MUSC implants telescope in the eye of a macular degeneration sufferer
Friday the 13th, despite its reputation, is Justine Wise’s lucky day.
Age-related macular degeneration, a leading cause of vision loss in older adults, is a disorder that destroys the macula and causes blindness or partial blindness in the central part of the eye.
Macular degeneration comes in two forms: dry and wet.
The dry form is more common and has three stages: early, intermediate and advanced. The wet form, considered more advanced and severe, is caused when new blood vessels under the macula leak blood and fluid.
People at greater risk for age-related macular degeneration are 50 and older, tend to be white and have a family history of the disorder.
Those wanting to lessen their risk for macular degeneration should avoid smoking cigarettes, exercise regularly, maintain healthy blood pressure and cholesterol levels, and eat a diet rich in leafy, green vegetables and fish.
SOURCE: The National Eye Institute
That’s what the 86-year-old Tiffin, Ohio, resident calls the day in July when she had a pea-size telescope implanted into her right eye at the Medical University of South Carolina’s Storm Eye Institute.
Suffering from end-stage macular degeneration, Wise is the first person in the Palmetto State to undergo the seemingly futuristic surgery, approved by the Food and Drug Administration in October 2011.
Within days, she was able to see people and objects directly in front of her for the first time since 2005, when her second eye began to degenerate from the condition. And while she demonstrated she could see specific images in front of her, Wise has one desire she’s yet to achieve.
“My main goal is getting back to reading something again. I love to read.”
Robbing golden years
According to the National Eye Institute, macular degeneration is a common eye condition for people 50 and older and is a leading cause of vision loss in older adults. The condition gradually destroys the macula and creates a centralized blind spot while peripheral vision remains intact.
As a result, many daily tasks most of us take for granted in youth and middle age — reading and writing, cooking, shopping, watching TV, driving and simply observing others — are slowly taken away. Oftentimes, macular degeneration can lead to depression and a host of physical ailments.
The eye institute estimates that while 1.75 million U.S. residents have age-related macular degeneration, the number is expected to climb to 3 million by 2020. Though the increase is due to the aging population, rates have dropped in recent decades.
The implantable miniature telescope was developed by VisionCare Ophthalmic Technologies and was provided through its CentraSight treatment program. The telescope, which costs about $16,000, and procedure are covered by Medicare.
Dr. Charlene Grice, a cornea surgeon with the Storm Eye Institute who performed Wise’s surgery, says until the telescope and procedure were approved by the FDA, there was nothing that surgeons could offer patients when they reached end-stage macular degeneration.
“We’d send them to low-vision therapy, teach them to use canes and tell them they can’t drive. We were supportive because, until now, it was all we had,” recalls Grice.
Yet before patients and families get their hopes up, Grice adds that the surgery requires meeting some fairly specific criteria, starting with being 75 or older and the disease progressing to end-stage. Also, a candidate must seem suited to extensive therapy and training for six months and must not have had cataract surgery in one eye.
“The telescope is implanted in the human eye at the same time we do cataract surgery, so if you’ve had cataract surgery (in both eyes), you’re not a candidate. We put the implant in with a telescope in it, so it’s much bigger and heavier and requires a bigger wound,” says Grice.
Eventually, Grice says, the procedure may progress to the point where it doesn’t matter if a patient has had cataract surgery.
As revolutionary as a miniature telescope eye implant is, Grice says it’s a worthy interim solution.
“The real solution is to prevent it. Macular degeneration is a blinding disease. With research, we want to be able to figure out what triggers it and how to prevent it or fix it,” says Grice. “Until we get there, it (the telescope implant) is one of the few things we can offer folks. It definitely improves their quality of life. People can recognize faces and write checks.”
Family support is key
Grice says Wise was an ideal first candidate for the surgery not only because of her proven will and spunk, but because of the support from her family.
In fact, it was her daughter, Kathy Aller of Elgin, who first found out about the procedure on CBS television’s “60 Minutes” show. After a quick Internet search, Aller called CentraSight but got no response. A subsequent call months later got a response.
Wise has been living with Aller in Elgin near Columbia since April.
“I don’t know what I’d do without my family. They help me so much,” says Wise. “With my therapy and my willingness to work through it, I know I’m going to get it done.”