Bill Harvey: The Ninth Wave
Author: Bill Harvey
Like a well-funded local bus service (remember them), after the calm of the summer months, two major eye health stories appeared last weekend.
The first was on the back of a study from John Dart’s team at Moorfields published in this month’s BJO. Rather alarmingly, the paper highlighted the steady and significant rise in reported cases of Acanthamoeba keratitis among contact lens wearers. The painful and sight-threatening condition was unheard of before the rise of soft lens wear and was initially a very rare occurrence. There were just eight reported cases at the hospital in 2000 and 10 in 2003. This had risen to 35 by 2011 and the figures from 2016 revealed 65 confirmed cases.
With the rise in daily lens wear over this period one might have expected a fall. Showering, swimming and hot tubs are cited as risk factors for those wearing lenses. More sinister, however, is the statement that the micro-organism is found in high levels in the UK water supply. I wonder if this has always been the case, and whether the same is true for comparable supplies in other European countries.
The second story brought a sigh of relief from all who wish to see NHS funding used to best effect and do not approve of the way multinational drug companies exploit the people-funded service by restricting access to cheaper alternatives (in this case Avastin as an anti-VEGF drug) readily available in other countries.
The IVAN study some years back implied the colon-cancer drug had comparable success to Lucentis and, at a tiny percentage of the cost of the latter, should save the NHS millions of pounds desperately needed elsewhere. So there are solutions to some drug company challenges, and not all as drastic as that suggested by Le Carre in The Constant Gardener.