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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.'
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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, 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.
