Advanced age-related macular degeneration is the leading cause of blindness in the U.S. in adults over the age of 60. It affects nearly 2 million people in the U.S., with half a million new cases diagnosed every year. It’s a big problem. And until recently, we didn’t have a very good way of treating it. Patients with end-stage degeneration typically had to rely on cumbersome, low-tech solutions to help them see–relics like handheld magnifying glasses and closed-circuit televisions. But earlier this month, a team of surgeons at the UC Davis Eye Center introduced a promising new solution: a tiny, implantable telescope.
To get a sense of how it works, you have to understand the malady it’s intended to treat. As macular degeneration worsens, scarring in the eye creates a foggy black spot in the center of the patient’s vision. The new implant magnifies the image entering the eye two to three times, projecting a larger image onto the scarred macula and thus reducing the size of the blind spot relative to whatever the patient’s looking at. Before, where a patient with AMD might have had a black spot that obscured the entire face of a loved one, rendering them unrecognizable, the telescope magnifies the face so the black spot only takes up a portion of it. It’s not a solution to AMD so much as a workaround for it.
But the eye is a tricky organ to design for. The tiny telescope necessitates ultra-precise manufacturing–it’s comprised of a fused silica capsule that contains the optical elements, a transparent thermoplastic carrier, and a blue light restrictor, all of which have to be “biocompatible” for long-term residence in the patient’s eyeball. A rep at VisionCare, the ophthalmic technology company that produced the implant, told me that in addition to the challenges of designing such a small, complex device, the implant has to be secure enough to move along with the eye it’s implanted in: “The eye moves relative to the head,” she explained, “so once in the eye the device must be secure and stay centered to the optical axis.”
Virginia Bane, an 89-year-old California-based artist, was one of the first to receive the implant. In an announcement following her trailblazing surgery, she reported that she can now see “better than ever.” “Colors are more vibrant, beautiful and natural,” she explained, “and I can read large print with my glasses. I haven’t been able to read for the past seven years. I look forward to being able to paint again.”
Still, patients can’t just take their new bionic eye and go on their way. After the operation, they have to adjust to an entirely new way of seeing, relying on one eye for peripheral vision and mobility and the implant-enhanced eye for up-close detail. “Postoperatively,” Dr. Jennifer Li, one of the surgeons at UC Davis, told me, “the two eyes will have different functions, and the training is to help the patient learn how to use the two eyes separately, each for its specific task.”
Currently, the FDA has only approved the procedure for patients age 75 and older, and the team at UC Davis is currently interviewing applicants for the next round of surgeries. So how much does a miniature sight-giving telescope run you these days? According to the Sacramento Bee, just north of $15,000. The good news? Medicare says they’ll cover it.