WESTCHESTER COUNTY, N.Y. -- Joe Vellone is a football fan. The retired Baldwin Place roofing contractor loves to watch the New York Jets on television, but that has become more and more difficult in recent years. Vellone, 76, has had his vision severely impaired by macular degeneration.
“It started about six or seven years ago and got progressively worse until I couldn’t see anything out of my left eye,” says Vellone, who with his wife, Ida, 75, has three daughters, six grandchildren and two great grandchildren. “That eye was absolutely blind.”
Macular degeneration is a leading cause of vision loss in Americans 60 and older. It involves deterioration of the macula, an oval-shaped area at the center of the retina that helps the eye discern fine detail. Although the condition is painless, it causes cells in the macula to die. When it is advanced, the person can no longer drive a car, read or even watch TV.
But Vellone is lucky. When he was referred to Gerald W. Zaidman, M.D., director of ophthalmology at Westchester Medical Center, he learned that in his case there was hope for improving this often hopeless condition.
“The doc said, ‘I have good news. You are a perfect candidate for this new surgery,’” Vellone recalls.
Dr. Zaidman was referring to an exciting new technology called imtimplantable miniature telescope. It involves implantation of a lens similar to those used in cataract surgery.
“It’s maybe twice the size of a regular implant,” says Dr. Zaidman. But the IMT is designed to magnify images that are still apparent to the outer edges of the retina. The diseased macula and its central vision cannot be replaced, but the brain can learn to interpret the enhanced peripheral vision and “fill in” the missing information, creating a more complete picture.
Only surgeons trained and accredited by the manufacturer of the IMT are allowed to implant the device, which was approved by the Food and Drug Administration and Medicare in December 2011. Dr. Zaidman is one of just a handful of surgeons in the northeast who perform the procedure.
“The surgical technique is a bit more complex and difficult than the usual cataract replacement,” he says.
In fact, to be eligible for IMT surgery, the patient must have a cataract in the affected eye, as many people with macular degeneration do. Candidates must also be 75 or older, he adds, but that age requirement will likely drop as more surgeries are completed. They must also be in overall good condition, with a reasonably healthy eye, and must undergo thorough educational screening by vision therapists. This last requirement is the key to success, Dr. Zaidman says.
“You have to retrain the eye and brain to recalibrate the new images,” the doctor explains. “You have to learn to work with the device, not fight it, and it takes two to three months to adjust. If you are not willing to commit to rehab, you may not be a candidate.” Rehabilitation can be done in the doctor’s office or at home.
Vellone underwent his operation last December 26, and he says the surgery itself “Was nothing to speak of. I was in and out in less than an hour, and home that day.”
At first, he could see nothing out of the eye, but little by little, with diligent rehabilitation, his vision began to improve. After about five weeks, he watched his first postoperative football game at home in his living room.
“I blocked my right eye, and I could see the game,” he recalls. “I was shocked.”
By summer, he could see “perfectly” with his left eye. Although he still cannot drive or read small print, “I can do just about everything else,” he reports.
“It has given me a second life,” he says. “For me it has been—I can’t describe it as other than great.” While riding in a car, he says, “I used to think what I would give to be able to see this and that. Now I can see those things.”
He can even see his beloved Jets, and in Dr. Zaidman he’s found a fellow Jets fan.
“I promised Joe we’ll watch a game and cry in our beer together,” says the doctor.
1 Eye Condition, 2 Kinds:
There are two types of macular degeneration, wet and dry, explains Gerald W. Zaidman, M.D., Director of Ophthalmology at Westchester Medical Center. In the wet version, abnormal blood vessels begin to grow beneath the macula, often leaking blood and fluid and damaging the macula in the process. It can be treated with a laser or injections into the eye.
Dry macular degeneration represents the end stage of the disease, when light-sensitive cells in the macula have broken down. Only individuals with the dry type are candidates for surgery.