IMPLANTABLE MINIATURE IMPLANTABLE MINIATURE TELESCOPESTELESCOPES

An introduction by

James Bole BSc (Hons). GCGI. MIfL

Director – Vision Rehabilitation Ltd

Vice Chair – RWPNTrustee – Headway (Aylesbury Vale)

Part of a group of Specialist Rehabilitation Officers working on the IMT project, through

FocalPoint UK

Who is involved....... Hannah Dunbar – PhD. MCOptom, Associate Director of

Clinical Services for VisionCare Ltd and Lead Optometrist for Moorfields Eye Hospital.

Mr Ahmed El-Amir – FRCOphth. FRCS. AAOphth – a world renown American-born surgeon in the field of vitreo-retinal surgery and a leading specialist in Paediatric Retinopathy of Prematurity screening------and (allegedly) an accomplished amateur footballer.

FocalPoint (UK) – a team of specialist Rehabilitation Officers lead by Andy Fisher, providing post-op low vision support to the IMT project

CentraSight Ltd – an American Opthalmic company leading on the development of IMT across the world.

VisionCare Ophthalmic Technologies – whose founders Yossi Gross & Dr Isaac Lipshitz invented the IMT

A multi-disciplinary approach.....

Initial diagnosis – Eye specialist

Candidate screening – Optometrist

Implant – Eye surgeon

Visual rehabilitation/training - ROVI

Background

End-stage Macular Degeneration

Vision less than 6/60

ROVI / LV practitioner has tried

everything.....

Where next ??

What is it.........

Is similar to an Intra-ocular lens but is 13 mm by 4 mm

Is a telescope designed by Dr. Isaac Lipshitz (in Israel), an expert in LV telescope design

What is it......... >X3 magnification

20 – 24 degrees visual field Fixed focal length

Spectacles to adjust focus

Inserted into one eye only for detailed tasks

Other eye for navigation / mobility

Requires intensive pre-operation training with patches to teach the brain to be able to switch

on and switch off each eye

Pre-op testingExternal Telescopic

Simulator (ETS) Simulates the experience

of the IMT in the eye Visual acuity can be

measured to determine the best eye for surgery

Includes caps to simulate near and distance vision

Left RightX3 external telescope – X3 wide angle IMTat 8 degrees at 24 degrees

Typical ARMD......

A simulation of the IMT......

How does it work

Scarred MaculaCentral Visual Field Projection (Natural Lens/IOL)

CAT CAT

Implantable TelescopeCentral Visual Field Projection

Surgical bit..........

Corneal incision >12mm

Capuslar incision >7mm

The end result (surgically).....

Mrs Margaret Wardaged 90, interestingly not registered at the time but with less than 6/60 in both eyes,

living quite independently with her 95 year-old husband in Aylesbury in

Buckinghamshire..........

Rehabilitation........

Re-learning to read.....

X A D F I IT – B – M – P – H (72)

X A D F I I

T – B – M – P – H (48)

Re-learning to read.....

N P U E G D S R (28)

N – P – U – E – G – D – S – R

A C M O V L M Q D

A – C – M – O – V – L – M - Q – D (22)

Re-learning to read.....WORDS....

rid use may buy big (28)

roof pure snow time

deliver flattery whether

The two women went to the shops.

After the meal they went to town. (22)

And a few puzzles.........

Conclusions....

It is not suitable for everyone

There are strict suitability assessments to go through

It is expensive

There are other similar alternatives (but which do not have the level of rehabilitation

support

It is NOT a cure, hence not available through the NHS (N.I.C.E.)

Now...how can YOU help ?? If you live and work particularly in the North of the country

Are good at rehabilitation, particularly Low Vision

Have time to commit to some training and taking on individual service users

Happy to be paid for a set of rehabilitation / low vision training sessions

FocalPoint UK would like to hear from you

BUT – there is no guarantee of work on a regular base

And finally...........

From the Journal of Nutritional Biochemistry – Feb 2015

Red wine is good for you......

Helps to burn fat

Helps to lower blood pressure

Has the potential to reduce effects of Dementia

Has anti-oxidants that help fight cancer(s)

Helps reduce strokes / heart disease

In the USA, documentary proof of 34% lower death rates amongst those who drink red wine.........

So..................

A healthy rehab forceis a happy rehab forceso.....get down to the pub and stay healthy