editor’s perspective

One-Size-Fits-One Eye Care

BY JASON J. NICHOLS, OD, MPH, PHD, FAAO

The Centers for Disease Control and Prevention estimated that healthcare costs in the United States are more than $3 trillion. More than half of these healthcare costs are associated with hospital care and clinical and physician services. In contrast to this, the current budget for the United States National Institutes of Health is $30 billion—a fraction of our total healthcare costs.

I think it is important to consider the idea of staying ahead of disease states in our patients, and to do this, we need more basic and clinical research. This is certainly true in the eyecare arena. Knowledge about disease etiology is the first step toward both treatment and prevention.

In looking at models for treatment of disease, there is no doubt that we are now in the midst of a paradigm shift in many ways. For years, big (and small) pharma was focused on small molecules targeted at treatment of disease for the masses. Often, these treatments worked. But, as we all know, sometimes these treatments failed to work, and we, in turn, failed to understand why they did not work in select patients. That begs the question—what makes each individual different?

More recently, we have seen incredible strides being made in genetics. In 2003, the Human Genome Project sequenced the entire human genome—about 20,000 protein coding genes. These genes are rich with information about what makes an individual an individual; in other words, it provides insight from biological variability as to why some treatments may or may not work for patients.

Hence, we can welcome the birth of the idea of “personalized medicine”: that healthcare is customized to individuals in light of their specific genetic, molecular, and cellular content. While not a solution to all problems in caring for our patients, it is a forward-thinking concept that will greatly benefit individual patients. Look for more information on personalized eye care in the future.