1 Implantable miniature telescope
A pea-sized optical lens magnifies and transmits images missed in blindspots and vision loss caused by age-related macular degeneration (AMD), which principally attacks the central vision. The device, developed by California-based VisionCare Ophthalmic Technologies, deploys two micro-lenses in a small glass tube that generates images that are picked up by healthy retinal tissue outside the central damaged areas. The eye’s natural lens is removed and the telescope implanted in its capsule enabling light to be enlarged by three times which, although it does not cure AMD, allows patients to recognise people and objects that would have appeared dark prior to the operation. The device is implanted in one eye, which experiences a loss of peripheral vision, and the brain learns to balance the information from both eyes to create fuller images.
2 Retinal pigment patch
An engineered patch derived from stem cells is used to treat people with severe sight loss from wet age-related macular degeneration (AMD), a chronic condition with swift onset. Diseased cells at the back of the patients’ affected eye are replenished with a stem cell-based patch, which is inserted under the retina with a special surgical tool in an operation lasting one to two hours. Two patients monitored on a 12-month trial went from not being able to read even with glasses, to reading 60-80 words a minute with normal reading glasses. The study by the London Project to Cure Blindness, a partnership between London’s Moorfields Eye Hospital NHS Foundation Trust, University College London Institute of Ophthalmology and National Institute for Health Research, could lead to off-the-shelf treatments being available on the NHS in the next five years.
3 Bionic eye
Patients in London and Manchester made history by receiving the world’s first bionic eye implants. The Argus II system, developed by US company Second Sight Medical Products, restores a degree of functional sight in patients with retina pigmentosa, an inherited condition. An implant, containing a micro-electronics pack, an antenna and an electrode, is positioned in the retina and links to a video processing unit pack and pair of sunglasses worn by the patient. The Argus II bypasses damaged areas of the eye by using a small video camera built into the sunglasses to generate images which are translated into electrical impulses that stimulate the remaining healthy cells in the eye to transmit visual images from the optic nerve to the brain. Hundreds of patients have successfully recovered some sight with the device.
The device shining a light on old-fashioned care
An innovative device, created by two final-year medical students at Imperial College London, could create a dynamic shift to preserve sight for patients and provide an economic boost across a strained health pathway.
Simon Rabinowicz and Uddhav Vaghela, both 23, got their idea after being on GP placements where they noticed the standard hand-held ophthalmoscope diagnostic tool was either feared or not used because of its poor functionality and results.
“This device had barely changed since the 1870s and we discovered that many doctors did not feel comfortable using it,” says Simon, who runs VUI Diagnostics with Uddhav in spare time around their studies.
“GPs are fearful of making a false diagnosis and, if you are not confident, then the likelihood is you will refer the patient on and so our clinics are packed with people who could have been diagnosed earlier.”
The pair combined their backgrounds in bio-engineering and software design to create the portable, box-shaped device which takes less than a minute to diagnose both eyes compared with the ophthalmoscope’s tortuous ten-minute process.
Our device removes doubt so GPs can make much clearer management plans and just saving a fraction of these will save millions of pounds for the NHS
“The ophthalmoscope involves the doctor getting very close to the patient and shining a light that gives a pin-hole image. They then have to move the light around and stitch every image together in their mind before making a diagnosis. It is uncomfortable and inaccurate,” adds Simon, who comes from London.
“Our system just involves the patient looking at the box while the camera takes an image and transmits it to a computer screen where a doctor can make a detailed assessment of a full image rather than trying to remember scores of tiny images.”
A simple, affordable solution to avoidable sight loss
The students’ ingenious application of technology won the £40,000 Venture Catalyst Challenge 2019 top prize earlier this year and has attracted support from experts at the Western Eye Hospital and Royal Free Hospital in London.
The device, which features proprietary technology to acquire and transmit images, is easy to operate and could be used by healthcare professionals or even patients at home. It is moving into clinical trials with the aim of launching in mid-2021.
“This is a simple, affordable solution that addresses a big problem,” says Uddhav, from Teeside. “We have spoken to patients who were put down for a non-urgent referral and seen months later by which time they had lost quite a lot of vision from macular degeneration.
“Our device removes doubt so GPs can make much clearer management plans and, if you think that every referral costs £120, just saving a fraction of these will save millions of pounds for the NHS.”
The students believe the device will have a huge impact in developing countries where avoidable blindness affects up to 800 million people, according to the World Health Organization. It can be used remotely to generate early and accurate diagnosis, so patients can be treated before their eyesight deteriorates or disappears.