Keeping up with the latest advancements for cataracts, glaucoma, macular degeneration, and dry eye
When it comes to medical advancements, it can be hard to keep up with the ever-evolving state of the art. This is true in all medical fields, including eye conditions. Treatments your parents relied upon are likely outdated—and have been for a long time. Even therapies that were top-notch just a few years ago may have since been supplanted by something better. To help you sort through all the new possibilities (and ones that are coming), here’s the latest on four major eye conditions:
Cataracts
The problem: Proteins in the lens of the eyes start to break down around the time you turn 40. As a result, the lens can become cloudy, causing blurred or double vision, sensitivity to light, or a loss of visual sharpness that makes colors look washed out. Most people over the age of 60 have some degree of clouding. “If you live long enough, you’ll develop cataracts,” says John Hovanesian, MD, AAO clinical spokesperson and a board-certified ophthalmologist with Harvard Eye Associates in California.
New solutions: Surgery is still the only treatment for cataracts, but some important advancements have made this procedure more effective. The basic operation hasn’t changed: your ophthalmologist removes the clouded lens and replaces it with an artificial lens that’s been corrected to give you as close to 20/20 vision as possible. However, in the past, it was difficult to estimate the amount of correction needed for the new lens. Prediction error, as well as a shift in lens placement (which can occur during the post-surgical healing process) often resulted in less than optimal results. Now doctors have a new tool—a lens that can be reshaped even after surgery. The RxSight™ Light Adjustable Lens lets doctors change the shape and corrective powers of the lens for two weeks after surgery. In addition, great strides have been made in the lenses themselves, with the introduction of multifocal and bifocal lenses, ones that offer extended depth of focus, and accommodating lenses that utilize the eye’s natural focusing ability.
On the way: Laser adjustments. If you’ve already had cataract surgery and still aren’t happy with your sight, a new laser system is under development that will allow doctors to adjust existing lenses without additional surgery.
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Glaucoma
The problem: This neurodegenerative disease occurs when fluid doesn’t flow properly through a tiny drainage canal in the eye. When too much fluid accumulates, pressure builds up behind the eye, damaging the optic nerve. Without treatment, glaucoma can cause permanent vision loss. “It’s almost impossible to tell that you have glaucoma, which is why it’s known as the silent thief of sight,” says Dr. Hovanesian.
New solutions: Doctors today use a procedure called minimally invasive glaucoma surgery (MIGS), which has fewer side effects and is less painful than traditional glaucoma surgery. During MIGS, your eye doctor implants a microscopically tiny tube, or stent, to restore the flow of fluid out of the eye. When appropriate, MIGS is performed at the same time as cataract surgery to save and improve sight.
On the way: An improved solution to increase fluid drainage and lower eye pressure. Currently, doctors rely on eye drops to do this job. “Unfortunately, about 90 percent of people don’t administer drops correctly, which makes them less effective,” says Dr. Hovanesian. Several sustained-release medication delivery systems are in development. The implanted devices slowly release medication over a course of weeks or months so there’s no need for drops.
Age-Related Macular Degeneration (AMD)
The problem: This common eye condition is a leading cause of vision loss among adults ages 50 and older. The most common type of AMD, dry macular degeneration, occurs when the center of the retina deteriorates due to a buildup of waste products. The wet version is more serious and aggressive. It occurs when abnormal leaky blood vessels grow under the retina. In both types, the back part of the retina (called the macula) becomes damaged, resulting in the inability to see things directly in front of you.
New solutions: Although AMD isn’t a cancer, radiation therapy is now being used to control AMD issues. The IRay Radiotherapy System uses targeted, weakened radiation beams to halt the growth of out-of-control blood vessels in the eye.
On the way: Fewer injections. Until recently, the best treatment for wet AMD involved monthly medication injections directly into the eye. Now under development: a new medication that would spread out the injections to once every 12 weeks. Sustained-release medication implants are also in the works.
Dry Eye Disease
The problem: Glands in the eyes produce fewer tears as you age. Dry eye disease, also called dysfunctional tear syndrome, is an irritating condition that can cause a burning, stinging, or gritty feeling. Dry eye affects both genders and people of all ages, but it’s more common among older women who have gone through menopause. “Your odds of having dry eyes are relative to your age,” explains Dr. Hovanesian. “If you’re 50, there’s a 50 percent chance you’ll have this problem.” After that, the risk only goes up.
New solutions: Artificial tears, or lubricating eyedrops, provide temporary relief, but require daily application. New treatments provide longer-lasting relief by administering outside stimulation that drives tear production. Your eye doctor may now use the LipiFlow® Thermal Pulsation System to send pulses of heat into glands in the eyelids. A combination of heat and pressure applied to closed eyelids helps to massage away blockages. If you prefer to manage your condition at home, one advancement is the TrueTear® handheld neurostimulator. This device sends tiny pulses of energy through prongs inserted into the nose. The stimulation tells your brain to send nerve signals to the tear glands, which in turn produce more tears.
On the way: A better understanding of what causes dry eye. Some doctors theorize that it may be an inflammatory disease and are studying that possibility. As they uncover new insights, the hope is for new types of treatments to bring patients relief, or even a cure.
