Telescope Implant Restores Vision in Those with End-State Age-Related Macular Degeneration

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telescope_dark backgroundBy Marc H.Levy,MD,FACS, Sarasota Retina Institute

As we age, it common for our vision to change and to need more regular eye exams to update our existing prescriptions.  But many older adults find their vision is further impeded by the onset of age-related macular degeneration (AMD), which can permanently block central vision in some people.  Tasks that used to be simple, like selecting the right can of soup or recognizing the face of a friend, become harder as the disease worsens. 

What is Age-Related Macular Degeneration?

Macular degeneration is an eye condition that attacks the macula, the region of the retina responsible for central, detailed vision. Although it does not cause complete blindness, it often leads to a central vision “blind spot,” which you cannot see around.  AMD does not affect peripheral vision, but while a person can see things to the side, it will be too blurry to discern any detail.

More than 15 million Americans are affected by some form of AMD and approximately 2 million Americans have the advanced (end-stage) form with permanent vision loss, which is the leading cause of irreversible legal blindness in individuals over the age of 60. Despite the availability of new drug treatments that slow, but not stop, the progression of AMD, the number of people with end-stage AMD is expected to double by the year 2050.

There are two primary forms of AMD, wet or dry.  Wet (neovascular) AMD is caused by abnormal blood vessels that leak fluid or blood into the region of the macula.  More common is dry AMD (also called atrophic AMD), which occurs when the layer of retinal cells found in the macula break down or die.

Caring for the AMD Patient

Caregivers can help their loved ones manage their diminishing vision and the tasks of daily living.  For example, as the blind-spot grows larger, patients will need assistance navigating around rooms.  It is helpful to describe the room and its furnishings to assist with orientation and reduces stress. 

Community low vision centers (e.g., Lions Clubs or Lighthouse organizations) can also provide education and access to low vision assistive devices that can improve patients’ ability to read, watch TV or use the computer.

AMD Treatment Strategies

AMD treatments have improved vastly in just the past ten years. Of course, patients should speak with their ophthalmologist before starting any treatment, which might include vitamin therapy, eye injections (e.g., Avastin, Lucentis, Eylea), or laser therapy.

One of the newest treatments for AMD is the CentraSight telescope implant, which is proven to improve vision and quality of life for patients with advanced AMD. The device is smaller than a pea and placed into only one eye. The telescope implant uses micro-optical technology to magnify images which would normally be seen in “straight ahead” vision and projects them onto the healthy portion of the retina not affected by the macular degeneration disease, making it possible for patients to see the object of interest. To be considered a potential candidate for the telescope implant, an ophthalmologist must first confirm that a patient:

  • Has irreversible, End-Stage AMD from either the dry or wet form of AMD
  • Is no longer a candidate for drug treatment
  • Meets age, vision, and cornea health requirements (the minimum age is 65 years)
  • Has not had cataract surgery in the eye in which the telescope will be implanted

Note, while cataract surgery is often performed on the AMD patient, studies show that there is little central vision improvement for the patient whose condition is advanced. 

The implantation procedure involves removing the eye’s natural lens and replacing it with the tiny telescope implant. The other eye is left “as is” to preserve peripheral vision, which is important for balance and orientation.  This part of the treatment is done in an outpatient setting by an eye surgeon (ophthalmologist). Following surgery, patients must work with specially trained optometrists and occupational therapists to learn how to use their new vision because there are different techniques involved when you are sitting still (e.g., reading or watching TV) versus when you are moving around (e.g., walking or cooking). 

The telescope implant is the only FDA approved surgical option for advanced AMD and is a Medicare eligible procedure. It’s important to note that the telescope implant is not a cure for AMD and is not the right option for everyone. It will not restore a patient’s vision to the level it was before the onset of AMD and it will not completely correct vision loss. Patients should talk to their ophthalmologist to discuss the risks and benefits of the telescope implant. To learn more, visit www.CentraSight.com or call 877-99-SIGHT.

Attitude and AMD

We don’t realize how much we rely on our vision until it starts to diminish.  People living with AMD reportedly experience increased depression and stressiv, so it’s important to provide both practical and emotional support as the disease progresses.

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