Last winter Samantha Fawcett spent a lot of time staring out of her kitchen window. She doesn’t live anywhere especially beautiful – her ex-mining home town in Leicestershire isn’t famous for its views.
But, as she explains: ‘For the first time since the age of four I was able to admire the leaves still on the trees and, best of all, watch my three-year-old son playing in the garden outside.’
Sam once suffered from such severe myopia, a prescription of -13, that without her spectacles she could see no more than a centimetre from her face. Even with them, making out detail far away was impossible.
Her problem was so pronounced, the strain her eye was under in trying to focus meant there was a high risk of retinal detachment – a condition that can lead to total blindness.
She also suffered from congenital cataracts, which were hereditary – a condition that causes the lens of the eye to become opaque and cloudy. When reading a book she could see only the line she was reading and not the one above or below.
Had her eyesight continued to worsen, experts advised that she could have been registered as visually impaired or even blind. But last November she underwent a groundbreaking operation to have new adjustable lenses implanted in her eyes. These have restored her vision to near perfect.
The procedure, developed by a Nobel Prize winner and pioneered by a British surgeon, is offering an exciting and permanent solution to hundreds of thousands of people suffering from cataracts and those who have vision impairment too severe to treat with traditional laser surgery.
Light adjustable lenses (LAL) are artificial lenses that are inserted into the eye and can then be fine-tuned to give perfect sight.
‘Most people suffer from cataracts as they grow older,’ explains consultant ophthalmic surgeon Bobby Qureshi, who developed the procedure in the UK at the London Eye Hospital.
‘It’s almost an inevitable part of the ageing process – generally in your 50s or 60s you will see the start of a cataract from a lifetime of damage caused by UV [ultraviolet] light from the sun.’
The lens sits behind the pupil, the opening at the front of the eye, and helps to focus rays of light on to the retina, a collection of cells at the back of the eye. When light reaches these cells, a chemical response is carried to the brain via the optic nerve, where the image is interpreted.
The lens is made mostly of water and protein. As we age, some of the protein starts to clump together to cloud the lens – this is a cataract. Vision is reduced and can’t be improved by glasses.
Traditionally, treating a cataract simply involves removing the damaged lens from the eye and replacing it with an artificial one, made of silicone.
Once implanted, the lens cannot be adjusted and if the shape isn’t quite right to correct vision, glasses will still be needed. NHS lenses are mono-focal – meaning that reading glasses are a necessity for all patients and 70 per cent will need them for short sight.
A surgeon in America complained about the situation in front of the winner of the Nobel Prize for Chemistry 2005, Professor Robert Grubbs, a chemist at the California Institute of Technology in Pasadena, and the co-inventor of the LAL.
As a result, his team created an artificial lens that was still made of silicone but with an added enzyme to create components called macromers, designed to be activated by harmless ultraviolet light, emitted with pinpoint accuracy by a special machine.
This triggers a process called photopolymerisation, which means that silicone molecules double in size and thus the curve of the lens can be very subtly changed after implantation.
Sam, 39, a senior human resources officer, lives with her husband Paul, an electrician, also 39, and their three-year-old son.
Her eyesight had always been bad – but the cataracts weren’t picked up until she was in her mid-20s.
‘Apparently I was born with them – they were like little fleck marks on the lenses.’
‘Without my glasses or contact lenses I was locked into a claustrophobic world where I couldn’t see anything further than a centimetre from my face.'
But by then, her progressive myopia – or short-sightedness – was severe.
‘I was on the cusp of not being able to drive when I had the operation,’ she admits.
‘Without my glasses or contact lenses I was locked into a claustrophobic world where I couldn’t see anything further than a centimetre from my face. I couldn’t make out faces – just vague shapes. There was no question of crossing the road. If I put my glasses down in our bedroom, I would have to shout for my husband to come and find them for me.’
Sam and Paul were on the verge of adopting a child when they heard about the operation in April last year. ‘There was a niggling worry about my eyesight. If I went swimming and lost a lens, I wouldn’t be able to see my child,’ says Sam.
While suitable for mild to moderate myopia, laser surgery is unable to correct severe short sight – and the operation is generally not considered suitable for those with cataracts.
‘Then I heard about the LAL implants on a radio news item,’ recalls Sam.
Mr Qureshi at the London Eye Clinic was confident that the operation could help her. An hour before surgery two or three drops of anaesthetic are put in the eye. This is repeated three times. The eye is cleaned and anaesthetic administered between the eyelid and the eyeball using a plastic cannula.
It is then clipped open to stop blinking. A minute incision – 2mm long – is made in the eye and the lens broken up and the pieces sucked out using a probe. The new lens is rolled up like a carpet, inserted, and unfurls once in place. The LAL has haptics – little legs – which centre the lens within the line of sight.
‘My eyes were done a week apart,’ says Sam. ‘After the first one I felt strange. The anaesthetic means that you don’t know whether your eye is open or shut. My eyelid was manually closed and I was given a patch to wear.’
The next morning, when she removed the patch, she literally couldn’t believe her eyes. ‘I could see clearly through that eye. I actually cried with joy.’
After a fortnight she returned to have her eyes adjusted. ‘I was amazed to find that this wasn’t painful either. It wasn’t particularly pleasant – it’s a very bright light shining directly into your eyes for up to a minute and a half.’
Patients have to wear dark glasses outside so that their eyes aren’t exposed to unnecessary ultraviolet light, and they can return three or four times until their eyesight is as perfect as possible.
‘It takes a couple of days for the eyes to settle down and the focus to sharpen,’ says Mr Qureshi, who managed to give Sam virtually 20/20 vision.
‘I can’t believe I’ve got good eyesight for life,’ she says. ‘My world has been changed beyond belief by these lenses. It was amazing, miraculous even.’
In that month – just under a year ago – their son’s adoption was finalised and in the same month she had the operation.
‘All the good things happened at the same time.’