Telescopic eye implant in optometry profession

Teleimplant

1. TELESCOPIC EYE IMPLANT BY EMEH EMMANUEL CHIAZOKAM 15/96754 OCHOMMA IJEOMA MADELEINE 15/96765   A SEMINAR PRESENTED TO DEPARTMENT OF OPTOMETRY , FACULTY OF HEALTH SCIENCES ABIA STATE UNIVERSITY. DECEMBER 2021   LECTURERS: PROF AMAECHI DR OMAKA

2. INTRODUCTION The telescopic lens implant is tiny, smaller than a pea and is implanted inside one eye, behind the iris. Once implanted, the telescope enlarges objects in the person's central visual field and focuses them onto healthy areas of the retina not affected by age-related macular degeneration. As a result, the individual must rely solely on the non‐implanted fellow eye for peripheral vision after surgery

3. WHAT IS AGE-RELATED MACULAR DEGENERATION (ARMD)? Age-related Macular Degeneration affects the macula - the part of the eye responsible for central vision. Central vision allows you to see the detail of what is in front of you Patients with end-stage AMD have a central blind spot - often described as a black hole in the middle of their sight, making it difficult or impossible to see faces or read. There are no drugs or treatments to cure end-stage AMD. Hence, the need for telescopic eye implant.

4. HOW CAN PATIENTS USE TELESCOPIC IMPLANT? The telescope implant does not limit your natural eye movements and does not require you to move your entire head, as you have to do with external magnifying appliances. You can use natural eye movements to see things that are close and far away from you, such as reading printed materials or watching television .

5. What About the Other Eye? End-Stage Age-Related Macular Degeneration(ARMD ) affects detailed central vision in both eyes. It does not affect peripheral vision. In the treatment program, a person uses the eye with the telescope implant for detailed central vision. The other eye is used for peripheral vision.

6. CANDIDATE EVALUATION The telescope implant has been shown to improve vision and quality of life in patients with End-Stage AMD. Not everyone who has End-Stage AMD is a candidate for the treatment program. The following criteria are to be met: In general suitable patients include those who are over 65 years or older, with stable/end-stage AMD. Have not had cataract surgery in the eye in which the telescope will be implanted. Meet age, vision and cornea health requirements. Adequate peripheral vision in the eye not scheduled for surgery Are no longer a candidate for drug treatment of your ARMD.

7. EYE EXAMINATION AND PRE-TRAINING Your Optometrist will also explain the benefits and risks of the treatment program. If you appear to be a good candidate, you will be referred to Low vision specialist The Low vision specialist will help use an external telescope stimulator to help you understand how your vision will change the after the telescope is implanted You will have a comprehensive eye examination by a Retinal specialist who will determine whether you are a good candidate for surgery based on your retinal exam.

8. SURGICAL PROCEDURE The telescope implantation surgical procedure is performed on only one eye. It involves removing the eye’s natural lens and replacing it with a tiny telescope implant. This part of the treatment process is done in a relatively short outpatient surgery by a specially trained ophthalmologist who performs cornea and cataract surgeries (cornea/cataract surgeon).

9. LEARNING TO USE YOUR NEW VISION After you have recovered from surgery, a specially trained Low Vision Specialist will work with you to help you learn how to use your new vision. You will be given exercises and tasks to help you to learn to use your new vision. Within that plan, the basic skills you will learn include: Localizing, Fixating , scanning, Tracing, Tracking and Navigating . Learning these skills under the guidance of your low vision team and practicing them at home will help you to excel at using your new vision for everyday tasks and other activities that are important to you.

10. ADVANTAGES OF TELESCOPIC EYE IMPLANT It improves vision by enlarging objects in central visual field It does not limit your natural eye movements and does not require you to move your entire head. The optics of the device is such that it is possible to obtain fundus photographs and fluorescein angiogram

11. DISADVANTAGES OF TELESCOPIC EYE IMPLANT Extensive therapy for proper use It eliminates peripheral vision in the eye which is implanted This can damage the cells on the inside of the cornea, which can lead to swelling and fluid retention in the cornea, affecting vision.

12. CONCLUSION The telescopic eye implant offers a unique opportunity to restore some central vision to patient whose sight has been impaired by end-stage Age-related macular degeneration. The treatment program suggests that patients can achieve significant improvement in best-corrected visual acuity, functional vision and quality of life.

13. REFERENCES Ferris , F.L., Fi ne , S.L, & Hyman, L .(1984). Age‐related macular degeneration and blindness due to neovascular maculopathy .  Archives of Ophthalmology , 1102 ( 11), 1640‐1642 . Garcia- Layanna , A., Cabrera‐ López , F ., Garcia- Arumi , J., Arias-Banquet, L ., & Ruiz-Moreno, J.M. (2017). Early intermediate age- related macular degeneration. Clinical Interventions on Aging , 12:1579-87 Bennion , A.E., Shaw , R.L., & Gibson , J.M. (2012). What do we know about the experience of age related macular degeneration? . A systematic review and meta‐synthesis of qualitative research . Social Science and Medicine, 7 5(6), 976‐985. Honeycutt , A . A ., Rein, D. B., Wittenborn , J .S. , Zhang, X., Lesesne , S . B. , & Saaddine , J. (2019). Forecasting age‐related macular degeneration through the year 2050: the potential impact of new treatments.  Archives of Ophthalmolog y, 127(4), 533‐540.

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