Gene-editing technology worth keeping an eye on

An April 29 segment on the TV news show "60 Minutes" underscores why doctors of optometry need to take the time to keep tabs on technological innovation.

In the segment, a researcher injects a gene-editing technology called CRISPR into a mouse and monkey, both blind from retinitis pigmentosa, and remarkably some sight is restored. CRISPR stands for Clustered Regularly Interspaced Short Palindromic Repeats. "If scientists can identify the typo (mutation in the DNA), they can program CRISPR to find it and try to correct it," a narrator on the segment says.

Paul Barney, O.D, chair of the AOA's New Technologies Committee, watched the segment closely and considered the consequences for optometry. Dr. Barney, like others who watched, were impressed. Human trials with CRIPSR are to come and it might be years before the technology can safely and effectively be applied to humans. But CRISPR holds promise for patients suffering from various conditions, whether it's retinitis pigmentosa, cancer or Parkinson's disease, according to researchers. CRISPR may someday be able to prevent a disease before birth or halt its progression after.

"It's fascinating stuff," says Dr. Barney, who practices in Alaska and has been aware of the gene-editing tool for some time. "If CRISPR's potential is realized, the quality of life of these patients will be dramatically improved. It has the potential to have a huge impact.

"The impact on optometry depends a lot on the mode of delivery and a state's scope of practice," he adds.

Preparing for the future

Currently, whether a doctor of optometry can provide medication by injection is determined by the state laws where they practice. Most states allow for either limiting the use of injectables for the treatment of anaphylaxis (22 states plus the District of Columbia) or use of injectables including for treatment of anaphylaxis (18 states).

In the state of California, for instance, doctors of optometry saw the number of procedures and medications they can provide patients expand significantly effective Jan. 1. The California Optometric Association worked alongside health care stakeholders to expand scope, including:

• Allowing therapeutic pharmaceutical agent-certified (TPA) doctors of optometry to give intravenous injection for the purpose of performing ocular angiography under a supervision protocol.
• Allowing TPA doctors to administer flu, shingles and pneumonia vaccines after receiving training and certification.

Dr. Barney says it is too soon to see how the technology may eventually be applied, whether it will be an injectable as it was on "60 Minutes." But that's why doctors of optometry need to stay on top of evolving technology such as CRISPR and work toward expanding scope in their respective states, so they can meet their patients' needs, he adds.

"We need to recognize good technology that will be around and has the potential for providing better care to our patients, and how we can incorporate that into optometry as the primary eye care providers in this country," Dr. Barney says. "If you don't embrace technology, you could find yourself on the outside looking in versus using technology to help grow the profession and your practice."