Looking ahead: Ophthalmologists envision a world without the toughest diseases

As Ophthalmology Times celebrates its 50th anniversary, we took the opportunity to ask a thought-provoking question to some of the field’s leading experts:

“In a perfect world, if you could cure one eye disease or condition with the snap of your fingers, what would it be—and why?”

Their answers reflect the diversity of challenges facing ophthalmologists today, from the most common causes of vision loss to rare, devastating conditions. What unites them is a shared commitment to improving patients’ lives, both now and in the decades to come.

Age-related macular degeneration: A persistent challenge

Age-related macular degeneration (AMD) was a recurring choice among experts, underscoring its prevalence and impact on patients. Andrew J. Barkmeier, MD, described AMD as a daily challenge in the clinic: “Despite recent advances, we still see too much severe vision loss. If I could eliminate one disease, it would be AMD.”

Sophie J. Bakri, MD, noted that current treatments can improve vision but remain limited. “Our therapies are not cures. They are constrained by fibrosis and atrophy. A true cure would change everything.”

Roger A. Goldberg, MD, MBA, emphasized the need to intervene earlier. “The holy grail is stopping AMD before it progresses to advanced disease. That’s where the greatest impact would be.”

Justis Ehlers, MD, FASRS, and Yasha S. Modi, MD, pointed specifically to geographic atrophy. “We still have no way to halt progression,” Ehlers said. Modi added, “Longitudinally, it is devastating to watch patients lose vision despite therapy.”

Inherited retinal diseases: The need for transformative therapies

Several experts focused on inherited retinal diseases, reflecting the lack of effective options. Vivienna S. Hau, MD, PhD, shared her experiences as a guide for visually impaired marathoners, many of whom live with retinitis pigmentosa. “These patients accomplish remarkable things, but the slow loss of vision takes a heavy toll. Preserving sight would be transformative.”

David S. Liao, MD, PhD, highlighted the lack of options: “For AMD and diabetic eye disease, we have treatments. For inherited retinal disease, we still have almost nothing.”

Jennifer Lim, MD, underscored the impact on younger patients: “Inherited retinal degenerations rob people of both peripheral and central vision, often early in life. A cure would allow them to live fully and independently.”

Joao Pedro Marques, MD, MSc, PhD, expressed the need for a broad approach. “What we need is a gene-agnostic treatment that could apply across all cases of retinitis pigmentosa, not just gene-specific solutions.”

David A. Eichenbaum, MD, FASRS, pointed to the aggressive X-linked dystrophies. “The vision loss is brutal, striking patients at a young age. Eliminating those mutations would mean decades of preserved sight.”

Diabetic retinopathy: A public health priority

Diabetic retinopathy was also high on the list, reflecting its status as a leading cause of vision loss among working-age adults. Danny A. Mammo, MD, called it one of the most heartbreaking conditions: “Young patients come in too late with advanced disease, and there is little we can do. If I could change one thing, it would be to prevent that outcome.”

Sally S. Ong, MD, emphasized the societal impact. “Diabetic retinopathy is the number one cause of vision loss in the working-age population. A cure would restore not only vision but also quality of life, productivity, and independence.”

Alan J. Franklin, MD, PhD, FASRS, echoed that perspective. “From a public health standpoint, diabetic eye disease and AMD remain our biggest challenges.”

Pediatric conditions: Safeguarding a lifetime of vision

Some experts turned their attention to pediatric diseases. Michael Lai, MD, PhD, chose retinopathy of prematurity (ROP). “ROP threatens vision at the very start of life. The surgeries are difficult, and the consequences are lifelong. If I could eliminate one disease, it would be ROP.”

Nimesh Patel, MD, agreed. “ROP is one of the leading causes of childhood blindness worldwide, and in many cases it is preventable. A cure would change lives around the globe.”

Sruthi Arepalli, MD, selected pediatric uveitis. “I care for children diagnosed as toddlers who grow up facing surgery after surgery. To erase that disease and let them see normally would be extraordinary.”

Glaucoma and optic nerve disease: The unyielding adversaries

For some, glaucoma and optic neuropathies represented the greatest challenge. Ella H. Leung, MD, described glaucoma as relentless. “Despite all our efforts, it continues to progress. We need a cure.”

Andrew G. Lee, MD, focused on optic atrophy, the common endpoint of many optic neuropathies. “If we could regenerate the optic nerve, it would rewrite what is possible in ophthalmology. What once seemed impossible is now within reach.”

Other urgent priorities

Several experts identified additional unmet needs. Matthew Starr, MD, pointed to geographic atrophy, calling it “an area where patients desperately want us to reverse time, but we cannot.”

Steven G. Ness, MD, chose proliferative vitreoretinopathy. “It is rare compared to AMD or diabetic retinopathy, but when it occurs, it is devastating. Patients undergo multiple surgeries and still lose vision.”

A shared vision for the future

From AMD and diabetic retinopathy to inherited and pediatric diseases, the range of responses reflects the breadth of ophthalmology’s challenges. It also highlights the specialty’s progress over the past half century.

As Ophthalmology Times marks its 50th anniversary, these reflections serve as both a reminder of what has been achieved and a vision for the future. The conditions that remain incurable today stand as the next frontiers for discovery—frontiers that tomorrow’s ophthalmologists may finally conquer.