It’s the little things that are so important

(Catherine Avalone – New Haven Register) Dr. Mark Milner examines the implantable miniature telescope in the lens of the right eye of Rosalie Cappetta, of Branford, Thursday, April 22, 2016, at the Eye Center of Southern Connecticut in Branford.


BRANFORD >> It’s the little things that are so important, especially if you can’t see them.

For Rosalie Cappetta, who has age-related macular degeneration, “my greatest thrill is that I can actually see what setting I’m putting the washing machine at,” she said.

Small numbers and even people’s faces are getting clearer every day, now that Cappetta, 72, has a tiny telescope in her right eye.

The 4.4-millimeter-long device, manufactured by VisionCare Ophthalmic Technologies of Saratoga, California, was surgically implanted by Dr. Mark Milner of the Eye Center of Southern Connecticut.

It has given Cappetta back the central vision in her right eye, though she now has peripheral vision only in her left.

“I would have to stand up very close to a person to see a face, to see who I was talking to,” said Cappetta, a Branford resident. “I could see off to the sides but not straight ahead.”

Cappetta had to keep her oven set at 350 degrees whenever she cooked, but she could only make recipes that she had memorized. She lost the ability to do crossword puzzles. Now, she’s pleased to be “able to write inside the lines. I’m getting better at that and better at writing a check.” She used to have to send her checks to her son in Florida to write out.

Since her Oct. 28 operation, with the help of occupational therapy, “everyday things get a little clearer for me to see,” she said. “It’s a gradual improvement. It’s not overnight, like … ‘A-ha! I can really see overnight!’”

But she’s really pleased with the results. “I would have gone to California to get this done,” she said. “I was bound and determined to do it.”

The procedure was introduced in California, and Milner is the only eye surgeon between New York and Boston who performs the surgery.

“These are patients who have advanced vision loss due to macular degeneration and scarring of the macula,” said Milner, who also has offices in New Haven, Hamden and Cheshire. The macula is the center of the retina and provides for central vision. Patients like Cappetta end up with only peripheral vision. When looking at a person, “it’s almost like the face is blocked out and everything else you can see,” Milner said.

He said macular degeneration is primarily genetic but can also be caused by risk factors such as smoking, high cholesterol and high blood pressure.

The telescope, which replaces the eye’s lens, magnifies the image 2.7 times, so more of the object is visible. Rather than having the face blocked, it may just be the nose that’s dark, Milner said. But Cappetta said she can even see people’s noses.

“She can ambulate better, she can recognize faces better, she can watch TV better and potentially read better,” Milner said.

In order to be eligible for the surgery, a patient has to be at least 65 years old and have vision of 20/160 or worse in both eyes. “

She technically has to be legally blind,” Milner said.

There also has to be enough depth between the iris and cornea to fit the lens with space to spare, “and she has to have enough endothelial cells, which are essentially pump cells, to be sure that the cornea doesn’t get swollen.” The endothelial cells pump out the aqueous fluid that naturally flows into the eyeball.

Cappetta was referred to a low-vision specialist to test which eye was a better candidate for the telescope. After the operation, she was paired with an occupational therapist “to be sure that with that magnification she can be trained with that telescope.”

“And make sure I didn’t bounce off any walls,” Cappetta interjected.

”The beauty about this is we’re giving somebody hope that never had hope before,” Milner said.

By Ed Stannard, New Haven Register