Point In The Right Direction

Painless eye injections prevent vision loss from retinal disorders.

John “Russell” Fahey and his wife, Pat

John “Russell” Fahey played football while attending New York’s Alfred University but took his student-athlete status seriously, studying diligently and ultimately graduating with a degree in materials engineering.

He went on to become a pioneer in the field of semiconductors.

“I started in the semiconductor business in 1960, and the devices were very crude back then,” Russell explains. “Today, we have phones with integrated circuits and other advances. I earned many patents as a young engineer and was very successful.

“I worked for the General Electric company for 25 years and was promoted to a management position. From there, I went to Hong Kong and Singapore and plied my trade in California.”

A man of many talents, Russell eventually became an investment banker. In that job, he bought and sold companies all over the world for six years before retiring 22 years ago.

Then, he took up oil painting.

“I paint just about everything,” Russell recounts. “I like to paint people, especially my grandchildren. I also paint landscapes and animals, including dogs. I’ve painted train stations as well, everything.”

Two years ago, a problem with Russell’s vision threatened his favorite pastime.

“I was watching TV with my wife one night, and I said to her, I can’t see out of my right eye,” Russell details. “My vision was very blurry, and it just got worse and worse. I went to several doctors all over the country, but it wasn’t until I visited Florida Retina Institute and saw Dr. Kumar that I found someone who could help me.”

Jaya B. Kumar, MD, is a board-certified, fellowship-trained retina specialist. Upon first seeing Russell in 2018, Dr. Kumar conducted a thorough evaluation and several tests to determine the cause of Russell’s condition.

“When Mr. Fahey came to us, he had distorted vision in one eye,” Dr. Kumar recalls. “To him, straight lines appeared wavy or bent. As part of our examination, we viewed his retina and concluded he had macular degeneration.”

Common Disorders

Macular degeneration is one of the most common disorders treated by the retina specialists at Florida Retina Institute. There are two types of macular degeneration, dry and wet. Both affect central vision, which is needed to see detail.

The dry type is more common and involves a thinning of macular tissue. The wet type is a progressive disease that is characterized by abnormal blood vessels that leak fluid or blood into the macula, the center portion of the retina.

“Most people think of the dry form as the ‘better’ type because no treatment is required,” Dr. Kumar reports. “But even with the dry kind, the retina gets thinner and thinner over time, and people can eventually lose some of their central vision.

“Mr. Fahey has wet macular degeneration. We began treating him with intravitreal injections of medication that helps reduce the amount of fluid and blood that leak out the blood vessels into the retina.”

The most common class of medications are anti-VEGF, or anti-vascular endothelial growth factor, the doctor explains. These target the receptors that cause the blood vessels to leak. They’re the same medications used to treat diabetic retinopathy and retinal vein occlusions.

Other Disorders

Along with both types of macular degeneration, which is sometimes referred to as age-related macular degeneration, or ARMD, diabetic retinopathy and retinal vein occlusions are common disorders treated at Florida Retina Institute.

“Diabetic retinopathy can affect anyone with diabetes,” Dr. Kumar maintains. “When blood sugar is elevated, it causes inflammation of the blood vessel walls, causing fluid, cholesterol and blood to seep out of the vessels and collect in the retinal tissue.

“The result is inadequate oxygen delivery to the retina, which triggers abnormal blood vessels to form to try and compensate. But these abnormal blood vessels are fragile, bleed and form scar tissue that can lead to retinal detachment and further vision loss.”

Retinal vein occlusion is usually triggered by another condition, typically hypertension. High blood pressure in the arteries causes the blood vessels to press down on the veins, creating a backup of blood trying to drain out of the eye. This causes the blood vessels to leak and the macula to swell, a condition called macular edema.

“Since I started receiving the injections, my vision has gone from 20/60 to 20/25.” – Russell

The macula is responsible for clear central vision, which is necessary for reading, driving and distinguishing facial features. Macular edema, the buildup of fluid in the macula, can lead to a loss of central vision.

FDA-approved anti-VEGF medications are bevacizumab, ranibizumab and aflibercept. The trade names for these medications are AVASTIN®, LUCENTIS® and EYLEA®, respectively.

Retina specialists sometimes inject steroids into the affected eyes to decrease inflammation and treat macular edema. Common steroids include triamcinolone and dexamethasone, which is often delivered as an intravitreal implant called OZURDEX®.

Gratefully Impressed

Russell initially expressed some concern about receiving injections into his eye. It wasn’t long, though, before the expertise of Dr. Kumar and her staff put his fears to rest.

“Imagine somebody sticking a needle into your eye; it’s not appealing,” Russell reasons. “But the shots don’t hurt. They numb the outside of my eye where Dr. Kumar injects the medicine. And she’s very good at putting the shots in my eye.”

Russell receives intravitreal injections into his right eye every six weeks. Since beginning the protocol, his vision has significantly improved, allowing him to resume painting. Unfortunately, wet macular degeneration is a progressive disease, so treatment may be needed indefinitely.

“Since I started receiving the injections, my vision has gone from 20/60 to 20/25,” Russell enthuses. “But the medicine fades with time. When I have a chart in front of me and I can’t read the lines beyond a certain point, it’s time for another shot.”

Russell is impressed by Dr. Kumar and grateful for all her help.

“I have a summer home in New York, and I have to keep up with the injections when I go there, but Dr. Kumar sets that up for me with the doctor I see there,” Russell applauds. “I appreciate that immensely and am very thankful for everything else she’s done for me.

“Dr. Kumar is a wonderful young woman. She’s very pleasant and easy to get along with, very knowledgeable and informative. She’s very good at what she does and very helpful.”

© FHCN staff article. Photo courtesy of John Fahey. mkb
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    • Florida Retina Institute

      Founded by James A. Staman, MD in 1979, Florida Retina Institute has 19 locations throughout Central Florida, North Florida, and Southeast Georgia. They have proudly delivered Excellence in Vitreo-Retinal Diseases and Surgery for 40 years. T... Read More

    • Jaya B. Kumar, MD

      Jaya B. Kumar, MD, is board certified by the American Board of Ophthalmology and the National Board of Medical Examiners. She earned a bachelor of science degree in the Honors Program and a Doctor of Medicine degree at St. Louis University in S... Read More