PROSE Treatment Information for Patients and Doctors

prior to getting my PROSE devices, life was hard. Everything that I loved to do was slipping away...That all changed the day I got PROSE.” — PROSE patient 2

PROSE Treatment Indications

Prosthetic replacement of the ocular surface Ocular Surface Disease Corneal Ectasia / ecosystem (PROSE) is a treatment pioneered Dry Eye Syndrome / k sicca Irregular Astigmatism by Boston Foundation for Sight that restores vision, • Ocular chronic GVHD corneal Degenerations supports healing, reduces symptoms and improves • Sjögren’s syndrome • Keratoconus quality of life for patients suffering with complex • History of refractive surgery • Keratoglobus corneal disease. BostonSight™ PROSE uses FDA (LASIK/ PKP) • Pellucid marginal approved (1994) custom designed and fabricated • Rheumatoid arthritis degeneration prosthetic devices to replace or support impaired • Post-radiation • Terrien’s marginal ocular surface system functions. degeneration Limbal Stem Cell • Salzmann’s nodular BostonSight PROSE treatment is available at Deficiency degeneration top-ranked academic medical centers and clinics • Stevens Johnson syndrome • Elhers-Danlos syndrome across the U.S. • Aniridia • Ocular cicatricial pemphigoid corneal Dystrophies Benefits • Chemical / thermal injury • Cogan’s dystrophy (map–dot– • Persistent epithelial defect (PED) fingerprint) ™ BostonSight PROSE can: • Bowman’s dystrophy (Reis– Epidermal Ocular Bucklers) • Reestablish a healthy and stable ocular surface Disorders • Granular corneal dystrophy environment that supports healing and reduces • Goldenhar syndrome • Lattice corneal dystrophy symptoms • Ectodermal dysplasia • Meesmann’s corneal dystrophy • Improve blurry vision by masking surface corneal • Atopy irregularities and transmitting a sharp image to the • Epidermolysis bullosa Post Operative Astigmatism back of the eye Neurotrophic • Cornea transplant Keratitis • Prevent further damage by protecting the cornea (PK, PKP) • Herpes zoster (shingles) against the environment and eyelids • Radial keratotomy (RK) • Herpes simplex (ocular herpes) • Photorefractive For many of the thousands of patients suffering with • Familial dysautonomia keratectomy (PRK) complex corneal disease, PROSE may be the ideal, • Moebius syndrome • Phototherapeutic and sometimes only, treatment capable of restoring • Trigeminal nerve keratectomy (PTK) vision and dramatically reducing eye pain and dysfunction • Epikeratophakia light sensitivity. • Post-surgical • LASIK • Trigeminal Ganglionectomy • Open globe injury

Corneal Exposure/ Corneal Scarring Lagophthalmos • After trauma • Anatomic • After infection • Paralytic – Acoustic neuroma

Devices Used in PROSE Treatment Steps

The prosthetic devices used in BostonSight™ • Referral from primary eye care provider, PROSE treatment are transparent domes, about medical doctor or cornea specialist the size of a nickel, made of gas-permeable • Initial medical review by PROSE doctors plastic that allows oxygen to reach the ocular • 2 to 3 hour medical consultation surface. Devices fit under the eyelids and rest • Insurance coverage determination and potential on the sclera (the relatively insensitive white eligibility for financial assistance (2 to 6 weeks) tissue of the eye), vaulting the damaged cornea • PROSE treatment (4 to 12 day-long visits) and creating a new smooth optical surface that • Periodic follow up visits as required protects the eye from the environment and blink • Annual evaluation by the PROSE team trauma. The removable devices are filled with PROSE doctors work with each patient, saline at the time of application, creating a his/her support system and other medical reservoir of fluid that continuously bathes the providers to understand their specific needs eye in oxygenated artificial tears. and reach treatment goals together.

PROSE creates: Patients continue to be followed by their primary eye care provider during and after treatment; • A new transparent, smooth optical surface over ongoing care is managed with their primary the irregular, damaged or diseased cornea provider and PROSE treatment team. • An expanded artificial tear reservoir that provides constant lubrication while maintaining Insurance Coverage necessary oxygen supply Many major insurance carriers cover BostonSight™ PROSE treatment and services. Financial Liquid Prosthetic assistance may be available for those who Reservoir Device qualify. Check with your local PROSE Provider.

Treatment Process

PROSE treatment teams include cornea specialist ophthalmologists and optometrists who have completed an intensive BostonSight PROSE Clinical Fellowship. Clinical Fellows use a proprietary DTF™ CAD/CAM system to design each device to precisely fit the patient’s unique eye shape and maximize ocular surface system function. All PROSE devices are manufactured at Boston Foundation for Sight’s state-of-the-art lab.

Symptoms and Treatment Success Peer-Reviewed Research

A recent Boston Foundation for Sight report based BostonSight™ PROSE treatment: on a survey of over 1,000 people with corneal disease, including 378 BostonSight™ PROSE “...significantly improved visual acuity and visual patients, found that: functioning in patients with corneal ectasia, • 80% had moderate or severe eye pain irregular astigmatism and ocular surface • 72% had light sensitivity disease…” • 72% had difficulty driving at night — American Journal of Ophthalmology • 69% had difficulty reading regular print 2010; 149: 54-61 newspapers, magazines or websites “...yielded significant increase in visual • 65% had difficulty with work or hobbies function…with high tolerance (wearing failure that require seeing up close 8%) at 6 months. 93.1% of eyes achieved The survey also asked respondents about their visual acuity of 20/40 or better.” success with a variety of treatments. Of the most — Poster Presentation, World Cornea Congress VI, common: April 2010 • 5% had significant success with oral BostonSight PROSE Providers have published antibiotics, fish oil or flaxseed oil more than 25 peer-reviewed publications • 6% with punctal plugs and 50 papers and presentations on PROSE • 6% with topical immunosuppressant treatment. Visit www.bostonsight.org/research. medications (cyclosporine / Restasis) • 10% with artificial tears, lubricant gel or lubricant ointment • 10% with topical steroids 80% had significant success with BostonSight™ PROSE 95% had moderate or significant success

About Boston Foundation for Sight BostonSight™ PROSE Provider Network

Boston Foundation for Sight is a world renowned Alkek Eye Center nonprofit eye health care organization with a mission Baylor College of Medicine, Houston, TX to improve the quality of life for patients and their bascom palmer eye institute families by transforming the understanding, University of Miami, Plantation, FL treatment and care of complex corneal disease. boston foundation for sight The Needham, MA Center of Excellence includes Needham, MA a Medical Institute, a BostonSight™ PROSE Device Manufacturing Lab, a Clinical Research Center and Brooke Army Medical Center a Patient & Community Support Center. San Antonio, TX Illinois Eye and Ear Infirmary University of Illinois College of Medicine, Chicago, IL

Kellogg Eye Center University of Michigan, Ann Arbor, MI

massachusetts eye and ear Boston, MA

North Shore — LIJ Health System Great Neck, NY

Through educational partnerships with the proctor foundation acclaimed Massachusetts Eye and Ear and New at University of California, San Francisco, CA England College of Optometry, Cornea Fellows and Optometry Residents are educated in the latest USC Eye Institute treatments and join doctors in cutting edge clinical University of Southern California, Los Angeles, CA research. Weill Cornell Eye Associates Clinical collaborations with top-ranked academic Weill Cornell Medical College, New York, NY medical centers continue to expand access to Wilmer Eye institute BostonSight PROSE treatment, restoring sight at Johns Hopkins, Baltimore, MD to thousands of patients worldwide. The BostonSight PROSE Network is always www.bostonsight.org expanding. Visit www.bostonsight.org/providers.

About Illinois Eye and Ear Infirmary Meet Our Doctors

The University of Illinois, Chicago, Department of Ophthalmology and Visual Sciences is dedicated to combating vision loss and blindness by providing the most advanced and compassionate patient care, conducting exemplary research, and offering the best possible physician and resident education programs. The Illinois Eye and Ear Infirmary’s commitment Elmer Tu, M.D. Ellen Shorter, o.D. to treating the most difficult and complicated director, cornea service bostonsight prose cases now includes a BostonSight™ PROSE clinical fellow Clinic under the direction of Ellen Shorter O.D., Contact Lens Service, and Elmer Tu, M.D., Director, Cornea Service. With over 30 physicians in all the major areas of ophthalmologic subspecialties, the IEEI leads in the diagnosis, management and treatment of the most difficult and complicated cases including patients visually disabled by corneal diseases or severe ocular surface disease that require special customized prosthetic devices.

Charlotte Joslin, o.D., ph.d. director, contact lens service

call today for a consultation

To learn more or set up a consultation contact the BostonSight™ PROSE Clinic today at 312-996-5410. University of Illinois at Chicago Eye and Ear Infirmary 1855 W. Taylor Street, Room 3.164 Chicago, Illinois 60612 www.uic.edu/com/eye