The most advanced form of age-related macular degeneration (AMD), which is the leading cause of blindness in the United States, is end-stage AMD. It causes irreversible loss of central vision, making it difficult to perceive or recognize people and objects. Unlike less severe forms of AMD, end-stage AMD irreversibly damages the macula, the small part of the retina responsible for central vision, and does not respond to therapy with glasses, medications, or artificial lenses implanted during cataract surgery. The world seems to vanish before their eyes for these approximately 2 million sufferers, making it impossible to accomplish daily duties.
The gadget is a surgically implantable micro telescope (IMT), the first Medicare-covered low-vision equipment. Although it is not a cure or a quick fix, the IMT can help certain patients with severe AMD who have exhausted all other treatment options.
The Telescope’s Operation
The Food and Drug Administration authorized the IMT in 2010. After the normal lens is removed, the miniature telescope is placed in front of one eye.
The IMT works like a telephoto camera lens. These magnifying pictures enter the eye by more than two times and project them onto the retina’s healthy area to aid in central vision improvement.
This enables the patient to recognize and distinguish images that were previously unrecognizable or difficult to view. The non-implanted eye continues to see with peripheral vision, while the telescope-equipped eye sees in detail in the center. Patients who have had implants require counseling to help them retrain their brains to utilize each eye differently.
What Is the Purpose of the Telescope?
Due to the requirements of continued post-operative therapy, the IMT is not for everyone with age-related macular degeneration, even though it is a promising tool for some.
Candidates must undergo a thorough screening process that includes two types of ophthalmologists, a cornea surgeon, and a vitreoretinal specialist, as well as an occupational therapist and a low-vision optometrist. That is because IMT treatment is a time-consuming procedure that requires an average of 12 appointments spread out over four to six months, and post-operative “homework” to keep the eye proficient at using the device.
As a result, IMT candidates are carefully chosen based on their overall medical, psychological, and social circumstances. The patient must meet the following basic requirements:
- You must be sixty-five years old or older.
- You have AMD in both eyes, and your vision is 20/160 or worse
- You have eyes that are steady and do not leak blood or fluid
- You never had cataract surgery before
- You are well-informed and have realistic goals for eyesight development
Then, if they meet the criteria, they must go through testing using an external telescope that simulates the effect of an IMT to see if vision improvement is possible and how they might adjust to the difference in vision between their two eyes.
Candidates must also make an upfront commitment to vision training following surgery. They should have relatives or friends nearby who can help them with transportation and assistance. It also helps to have a positive mindset. “Only roughly a quarter of patients who are medically eligible will go on to qualify for the operation; we want to be extremely confident that the patient will be successful,” Dr. Hudson explains.
