Who has not seen a movie of a child leading a blind grandparent? In many parts of the world, cataract is still the leading cause of blindness, and it is treatable. In many emerging countries, measures are being taken to take care of this type of blindness and many efforts are taken to educate enough eye doctors. That is good news!
In the Western world, many people suffer from glaucoma, uveitis, macular degeneration. We have only a limited idea about the basic pathogenesis of these diseases, and therefore cannot provide a curative treatment (instead of the chronic use of eyedrops or a risky operation). An example is HLA-B27 associated uveitis: we know about the genetic association, but most people who inherited the HLA-B27 gene from a parent never develop uveitis. We need to understand the basis and that will lead to treatments that interfere with the disease process, for ever. For this we need more basic and clinical research.
In internal medicine, very large amounts of money are spent revealing the pathogenesis of frequenty occurring diseases like diabetes, rheumatoid arthritis, cancer and arteriosclerosis. And that works! Look at the tremendous improvement of the treatment of atherosclerosis and cardiac infarctions.
Can we not do likewise with regard to eye diseases? Yes, we can, if the best researchers focus on eye diseases, if they get the chance to work in the best environments, if the best youngsters choose to study the eye. We have to convince the organisations that decide on the distribution of money that the eye should constitute an important area that needs their support.
We can only improve the impact of our research if we can attract the young bright people and show them that eye research is not only important, but offers an attractive subject that can keep you busy for life. Apart from the large international meetings, local national or regional basic science meetings concentrating on eye disease will help researchers to get to know each other and exchange ideas.
We must also work together to try to make sure that the funds exist so that these brilliant youngsters can have a career in this field and contribute effectively to the treatment of eye diseases and the real prevention of blindness, so that all diseases become treatable or preventable. Then we can make a difference!
Dr. Martine J. Jager
Past-president of ARVO, Board Member of EVER, Member of the Advisory Board of the ICO.
Leiden University Medical Centre, The Netherlands