Eye of the Storm

The anatomy of a human eye is a very delicate thing, with every piece depending on the health of one another to operate smoothly. If one thing goes wrong, even elsewhere in the body, eyesight can become compromised or even completely lost.

One common retinal disease many of our patients suffer from is diabetic retinopathy. With the rise of diabetes rates in the United States, we’ve seen a spike in diabetic-related illnesses, in regards to vision. Diabetes-related illnesses are the leading cause of blindness in patients younger than 60 years of age.

This is significant, because these are people of working age potentially being taken out of the workplace due to vision loss. Diabetic retinopathy is caused by blood vessels damaged by uncontrolled diabetes. These cells can damage the eye in many different ways, such as causing the retina to swell and deteriorate vision.

The condition, if caught early, can be managed by getting the patient’s diabetes under control. If patients are proactive and able to keep control of their blood sugar, cholesterol and overall well-being, alongside regular treatments, the disease can be slowed to prevent complete blindness. However, if nothing is done on the end of the patient, progression of the disease is inevitable.

Another common disease we see at Cincinnati Eye Institute is macular degeneration. This particular disease, unlike diabetic retinopathy, is the leading cause of blindness in patients older than 60 years of age. It can cause patients to slowly lose their reading vision in the beginning and progress to severe center vision loss; it can also cause the patient to lose the ability to recognize faces, if the retina becomes damaged enough, because information is not correctly transmitted to the brain.

The third most common form of retinal damage is retinal detachment, where the retina peels away from its underlying support tissue. This can happen through trauma, but it’s a common misconception that trauma is the only thing that can cause retinal detachment. It can also occur with age; the vitreous fluid in the eye is jelly-like at a young age, but as we get older, it breaks down and the retina can spontaneously separate. This is an urgent condition, and the surgery is complex.

With the exception of retinal detachment, these diseases require consistent visits to a doctor and very regular treatment. Diabetic retinopathy involves laser surgery to the eye and medicinal injections administered by a physician monthly. Macular degeneration is currently only managed by injections to the eye every four to six weeks, and most patients need these injections for life.

Currently, however, Cincinnati Eye Institute is working on promising clinical trials that could potentially further the treatability of these two conditions. One trial for diabetic retinopathy is testing a treatment that patients could administer themselves, without having to come in to see a physician every month. This would reduce the burden on the patient, but the treatment is still in the trial stages and the efficacy has yet to be determined.

A trial we’re doing for macular degeneration involves implanting a device directly into the patient’s eye that would regularly release medicine in appropriate doses over time, and would require the patient to come in and have the device refilled only every four months.

While neither of these treatment trials are curing the diseases outright, they could help increase the patient’s quality of care and life. Cincinnati Eye Institute is constantly involved in trials like these, and is a leader in treatment innovation and clinical trials; it’s one of the things that make me most proud to work at Cincinnati Eye Institute.