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Big Changes in a Small Package

It’s strange to think that something the size of a pea is promising to revolutionize patient care, but that is precisely the case with the new implantable telescope.  It fits easily on the tip of your finger, but when implanted into the eye, has the ability to magnify images and afford patients with age-related macular degeneration (AMD), a second chance at sight.

For patients who have lost their central vision due to AMD, the newly FDA approved telescope from VisionCare™ may expand their options and provide the opportunity to regain some of what they have lost to AMD.

Normally, light enters the eye through the cornea (clear front of the eye), and is bent by the natural lens suspended behind the pupil, and finally focused onto the retina (the light sensitive tissue in the back of the eye).  AMD is a degenerative condition which results in the loss of the photosensitive cells of the macula, the part of the retina responsible for central vision, reading, and fine details.

Some patients with AMD may go their entire lives without losing any vision at all, while other patients are severely affected and lose a great portion of their central vision, and everything in between.

“The one thing about AMD is your vision doesn’t go completely black,” said Matthew Ohr, MD, a retina and cornea specialist. “So, in the most severe cases you lose central vision, which can have a big impact on things like reading, but you’re still able to get around because you have peripheral vision that still allows you to see objects in the edges of your vision. Still, losing central vision in both eyes can be a very big challenge.”

The new implantable telescope is designed to be embedded into the natural lens of the eye during cataract surgery in place of the standard intraocular lens that is used in most cataract surgeries.  The telescope magnifies an image to cover a larger portion of the retina and allowing patients to see around blind spots caused by AMD. The Ohio State University Havener Eye Institute is one of only a handful of selected sites in the country that are actually able to offer the telescope to patients.

“Cataract surgery has made huge advancements in the past few years,” said Thomas Mauger, Department Chairman and a cornea specialist. “This telescope lens is another step in the evolution of the lens implant. By implanting a telescopic lens, AMD patients will be able to see in ways they never could with a standard lens implant.”

While the idea of magnifying images to compensate for areas of decreased vision is not novel (some early references date back to 424 BC), most of these devices are large and cumbersome.  The implantable nature of this new telescope offers many obvious advantages, but some patients might not be candidates because they are unable to adapt to the way the telescopic lens magnifies an image in only one eye.  If they cannot adapt, the only way to reverse the procedure is to surgically remove the lens.

Before being selected as a candidate, a patient has to go through a lengthy pre-screening process, the CentraSight® program, which requires coordination between a patient’s primary care physician, their ophthalmologist, occupational therapy, and low vision services.  As part of the screening process, patients are given an external telescopic device to simulate the effect of the telescope after implant.  That way, they can experience what it would be like to have the telescope all the time in one of their eyes.

“This is an important part of the candidate’s occupational therapy,” said Dr. Ohr.  “They get to preview what it would be like to see through a telescope all the time.  They also get to see the value of having one implanted instead of external.  Since the telescopic lens is inside the eye, you don’t have a bulky set of glasses to wear all the time and keep track of and it can’t get lost in the couch cushions.”

The telescope might not be able to help everyone, but for those who are good candidates, it can make all the difference in daily living.

“Any type of lens implant advancement is exciting,” said Dr. Mauger.  “However, there is a lot of potential to be seen with the telescopic lens.  We are very excited to be one of the few sites to be able to offer this innovative option to patients with advanced AMD.”

From the inventive lens design to expanding AMD patient care options, the tiny device is pioneering big change in the field of ophthalmic care.  While there is much to look forward to with these future innovations, the better news is that a population of patients who previously did not have much to hope for, are seeing the world in a whole new light.