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  • Eye conditions are on the rise. From cataracts to near-

  • sightedness and macular degenerationmillions of

  • people worldwide suffer from poor vision.

  • Reading fine print is almost impossible. You have to hold

  • the book up to your face.

  • Young people are increasingly affected -- around 217 million

  • people are visually impaired, and 36 million

  • are blind worldwide.

  • Our sense of sight plays a vital role in our lives, and

  • things are very difficult for people who are blind.

  • Modern surgical techniques are less invasive

  • and can help restore eyesight.

  • It's a quantum leap — a minor revolution.

  • From stem cell therapy to laser surgerynew

  • treatments are giving patients hope.

  • This residential development in the city of Mainz, Germany,

  • is home to Lilli, her brother Max, and their parents. 13-

  • year-old Lilli is an ordinary teenager - she goes to dance

  • class twice a week, and she likes to chat with her friends.

  • Lilli has been near-sighted since the fourth grade. She

  • has minus 4 diopters in her right eye,

  • minus 0-point-5 in her left one.

  • When Lilli takes off her glasses, the world looks like this

  • even nearby objects appear blurred. And her

  • eyesight is continuing to deteriorate.

  • I see things best when they are very close, but it keeps

  • getting worse. When I take off my glasses, even my hand

  • looks blurry. Anything further away is even blurrier.

  • Nearsightedness - or myopia - is the result of the shape of

  • the eye. Normally rays of light entering the eye are refracted

  • so that they focus on the retina at the back of the eye.

  • When the eyeball is too long or the cornea too curved,

  • the light focuses at a point in front of the retina.

  • Objects that are further away appear blurred.

  • Our eyes are designed for distance vision. Spending a

  • lot of time looking at nearby objects puts strain on our

  • eyes. Our eyes then gradually deform so that we can see

  • nearby objects more easily. But then we end up not being

  • able to see objects at a distance as well. That's

  • what's called being nearsighted.

  • Myopia is partly hereditary. Lilli's parents

  • are also nearsighted.

  • Lilli has an appointment at the Eye Clinic in Mainz for a

  • thorough examination.

  • Norbert Pfeiffer heads the eye clinic, and is a specialist in

  • near-sightedness.

  • First comes the exam with the slit lamp.

  • So put your chin on the chin rest.

  • He first examines the ocular fundus and optic nerve in both

  • eyes. Near-sighted people should get a vision exam at

  • least once a year. Myopia can promote the development of

  • other serious eye disorders. It increases the risk of retinal

  • detachment and cataracts.

  • Lilli is nearsighted, at minus 4 to 5 diopters. That's fairly

  • nearsighted - not as much as some, but it's quite a lot. She

  • started out with a quarter of a diopter, when she was

  • about ten. That tends to increase with age,

  • until maybe age 18 or 20.

  • For Norbert Pfeiffer, Lilli is an example of how

  • nearsightedness is on the rise. He's investigating the cause of

  • this increase in a large-scale German study involving

  • 15,000 patients. The study has been underway for 12 years.

  • The longer you go to school, the more near-sighted you

  • become. For every year you go to school, you get a bit

  • more near-sighted. And that goes for university degrees

  • the longer you study, the more nearsighted you

  • become. So nearsightedness has a behavioral component.

  • So myopia isn't just hereditary -- our lifestyle plays a role.

  • Near-sightedness is linked to educational levels

  • and is on the rise worldwide.

  • In Asia, even more young people are nearsighted. In

  • some countries, up to 80 or 90 percent. We think one

  • factor might be the age at which children start school. In

  • some Asian countries, they start school when

  • they're just three or four years old.

  • In Taiwan, for example, myopia has reached epidemic

  • proportions. Up to 90 percent of schoolchildren in major

  • cities are nearsighted. Schools and universities are pressure

  • cauldrons. The workload is heavy - even more than in

  • Europe. Long hours of studying lead to more near-

  • sightedness. What many don't realize is that if myopia

  • remains untreated, it can even lead to blindness.

  • Russ Khan shrugged off his vision problems for years. A

  • software engineer, he was working on a new program

  • when he suffered a retinal detachment. He underwent

  • 12 surgeries, but nothing helped. Russ Khan is now

  • blind. At one point, he contemplated suicide.

  • I can hear. I can move. They're always going to be

  • there for me. That's the love. And because of the family

  • bondings. They made me realize that perhaps if I'm

  • settled down more myself, I can do something. I can still

  • do something for myself and others.

  • Russ Khan now goes to schools to tell his story and

  • raise awareness about near-sightedness.

  • In the classroom, he tries to connect with

  • the children on a personal level.

  • Every half hour, we let our eyes have a break. How long?

  • Ten minutes, they reply.

  • And lastly, how long should you play outside every day?

  • Two hours!

  • The children are supposed to give their eyes a break from

  • schoolwork. But long hours hitting the books is ingrained

  • in Asian culture. It's an uphill battle. The WHO estimates

  • that half the world's population will be shortsighted

  • within 30 years. But simple measures

  • could make a difference.

  • The most important thing is to send children outside into

  • the sunlight for two hours every day. We know this is

  • the best way to prevent nearsightedness.

  • An instrument called a luxmeter is

  • used to measure light intensity.

  • You'd probably say there's plenty of light in this office,

  • enough to work by. But the meter is showing 102.5 lux.

  • That's not much light. The light is much brighter outside.

  • Even bright lamps are no substitute for daylight. Eyes

  • need sunlightthe chance to view objects at a distance.

  • Outside, the light intensity is 100 times higher:

  • I took the meter outside. Even though it's cloudy, we're

  • seeing 13,600 lux. That's much higher. If it were sunny

  • out, it would be even higher than that.

  • Bright sunlight can be up to 100,000 lux or more. It may

  • seem trivial, but daylight works wonders

  • against nearsightedness.

  • Back at the clinic, Lilli is undergoing another a vision

  • test. She's supposed to read the numbers off the chart.

  • She's asked if she can read the largest number.

  • Even the largest number is blurred.

  • Norbert Pfeiffer will continue monitoring Lilli's vision and

  • making sure she gets enough sunlight. It's the only way to

  • treat her nearsightedness and preserve her vision.

  • An eye clinic in Cologne, Germany, specializes

  • in other vision problems.

  • Alfred Remmert is 60 years old. He lives an hour away and

  • comes here for treatment. Remmert runs a company

  • with over two thousand employees and often travels

  • abroad. His vision has been deteriorating

  • for some time now.

  • This is what it looks like out the window. This is what

  • Alfred Remmert sees. And it's getting worse.

  • It's all kind of foggy. Blurry and foggy. Right now I'm still

  • coping but ordinary activities are getting more difficult.

  • Alfred Remmert has come here for a consultation with

  • Claus Cursiefen. He's chief physician at the clinic and a

  • leading expert in corneal disorders. His exam shows

  • that Alfred Remmert is a good candidate for surgery.

  • The lens and cornea are clouded. So two layers of the

  • eye are clouded. In one surgical procedure, we'll try

  • to eliminate both sources of this clouded vision. We'll

  • replace the lens, and transplant the

  • inner layer of the cornea.

  • The transparent cornea is part of the outer casing of the eye,

  • and serves as a kind of windshield. Behind it, the iris

  • opens and closes to control the amount of light entering

  • the eye. The lens focuses the incoming light to create a

  • sharp image on the retina. The optic nerve then transmits

  • that information to the brain.

  • Two hours later, the surgery is underway. Claus Cursiefen is

  • preparing the corneal transplant. The clinic has its

  • own eye bank - with corneas from organ donations. The

  • cornea does not have a direct blood supply. For that reason,

  • it can be removed up to 72 hours after death.

  • Claus Cursiefen carefully removes the edges of the cornea.

  • The blue contrast agent helps him guide

  • the delicate incisions.

  • The cornea is only a few thousandths of a millimeter

  • thick. Using a precision instrument, he removes the

  • inner layer of the cornea.

  • The delicate tissue is rolled up, and then placed on injector.

  • The instrument will later help him position the

  • cornea in the patient's eye.

  • The patient is wheeled into the operating room. Alfred

  • Remmert already under general anesthesia.

  • The eyelids are held open with retractors.

  • With three tiny incisions, the diseased inner layer

  • of the cornea is removed.

  • This is the inner, clouded layer of the cornea, which is

  • selectively removed. It is about ten-thousandth of a

  • millimeter thick. We only remove the diseased layer

  • here and can leave the rest of the cornea in place.

  • That speeds up the healing process. Just a few years ago,

  • the entire cornea would have been transplanted.

  • Then the injector is inserted into the eye and the thin

  • corneal layer is unraveled.

  • The blue-colored structure in front of the eye is the

  • transplant. Now we have to put it in the proper position.

  • Now we fill the eye with a gas. The gas bubble presses the

  • transplant firmly onto the back of the cornea. We don't

  • sew it onit's held in place by this gas bubble.

  • The gas bubble pushes the transplant onto the cornea. In

  • order for it to attach properly, the patient will need to lie on

  • his back quietly for several days.

  • Everything goes smoothly and the surgery is a success.

  • Sigrid Roters helps manage the eye bank at the clinic.

  • Today she retrieved a donor eye from the pathology

  • department. The clinic in Cologne opened its

  • eye bank in 2000.

  • Sigrid Roters carefully examines the eye for any sign

  • of disease. Then she detaches the cornea bit by bit. Human

  • corneas are still used in transplants, but artificial

  • corneas are now under development.

  • The doctor places the cornea in a nutrient medium and

  • maintains the incubator at the perfect temperature, ready

  • for the next transplant surgery. Demand is high.

  • 6,000 corneal transplants take place each year in

  • Germany and there are another 6,000 recipients on

  • the waiting list. Of course, we would like to have more

  • donors to meet this demand.

  • Five weeks after the procedure, Alfred Remmert is

  • back at the Cologne clinic for a checkup. Since corneas don't

  • have their own blood vessels, they're rarely rejected by the

  • recipient's immune system

  • unlike with donor hearts, for example.

  • But he did have some difficulties at first.

  • I'm doing well now but the first 14 days were hard. My

  • eye was very sensitive, I could hardly open it. My eye

  • was watering and my vision was blurred. Then my other

  • eye started watering, too, and felt the strain. But about

  • ten days ago, things got a lot better.

  • The surgery was a complete success, and the healing

  • process is going well. Before the surgery, Mr. Remmert's

  • vision was down to about 40 percent. Now it's at 90

  • percent and it will continue to improve.

  • Alfred Remmert's vision in his right eye is

  • almost normal again.

  • The University Hospital in Bonn, Germany, focuses on

  • one of the most common eye conditions in the Western

  • world: age-related macular degeneration, or AMD.

  • Karin Krause-Zillich suffers from what is called wet AMD.

  • This is how healthy eyes see the world. This is what Karin

  • sees. She is almost blind in her left eye.

  • Wet AMD is less common than the dry form, and it

  • progresses more quickly. At first Karin Krause-Zillich barely

  • noticed the symptoms.

  • When I was doing my make-up and would close one eye

  • to do the other one, I thought, something's not right. There's

  • a dark spot that shouldn't be there. Then I saw my

  • ophthalmologist. He did several tests

  • and I got a diagnosis.

  • The macula is a small area in the retina at the back of the

  • eye. It's where our vision is the sharpest and it contains

  • most of the light sensing cells. In AMD, blood vessels leak

  • fluid or blood into the macula. That leads to swelling, and

  • damages the photoreceptors.

  • Frank Holz specializes in the treatment of macular

  • degeneration. Although AMD cannot be cured, its

  • progression can be slowed.

  • The dangerous thing about this condition is that it

  • irreversibly destroys the photoreceptors located in the

  • center of the retina, in the macula, where our vision is

  • the sharpest. That's what allows us to read, recognize

  • faces, and driveso many everyday activities rely on it