The last decade has seen many advances in medicine, especially in the field of optometry. With the advent of new technologies, therapies and treatments, local medical professionals agree that big changes in eyecare will continue to have a positive impact on patients for years to come.
Advances in eyecare
Leading up to 2020, there have been major changes in optometry, including optical coherence tomography (OCT) imaging, gene therapy and new surgical techniques. “OCT imaging is like an ultrasound for the eye,” explains Dr. Heather French, an optometrist with the Medical Eye Center in Medford. This technique creates high resolution images of the eye, which gives a detailed picture of the retina’s distinctive layers. “We can map and measure the thickness of the layers, which helps with reaching a diagnosis. The images also provide treatment guidance for glaucoma and other retinal diseases, including age-related macular degeneration and diabetic eye disease.”
OCT imaging is not a new technique, but recent technological developments have made it a much less invasive form of testing, according to Dr. Justin Spaulding, an ophthalmologist with Cataract & Laser Institute of Southern Oregon. “It is a simple and easy test. The patient sits in the machine with their eyes open during the procedure, and no radiation is used,” he explains.
However, there have been even greater changes in eyecare that go beyond testing. Doctors are just starting to learn what eye diseases gene therapy can affect, says Spaulding. In 2017, the Food and Drug Administration approved a new gene therapy that can treat a specific inherited eye disease. “Luxturna treats the effects of the biallelic RPE65 mutation, which is associated with retinal dystrophy, a rare genetic eye disease,” Spaulding explains.
Before the approval of Luxturna, French says doctors didn’t have many options available, and people with this retinal dystrophy would either go blind or have minimal vision. Today, doctors can inject the medicine into the subretinal space, she explains, adding that studies have shown people are getting useful vision improvements from the treatment. “The downside is it’s very expensive, with one injection costing about $500,000. The procedure is also done in only a handful of places. But you just need to get the injection once and it lasts for your entire life.”
New surgical options
In addition to new medications and tests, surgical advances have made a major impact in the field of eyecare, especially for treating glaucoma. A healthy eye functions like a sink, explains Spaulding, but when you have glaucoma, the sink isn’t draining. “The water has nowhere to go so the pressure goes up into the eye,” he says.
In the past, doctors used selective laser trabeculoplasty (SLT) as a secondary glaucoma treatment after eye drops; however, a recent study has provided evidence that SLT is as effective — if not more so — than drops as the first line of treatment, according to Spaulding. “The laser is applied to the drainage tissue in the eye,” he explains. “It creates a chemical and biological change in the tissue that results in better drainage of fluid through the drain and out of the eye.”
Corneal surgeries have also changed greatly, according to French. “In people with a specific genetic condition, the cells responsible for maintaining water in the cornea are less efficient, which negatively impacts vision,” she explains. Previously, she says the only fix was a corneal transplant; however, the grafts had a high rate of rejection and people often needed specialty contact lenses. “Today, we’re able to take a thin graft from a cadaver cornea and transplant it internally. Patients have had better vision outcomes with this surgery.”
Keeping your eyes healthy
Even though the past decade has seen amazing technological advances, new surgical techniques and better medications, Spaulding and French agree that a healthy lifestyle directly impacts your eyes. “A healthy body helps you have healthy eyes,” says French.
Yearly eye exams are essential, according to Spaulding, because with diseases like glaucoma, you don’t know you have a problem until you’ve experienced some vision loss. “It’s always good to visit your eye doctor once a year for a general eye health check,” he says.