Jewish eye doctor’s pioneering treatment saves vision of patients with previously incurable condition

Until now, it has not been possible to restore the sight of patients suffering from the disorder, but seven of the eight patients at Moorfields have responded to the pioneering treatment, researchers have found.

Petrushkin, who lives in Cricklewood, comes across hypotony, which is typically asymptomatic in children, “all the time”.

While screening programmes now pick up many children with the disease, he said has seen many adult patients turn up with end-stage hypotony throughout his career.

“We were taught that was end-stage eye disease, you can't do anything about that. And that has always bothered me quite a lot,” he told the JC.

When Guy – who experienced eyesight problems after having her son in 2017 – came to Petrushkin as a patient in 2019, she had been prescribed eye drops by previous ophthalmologists. A cataract removal in routine surgery then led her to become suddenly blind in the same eye.

“[Her eye] just deflated,” recounted Petrushkin. “I then spent the next two years trying to stop the exact thing happening to the other eye, with lots of immunosuppression drugs. But it made no difference.”

When doctors came to do the cataract surgery in her second eye, the same thing happened. “At that point we were in a situation where we either put a clear silicone-based oil inside the eye, which is the best standard care that we have, or we try something different. And I was just at a point in my career, and she was the right patient, and I was surrounded by supportive people in the organisation to try something different,” the medic explained.

His team then came up with the idea of injecting clear HPMC gel – hydroxypropyl methylcellulose – into Guy’s eye once every couple of weeks for around ten months, to restore the shape of the eyeball.

Petrushkin said: “The way that we chose to do it, and to repeatedly do it, with a target in mind, is the new thing about this research. Like if you take a flat tyre and pump it up once, the tyre doesn't work, and you have to pump it up more.”

He added that doctors previously had “had the right idea, but they didn't get it to the point where it needs to be by doing it often enough”.

Guy told the BBC the treatment is “life-changing” and said: “It's given me everything back. I can see my child grow up. I've gone from counting fingers and everything being really blurry to being able to see.”

Petrushkin estimated that between 500 and 1000 patients per year will benefit from this treatment.

“One of the great things about ophthalmology is that you constantly have patients come up to you and say, ‘You changed my life. I was blind, and now I can see,’ because we're constantly doing operations that do that,” he said.

“This happens to be a scenario where what we normally do doesn't work. I'm very happy, because it's wonderful for Nicki, but what I hope is that there's a paradigm shift in the conventional wisdom of when an eye is beyond hope, and to have a much more open approach to not writing off eyes where there potentially is something to be salvaged. It has given me a soapbox that I can stand on and say to colleagues: ‘Don't stop thinking.’”