nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Wednesday, July 7, 2010

Going Blind? Getcher Mini-Telescope Implanted Surgically.

At first I though this was a hoax.  Apparently not, and it's not the strangest thing out there for vision improvement.

According to the Assoc Press (July 6), the FDA has approved a device that can be surgically implanted in one eye to improve vision for those older individuals who are experiencing a condition called macular degeneration.

In this disease, the central part of the retina, which is responsible for seeing fine detail begins to fail.  The surrounding parts of the retina, which are best for gross vision and sensing movement, remain intact, but this leaves the person with a slowly deteriorating condition with only a coarse sense of objects and movement.  And it happens to both eyes.

BUT, if you could fix just one eye, by enhancing the image for that spot on the retina with a mechanical device that takes over the work of resolving fine detail, you can improve a person's eyesight substantially.

The FDA-approved device, called Centrasight (natch), produced by VisionCare Ophthalmic Technologies does just that in a pea-sized object that would address the vision of a portion of those 2 million Americans who have macular degeneration.

Here's the limitations:
1.  Patients who might benefit tend to be much older, and must have a need for surgery that includes removing a cataract.  From the article:
"But it's only for a subset of the nearly 2 million Americans with advanced macular degeneration, Eydelman warned: Those 75 and older, with a certain degree of vision loss, who also need a cataract removed. In fact, the FDA took the highly unusual step of requiring that patients and their surgeons sign a detailed "acceptance of risk agreement" before surgery, acknowledging potential side effects - including corneal damage and worsened vision - and the need for lots of testing to determine who's a candidate."
2.  Our brains must learn how to take the input from two eyes and merge it into a single view.  This normally occurs early in life, and is difficult to change later.   Surgical patients would have to "teach" their brains to adapt to the presence of the new image because one eye is now seeing very differently. 
3.  It doesn't restore normal eyesight.  It's not that good:  you need two normally functioning eyes for that--not one bad one, and one improved one.

Note:  Hearing aids have a parallel history.  People who begin to use them have to adapt to the increased sound input, their brains filtering out what's noise and what's communication or meaningful sound.  This leads to failure in a significant number of people...they take it out and don't use it....because they can't adapt.  I suspect this device will be the same, except YOU CAN'T TAKE IT OUT like a hearing aid.  (Without more surgery)

Lastly, it's expensive.  About $15,000 for the product alone.  Add in surgeon, hospital, after-care, rehab....  We're talking big money for older folks.  I wonder whether Medicare will determine it's not "reasonably necessary and cost-effective."

My advice is to wait, see what patients experience over the next couple of years.  The question of who really can benefit will be clearer then.

Doc D
PS:  Note I said it's not the only strange vision thing out there.  Other researcher are working on an artificial  lens that senses the curvature of your biological lens and can bend and shape itself to the optimal curvature needed for your best sight.  Ever notice how your vision (even if you don't wear contacts or glasses) changes slightly during the day?  This lens would adapt to that throughout the day.  Cosmic, huh?


The 50 Best Health Blogs said...

"My advice is to wait, see what patients experience over the next couple of years. The question of who really can benefit will be clearer then."

That sounds like really good advice. And maybe the price will come down.

I have a different condition, macular edema.


Doc D said...

Depends on the cause, but I read somewhere that Lucentis approval has been extended recently to macular edema.

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