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Glossary
NEWS AND PUBLICATIONS
The New York Times
TUESDAY, JULY 1, 2003A New Lens Restores Vision and Brings Relief
By ABIGAIL SULLIVAN MOORE
For 17 months, Joe Zienowicz lived in a world of darkness and pain, where
every eye blink felt like barbed wire and even the dimmest light was an
unbearable torment.
At 38, Mr. Zienowicz (pronounced ZEN-o-witch) contracted Stevens-Johnson
syndrome, a severe and violent allergic reaction to medicine prescribed
for a sore elbow. The disease had blistered his skin, his mucous membranes,
even his eyes.
As Mr. Zienowicz's body sloughed off burned skin, the lining from his
eye sockets and eyelids peeled away. Meanwhile, the disease eroded his
corneas — a devastating injury.
The cornea is the transparent, dome-shaped covering of the colored part
of the eye.
It helps focus light onto the retina, which in turn converts the light
rays into nerve impulses that go from the optic nerve to the visual part
of the brain.
Dense with nerve fibers, the cornea is also the body's most sensitive
tissue; for proper vision, it must be smooth and clear.
Now suddenly and, it seemed, irrevocably, Mr. Zienowicz, a security employee
for Federal Express who lived in Downingtown, Pa., was blind and in constant
agony.
Until recently, ophthalmologists would have had little to offer him. But
a new kind of contact lens is giving him relief and sight, and it has
potential to offer similar benefits to at least a half million people
worldwide with severe eye-surface diseases.
"It's a great, great advance," said Dr. Leo J. Maguire, a corneal
specialist at the Mayo Clinic.
The new lens also has the potential to change the treatment strategy for
keratoconus, a progressive thinning and bulging of the cornea that affects
1 in 2,000 Americans, distorting vision.
It may restore vision when a corneal transplant heals poorly. And it may
comfort nonblind people with painfully dry eyes.
"The beauty of this lens is that it doesn't touch the cornea,"
said Dr. Ernest W. Kornmehl, a corneal specialist in Boston who is a spokesman
for the American Academy of Ophthalmology. Conventional contact lenses
rest on the cornea, while the new lens rests on the sclera, the white
of the eye, which is far less sensitive.
About the size of the quarter, the lens — called the Boston scleral
lens prosthetic device — creates a sort of liquid bandage for irritated
corneas. Filled with a fluid that is supplemented with the eye's own tears,
it soothes the damaged cornea. The fluid serves as a new corneal surface,
masking its irregularities and improving vision.
The fluid within the lens bends the light as it passes through, aiding
vision the same way healthy corneas do, said the lens's creator, Dr. Perry
Rosenthal, a corneal specialist who runs an eye clinic in Chestnut Hill,
Mass.
Approved by the Food and Drug Administration in 1994, the lens has been
evolving ever since.
Dr. Rosenthal has fitted it in about 500 patients, most in the past few
years, he said in a recent telephone conversation.
Dr. Rosenthal said that at first his success rate was about 40 percent,
but that it has risen to 90 percent with a new computer program linked
to a digital lathe donated by Bausch & Lomb.
Yet Dr. Kornmehl says that because the lens is relatively new and because
Dr. Rosenthal's patients suffer from rare "orphan" disorders,
many ophthalmologists still do not know about it.
Dr. Walter J. Stark, director of cornea and cataract services at Johns
Hopkins Hospital, says most patients with advanced keratoconus can be
fitted with conventional lenses, and the scleral lens is costly and time-consuming
to fit.
But for the 10 percent to 20 percent of keratoconus patients who can no
longer get a comfortable fit or good vision with hard contact lenses,
he added, "The cost is well worth it, if a transplant can be avoided."
The scleral lens is available only at Dr. Rosenthal's clinic and in Tokyo
through a colleague, Dr. Kazuo Tsubota.
Because most insurers balk at the $7,600 customized lenses, the Boston
Foundation for Sight, which Dr. Rosenthal founded for corneal disease
patients, has subsidized many patients' lenses. He is seeking Medicare
approval to ease the way for insurance reimbursement.
Even though he has given lectures to fellow ophthalmologists and published
papers about the lens, Dr. Rosenthal says the spread of news to colleagues
has been frustratingly slow.
Determined to change that, he recently won a $240,000 grant from Johnson
& Johnson Vision Care Inc. to help train specialists here and abroad
in fitting the lens and to establish a network of affiliated clinics.
Most scleral lens patients are relatively young, Dr. Rosenthal says. Typically
they have been in pain and functionally blind for years, despite numerous
visits to other vision specialists.
After a bone marrow transplant 15 years ago, Cornelius Jones of Houston,
now 31, developed severely dry eyes, along with blurred vision and constant
pain.
Opening his eyes in light was like staring into a blazing sun, he said.
He went through 12 vials of lubricating drops every day.
Last April, after his mother saw the lens on "Oprah," Mr. Jones
was treated by Dr. Rosenthal. Wearing the lens, he found instant relief
and improved sight.
"If I could have, I would have cried," Mr. Jones said. "I
honestly felt like I was reborn." Instead, he said, his mother cried
for him.
Dr. Rosenthal's patients say the lenses are comfortable. Cleaning, applying
the saline fluid and inserting them take only a few minutes. Tiny channels
between the lens and the sclera promote an exchange of fluid and tears,
preventing harmful suction on the cornea.
The minute channels also block irritating air bubbles from the cornea.
But because the lens is gas-permeable, vital oxygen can get through.
Some ophthalmologists say they worry that the lens may cause infections
in eyes so vulnerable. But Dr. Rosenthal says that to date, only one patient
has sustained an infection from daily wear, and he adds that the lens's
benefits far outweigh its risks.
Mr. Zienowicz, the Federal Express employee who regained his vision, agrees.
Now living in Indianapolis, he is back on the job, having been promoted
to zone manager.
"It's given me my life back," he said.
Tom Strattman for The New York Times
HARVARD GAZETTE ARCHIVES
Rosenthal is Morgan Chase Award finalist
Assistant clinical professor of ophthalmology at Harvard Medical School Perry Rosenthal has been selected as a finalist for the JP Morgan Chase Health Award at the Tech Museum of Innovation Awards, presented by Applied Materials, Inc. The founder of the Massachusetts Eye and Ear Infirmary's Contact Lens Service, Rosenthal was elected for his involvement in the development of vision-rehabilitating contact lenses. Conducted independently by Santa Clara University's Center for Science, Technology, and Society, the Tech Museum Awards are designed to recognize individuals and organizations that develop or adapt technology to solve global challenges and have a high potential of yielding a lasting, beneficial impact. Each year, the awards honor innovators from around the world in five universal categories: education, equality, environment, economic development, and health. This year, more than 460 nominations were received from 59 countries. One winner from each category will receive a $50,000 honorarium, to be presented at a ceremony on Nov. 7 in San Jose, Calif. "The recognition of our work by the Tech Museum of Innovation," Rosenthal said, "has energized our mission to provide our vision-restoring contact lenses to the hundreds of thousands of people worldwide who are visually disabled from corneal diseases and can benefit from our technology - regardless of the patient's ability to pay or where they live." Rosenthal developed a unique family of contact lenses that have rehabilitated the vision of hundreds of patients with corneal diseases, more than half of whom had no other options for recovering functional eyesight. Unlike conventional contact lenses, the quarter-size Boston Scleral Lens maintains a cushion of oxygenated artificial tears over the fragile diseased cornea that neutralizes much of its surface defects to restore vision while providing a healing environment. The product of more than 15 years of research, the lenses incorporate state-of-the-art polymer chemistry and a patented computer design/manufacturing program. Rosenthal's clinical team has achieved a success rate of more than 80 percent in rehabilitating the vision and eliminating the eye pain for people who suffer from blinding eye diseases, for which there had been no definitive treatment
The Tech Museum of Innovation Award
Dr. Perry Rosenthal was inducted into the community of Tech Lauriets by the Tech Museum of Innovation at a formal ceremony in San Jose on November 7, 2002. The development of the Boston Scleral Lens was selected by a panel of international judges from a field of 460 outstanding candidates, representing 59 countries. These awards honor innovators and visionaries from around the world who are applying technology to profoundly improve the human condition. The purpose of the Tech Awards is to inspire future scientists, technologists, and dreamers to harness the incredible power and promise of technology to solve the challenges that confront us at the dawn of the 21st Century.
.
Newton Magazine Article
National Enquirer Article
Ophthalmology Times
Bone Marrow Transplant Newsletter
Contemporary Ophthalmology
Good Housekeeping
Doctor's
Guide to
The Boston Scleral Lens Prosthetic Device
(PDF Download)
Help
for Severe Dry Eye
(PDF Download)
Treatment
Options
for people with
Keratoconus
(PDF Download)
Coverage on WCVB
Read the article
about the Boston Foundation for Sight that aired on ABC Channel 5 in Boston
and on CNN nationally.
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