New drugs may go beyond just repairing problematic blood vessels. They might also prevent abnormal ones from forming. [Photo: JirehDesign]

The lens of the eye is important to vision, says Dr. Mark Michels, but the back of the eye — the retina — does most of the real work. At the center of the retina is an area called the macula, which “gives us our crisp reading and recognizing vision,” he says. “It doesn’t matter what kind of lens you put on the camera of this eye. If the macula is not good, the picture is not going to be clear. If the macula is not working, patients don’t see.”

Deterioration of the macula caused by either age or disease is the world’s most common cause of blindness. When the macula degenerates, it’s usually because of leaky, clogged or abnormal blood vessels in the eye. Lasers can slow down the disease’s progress but can’t do much to fix the retina.

Michels

Michels, an ophthalmologist at Retina Care Specialists in Palm Beach Gardens and Stuart, began practicing in 1991. Back then, he says, he typically had to tell patients with macular degeneration that “you probably won’t need a Seeing Eye dog, but unfortunately you’re not going to see very well no matter what we do.”
These days, however, Michels is giving his patients a much more hopeful talk. He encourages many to participate in clinical studies of new drugs that appear to repair problematic blood vessels and prevent abnormal ones from forming. The drugs include Lucentis, the subject of a 2006 article Michels co-authored in the New England Journal of Medicine. The drugs show promise not only in treating macular degeneration, but also in treating the second- and third-leading causes of blindness: Diabetic retinopathy, damage to the retina caused by diabetes, and central vein occlusion, blockage in the central vein supplying blood to the retina.

“We’re at the dawn of a new era in the care of retinal diseases,” Michels says.

Eye Innovations

Wavelight Allegretto Laser

» Spectral Domain Optical Coherence Tomography — Physicians at the Bascom Palmer Eye Institute at the University of Miami are using this new, non-invasive imaging technology to diagnose early stages of macular degeneration, glaucoma and other eye diseases. The equipment uses reflected laser light to allow physicians to study an eye’s anatomy and topography.

» Lasik Advancements — Lasik surgery has two parts. The first creates a flap to gain access to the cornea, and the second reshapes the cornea to achieve better vision. Dr. Cory Lessner, an ophthalmologist at Millennium Laser Eye Centers in Sunrise, touts the newest IntraLase Laser’s speed and accuracy in creating the flap. “Not only does it make a more precise, thinner flap, we believe it also spares more of the sensation to the cornea and helps with dry eye issues,” he says. Lessner also says the new Wavelight Allegretto Laser makes shaping the cornea easier and safer.

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In the News

Florida's State Capitol, Tallahassee [Photo: Name of photog]

» Ophthalmology professor Eduardo C. Alfonso has been named interim chairman of the Bascom Palmer Eye Institute at the University of Miami. He replaces Carmen A. Puliafito, who left last year to take over as dean of the Keck School of Medicine at the University of Southern California.