If you or a loved one has been diagnosed with age-related macular degeneration (AMD), you know all too well how it can affect vision and daily life. With the damage AMD does to central vision, basic tasks such as reading, driving, personal hygiene and recognizing faces become difficult. In the most advanced form of AMD, end-stage AMD, central vision in both eyes is lost. The resulting blind spot, or missing area, in the center of vision is permanent and not correctable with glasses, medication or surgery. However, thanks to the CentraSight treatment program, this may no longer mean complete loss of independence for the AMD patient.
The CentraSight treatment program is designed to improve vision and quality of life for patients with end-stage AMD. It involves placement of the Implantable Miniature Telescope (by Dr. Isaac Lipshitz) inside the eye. The telescope is about the size of a pea and is surgically implanted into the eye. The eye’s natural lens is removed and the telescope takes its place. The telescope magnifies the object the patient is looking at and projects it onto an area of the retina that isn’t affected by AMD so the object can be seen. The telescope is FDA-approved and is the only treatment of its kind.
In the CentraSight treatment program, the patient is cared for by a retina specialist, a cataract surgeon and an optometrist or occupational therapist who specializes in low vision. The program consists of four steps:
To be eligible for the program, you must be examined by a retina specialist who confirms you have end-stage AMD and are no longer a candidate for AMD drug treatment.
You must have a medical and vision evaluation to determine whether you’re a good candidate for the telescope. The evaluation also includes assessment and training (typically 2 to 4 sessions) with low vision specialists. During the sessions, you’re able to use an external telescope device to simulate what your vision would be like with the implanted telescope. You’re informed about the risks and benefits of the telescope and the risks of the implantation surgery.
Not every patient with end-stage AMD is a good candidate for the telescope. For example, patients who’ve had cataract surgery in the eye in which the telescope would be implanted aren’t eligible. If the evaluation indicates to the CentraSight care team that the telescope is a good option for you, you make the final decision to proceed with the program or not.
The surgery to remove your eye’s natural lens and replace it with the telescope is outpatient. The surgery itself takes approximately one hour. The telescope is implanted in one eye. (Which eye is determined during the evaluation.) After surgery, the telescope eye is used for central vision. The other eye is used for peripheral vision, which is needed for seeing things to the sides and safely moving around. The telescope is barely visible to others.
As soon as your eye heals from the telescope implantation surgery, the rehabilitation part of the CentraSight treatment program begins. Over several weeks, you and the care team work on an individualized plan to help you reach your personal goals. A low vision optometrist prescribes glasses to enhance your new vision. You work with the low vision specialist to adapt to and maximize your new vision. You perform eye exercises such as tracking objects with the telescope eye, watching TV, practicing reading large print, and following moving objects outdoors (e.g., pedestrians on a sidewalk). Practicing at home is important. You also learn how to use your other eye to safely walk and move around.
Every patient’s results are different, but after telescope implant surgery and rehabilitation, patients are usually able to see 3 to 4 lines better on the eye test chart. In general, they report they are less dependent on others, less worried or frustrated about their vision, less limited in activities related to vision, more able to visit with others, and better able to recognize faces and see the facial expressions of family and friends.
It’s important to understand that the telescope isn’t a cure for end-stage AMD. While it can improve your life as it relates to vision, it won’t restore your vision to the level it was before AMD. While the telescope may improve your near and distance vision in comparison to not having the telescope, driving won’t be possible. The telescope doesn’t “see” for you. The success of the CentraSight program requires you to be an active participant in all phases, especially the rehabilitation and rehabilitation “homework” that help you adapt to and maximize your new vision.
Unrealistic expectations for your vision with the telescope include being able to drive, see a golf ball in flight, play tennis, or never having to use a magnifying glass again. Realistic expectations include being able to recognize faces, watch TV, read, and return to hobbies such as painting, knitting or gardening.
The cost for the telescope implant and visits associated with the CentraSight treatment program are eligible for Medicare coverage in all 50 states.
Call Barnet Dulaney Perkins Eye Center today for more information.