugs, glasses, or cataract surgery. However, the CentraSight treatment program can help improve vision. The telescope implant has been shown to improve vision and quality of life in appropriate patients with End-Stage AMD. The program uses a tiny telescope, created from VisionCare Ophthalmic Technologies. The implantable telescope is about the size of a pea. It is implanted behind the iris, the colored part of the eye. The implant is barely noticeable in the eye. Once the telescope is implanted inside the eye, it projects images in the field of view onto healthy areas of the central retina outside of the degenerated macula. The image is enlarged and it reduces the effect the blind spot has on the central vision. Usually the healthy areas outside the macula are used for peripheral vision. The magnification the telescope implant provides (2.2x or 2.7x) makes it possible to see or discern the central vision object of interest. In the CentraSight treatment program, a person uses the eye with the telescope implant for detailed central vision (like reading). The other eye is used for peripheral vision (like checking for cars while driving). The implant doesn't limit the natural eye movements and it doesn't require the patient to move their entire head, unlike external magnifying appliances. As a patient in the CentraSight program, they will need to work with low vision specialist to develop the skills they need to use. One of the skills that they have to learn is how to switch their viewing back and forth between the eye with the telescope implant and the eye without the implant. They will also need to wear eye glasses and may need to sometimes use a hand-held magnifier with the telescope-implanted eye to read. (Source: http://www.centrasight.com)

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