My Mum/Dad has got Macular degeneration what next?

worried-look

It is difficult to answer this as there are three distinct stages of the disease, essentially it boils down to;

  • Early diagnosis no loss of vision
  • Loss of vision in one eye but good vision in the other
  • Loss of vision in both eyes

As a child albeit a middle aged child you may first hear about their problem at any of these stages. This depends on the parent they may casually inform you that their optometrist mentioned they had a bit of a problem, but not worth worrying about. Or it may be a major crisis as a problem they had been ‘managing’ has now got out of control.

For what ever reason it has driven you to this site so it needs addressing. The three stages need different approaches and you need to understand the underlying problems as well as the immediately obvious ones.

Go to the appropriate posts for more info.

Lucentis Vs Avastin

There has been much discussion over the subject of AMD treatments the table below lays out the costs to the NHS for drugs in hospitals in 2012. The cost of Lucentis at that time was £193 million. Since then drug prescribing for AMD has changed Eyelea is now probably the top drug.

Table 2. Top 10 medicines by cost for medicines positively appraised by NICE issued

in hospital in 2012

DRUG NAME NHS Cost £ (thousands)
Adalimumab (Humira,AbbVie)

251,716.20

Etanercept (Enbrel, Pfizer)

202,720.60

Ranibizumab (Lucentis, Novartis)

193,525.30

Rituximab (MabThera, Roche)

121,740

Infliximab (Remicade, MSD)

121,653.20

The interesting wording on the table is ‘positively appraised by NICE’ . There was much discussion about the drug Avastin a very similar drug to Lucentis it had been developed for a very different probem. It first gained approval in the US to fight colon cancer, but was subsequently discovered to be effective against AMD.

The interesting thing about it was that its cost was  roughly 15x cheaper than Lucentis. The NHS could have saved £180 million pounds by switching from just one drug to another. Why didn’t they do this? Well the simple answer was that Avastin was not NICE approved so clinicians were unable to use it. Why didn’t NICE approve it? NICE can only approve drugs that are submitted to it, if they are not submitted they are not used.

Avastin is a drug developed by Roche, Lucentis was developed by Novartis, who have a holding in Roche. Roche for some reason never felt the need to submit Avastin to NICE maybe they didn’t want to sell their drug to the NHS, I can’t for the life of me think why?…

The idiocy of NICE is stunning it is the National Institute for health and Care Excellence, common sense doesn’t seem to come in to it. Let us hope Novartis spent their £180 million pounds on lots of research into AMD.

Robot surgery

Exciting news about robot surgery in the press. The reports highlighted new robot equipment to do surgery on the back of the eye. While this is not directly linked to AMD at this stage it is extremely good news.

robot-surgery

The operation done in Oxford was a macula peel operation. This is when the fine membrane that is between the retina and the vitreous humor is removed. This operation has only been possible over the last ten years or so. It is an incredibly delicate piece of work, I have great admiration for the guys who perform this daily. They are working with operating microscopes all the time, it is like peeling off that layer of membrane that attaches to a boiled egg, between the shell and the egg. They are doing this inside the eye.   Read the report at The Guardian or see the report BBC news report.

The reason it is so important is that in the next few years stem cell therapy will be started for AMD. The ability to use robots for this type of surgery will raise the success rates when it eventually starts as it will be comparable in complexity to macula peel operations now. This is one of those stepping stones necessary to make future treatments more likely and more successful.

The company that developed the robots is Preceyes look them up for more information.

 

Top ten magnifiers 10

Top tenth magnifier.

nokia-lumia-1020-main

This may not obviously be a candidate for our list of magnifiers. However whether you have an apple iphone or an android version any smart phone with a camera can be used as a magnifier.

If you can’t see something clearly use the camera phone to take a picture. Once you have captured it you can then blow the image up on the screen to see it more easily. It is a very flexible magnifier which is probably easily to hand.

For more information on mobile phone use go to the synapptic app page

 

Top ten Magnifiers 2

Top ten Magnifiers 2

The eschenbach 17202 magnifier

small-eschenbach-mag

 

This is one of the simplest magnifiers you will come across but don’t right it off it is a remarkably useful piece of kit. It is bulletproof in performance; there is nothing to go wrong. It is inexpensive and is fantastic to carry around in a pocket or purse all day long. Whip it out whenever you need it to read instructions or prices. The one drawback is there is no light within it, but the upside is, it won’t breakdown. I would pop one of these into anybody’s stocking at Christmas if they have MD.  For best results  See how to use a magnifier  A worthy number two in our list of top ten magnifiers.