The Eyes 69line of vision. The lens remained within the eye as
though resting, hence the term “couching.” The
result was less than perfect because the person lost
the refractive ability of the lens, but the procedure
restored enough vision to allow one to function in
daily life. In the 1950s ophthalmologists began
removing the cataract from the eye, but not until
the 1970s did technology and technique converge
in procedures that incorporated a replacement
lens.
Breakthrough Research and Treatment AdvancesThe evolution of knowledge and advances in laser
technology are converging to present treatment
options that were science fiction a decade ago.
New procedures are greatly expanding the poten-
tial for permanent correction of disorders and
defects of the eye, including refractive disorders,
that reduces and may eventually even eliminate
the need for corrective lenses. Refined laser tech-
niques such as LASIK allow ophthalmologists to
reshape the cornea in precise, microscopic incre-
ments. Implantable rings inserted around the edge
of the cornea can help flatten and reshape it to
alter its refractive ability. Permanent contact lenses
attached over the lens can have similar effect.
Implantable replacement lenses are expanding
beyond their initial application in cataract extrac-
tion and replacement to offer nearly ideal vision
for people with severe astigmatism or myopia
(nearsightedness).
Cataract extraction and lens replacement now
routinely restores sight for more than 90 percent
of people who otherwise would lose vision to
cataracts. Other surgical procedures offer hope for
altering the course of glaucoma. New treatments
may stem the loss of vision due to AGE-RELATED
MACULAR DEGENERATION (ARMD). These conditions
are the leading causes of vision impairments that
lead to functional limitations or legal blindness
among adults. And research continues to explore
a “bionic” PROSTHETIC EYEthat can convert light-
waves to nerve impulses and transmit them to the
brain. Such a prosthesis would function similarly
to the COCHLEAR IMPLANTused to restore some types
of neurosensory HEARING LOSS. Because many of
the conditions that result in vision impairment are
not preventable, technological innovations such as
these appear to be the future of ophthalmologic
treatment.