Curing Blindness: A message to patients and their families

We understand the suffering that vision loss brings. We know the statistics: hundreds of thousands afflicted by RP and related disorders, millions with AMD, glaucoma, diabetic retinopathy and other blinding diseases. The economic cost is staggering but the personal cost is greater: loss of mobility, livelihood, intimacy and independence; the emergence of fear and loneliness. Caregivers and family journey into an uncertain emotional landscape. For many in the underdeveloped world, blindness means total isolation or death.

We also know the challenges and allure of understanding the biology and chemistry of our amazing visual systems. Thousands of vision researchers world-wide dedicate their lives to understanding every facet of the eye. But why should we focus on biological details when the need for cures is so pressing? Because the answers are in those details.

The egg and the eye
Judah Folkmann (1933-2008) was a giant in the fields of blood vessel growth (angiogenesis) and cancer. In 1971, he wrote that cancers may involve flawed angiogenesis. These ideas were harshly criticized. Thirty years later, the first successful drugs for the treatment of AMD arose directly from his work.

Pond water
Thomas Cech's early studies focussed on ribonucleic acid (RNA) chemistry in the pond protozoan Tetrahymena, a microscopic whirligig that could capture the fancy of a child or a scientist ... hardly the stuff of curing blindness. Now a Nobel laureate, his work led to the discovery of RNA aptamers. These remarkable molecules bind tightly to other molecular shapes and are now one of the drugs for treating AMD. They work by targeting Judah Folkman's angiogenic molecules.

Beautiful images
Greg Hageman, Lincoln Johnson and Don Anderson worked for years to find the possible triggers of AMD using imaging to make their arguments. For a long time their ideas were dismissed ... perhaps the beauty of the images distracted us from their power. But this work poured out a cornucopia of discovery in genetic risk factors for AMD and a new understanding of the roles of the immune system in ocular diseases.

Though we are discovering that retinal diseases are more complex than expected, we are also finding new tools, pathways, and approaches that suggest strategies to preserve or restore vision ... even rebuild retinas.

How can we accelerate discovery? The stories above reflect an older, darker face of science: intense competition for limited resources. That strategy is futile and will guarantee the slowest possible rate of discovery. We need alliances that share discovery and methods: mission-based science like Apollo Programs. That culture is growing again, aided by new technologies. But such alliances also need a strong and stable NIH and NSF, as well as a strong philanthropic base. Scientists are taxpayers and donors too. Innovation is the job of our universities. Support your local university. The only time to lose hope is when vision researchers decide not to go to work in the morning ... and that is not likely in the Marclab.


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