The world of eye medicine has seen many innovations over the years. Eye health expert Professor Rupert Bourne shares his highlights.
There’s been a rapid advance in the treatments for eye disease over the last 10 or 20 years. From a worldwide perspective, cataract surgery is one of the most costeffective healthcare interventions ever – it has made a massive difference to many people’s lives.
And with diabetic retinopathy, there have been some very marked developments in the UK, for example the diabetic retinopathy screening service, where all diabetics are signed up for regular screening. It’s the envy of the world.
Glaucoma, which happens to be my specialty, has seen considerable developments in terms of new medications and ways of delivering them to the eye. You may know about eye drops being used to bring the pressure in the eye down. Now, there are studies looking at little pellets that can be inserted into the eye, which release the drug over time, meaning you won’t have to remember to take drops on time. With wet macular degeneration, there was a time early in my career when there was very little you could do for patients, who then suffered central visual loss. A dramatic change has occurred over the last couple of decades, where we now have treatments that we can deliver into the back of the eye, which can prevent progression of the disease.
There’s a lot of work into retinal diseases, and looking at new systems of delivery of treatments. There are new studies looking at treating geographic atrophy, which is what was called dry macular degeneration and that’s a disease that we’ve had very limited scope to treat in the past. Gene therapies, particularly 25 for inherited rare diseases, are very important, not just for the small numbers of individuals who could benefit greatly from these treatments, but also from the understanding of retinal diseases generally.
There are trials for gene therapy treatments going on at the moment, but it may be a few years before they are available. The studies need to be published, reviewed by other experts in the field and the NHS bodies need to look at whether it is suitable and cost-effective to be offered on the NHS.
We don’t currently know what the breakdown of blindness and vision impairment are within the UK. However, there is a new study called the UK National Eye Health Survey, which will hopefully start next year. It will be the first time in the UK that we have run a nationally representative study of eye disease, looking at 25,000 people over the age of 50 across the UK. This will give us the information we need to understand whether we really are targeting the right people and whether our resources are being properly utilised.
A fantastic development has been the amount of participation in research that is going on. Researchers are definitely listening to patients far more than they did in the past. We involve patients in the research process very early on now. We ask patients, how we should deliver a study to maximise the benefits for them. Ultimately, if you don’t ask the people who are going to benefit you’re not going to design a study in the right way.
At the moment, 80 per cent of our hospitals are delivering NHS eye research studies. There is far more awareness of patients and how they can get involved in this sort of work, which ultimately has great benefits for both the individual, but also for society.
Professor Rupert Bourne is Chair of the Institute for Health Research Ophthalmology Specialty Group.
Interested in participating in eye health research? If you’d like to get involved in a clinical trial, ask your eye specialist or go to clinicaltrials.gov where there is a record of all trials being done anywhere in the world.
Find out more about your eye health and eye conditions by visiting our eye health pages.
This article originally appeared in the Autumn 2018 edition of Connect Magazine.