Dr. Abhishek Mandal, Ph.D.

Senior Business Adviser, Vision Science Academy, London, U.K.

Vision Science Academy Exclusive

Retinal diseases, including age-related macular degeneration (ARMD) and diabetic retinopathy, are commonly encountered throughout the globe. These defects drastically impair individuals from identifying simple objects and people present in plain sight. To help them, external telescopes, lenses, and electronic devices have been utilized traditionally. Different surgical procedures like macular translocation and choroidal grafts have also been attempted but they provide very little benefit while they may even worsen an already existing pathology. Moreover, these remedies only worked remotely for patients who were diagnosed in the early stages of ARMD.

To challenge this persistent visual handicap, a new intra-ocular telescope has been approved recently by the food and drug administration (FDA). This IOT system helps the patients regain vision to such a level that enables them to perform their normal activities conveniently. The implanted telescope is fit inside the eye and magnifies the incoming light rays. The result is an improved vision as the image is much larger when it reaches the damaged macular area (Qureshi, Robbie, Tabernero, & Artal, 2015).

Working Mechanism

The IOT is actually the size of a pea. It is placed inside the capsule of the eye after removing the old lens from it. The light rays which gain entry into the eye are now enlarged 2-3 times as they pass through this newly transplanted intra-ocular system. The image produced is even larger when it is projected on the retina. The old and damaged cells can’t be repaired but the IOT directs the larger images to the healthy parts of retina to offset this problem. The disease itself isn’t cured by this modality but only allows the affected patients to improve their quality of life (Dunbar & Dhawahir-Scala, 2018).

Patient Selection Criteria

There are three types of IOT systems used for treating ARMD (PELI, 2002) which include the following:

1. IMT (implantable miniaturized telescope)
2. OriLens (mirror telescope implant)
3. IOL-VIP (two-lens system with one lens having high minus and the other having high plus power)

The first 2 systems provide a magnification power of 2-3 times while the IOL-VIP only enlarges the image to 1/3^rd of what is seen by the unaided eye.

All of these systems have a specific patient selection criterion (Dunbar & Dhawahir-Scala, 2018). But generally, the patients must fulfill the following conditions:

1. Bilateral retinal impairment (ARMD)
2. No other ocular diseases other than cataract or macular disease
3. Visual acuity improvement using an external telescope
4. The patient understands his/her condition and the complications that come along with the procedure.
5. The patient is motivated enough to undergo extensive rehabilitation that comes with this treatment.

Results

The results are quite satisfactory when it comes to improvement in the quality of life. The patients are better able to perform their daily tasks and feel less handicapped after undergoing this therapy. The disease itself may not be cured but the patients feel quite comfortable and confident after the improved vision this treatment has to offer.

References

1. Dunbar, H. M. P., & Dhawahir-Scala, F. E. (2018). A Discussion of Commercially Available Intra-ocular Telescopic Implants for Patients with Age-Related Macular Degeneration. Ophthalmol Ther, 7(1), 33-48. doi:10.1007/s40123-018-0129-7
2. PELI, E. (2002). The Optical Functional Advantages of an Intraocular Low-Vision Telescope. 79(4), 225-233.
3. Qureshi, M. A., Robbie, S. J., Tabernero, J., & Artal, P. (2015). Injectable intraocular telescope: Pilot study. Journal of Cataract & Refractive Surgery, 41(10), 2125-2135. doi:https://doi.org/10.1016/j.jcrs.2015.03.021