Michelle Roberts and Sophie Hutchinson
BBC News
Doctors say they have achieved what was previously thought impossible - restoring sight and preventing blindness in people with a rare but dangerous disease. eye hypotony (lowered eye pressure).
Moorfields Hospital in London is the world's first specialist clinic for this disease, and a pilot study shows that seven out of eight patients who received this pioneering therapy responded positively.
One of them, and the first, is Nikki Guy, a 47-year-old who exclusively shared her story with the BBC.
He says the results are incredible.
"This changed my life. It gave me everything back."
"I can watch my child grow."
"I went from counting my fingers and everything being completely blurry to now being able to see."
He can currently see and read most of the lines on the vision testing board.
She only needs to read one more line to meet the legal driving requirement, which is a huge change from when she was visually impaired, used a magnifying glass for everything she needed to see up close, and mostly navigated the house and outdoors by memory.
"If my vision stays like this for the rest of my life, that would be great."
"I may never be able to drive again, but I accept that," she says.
In hypotony, the pressure inside the eyeball drops dangerously, leading to its collapse.
This happens when there is insufficient production of the natural, gelatinous substance inside the eye, for example after an injury or inflammation.
Sometimes it is a side effect of eye surgery or certain medications.
If left untreated, blindness can occur.
Until now, doctors have tried using steroids and silicone oil to fill the eye.
However, it can be toxic over a long period of time and does not restore much vision.
Even when the cells at the back of the eye, which are responsible for vision, are working, it is difficult to see through the silicone oil, so vision remains blurry.
Experts at Moorfields Hospital decided to try a different approach, using something they already had in their cupboard - a cheap, clear, water-based gel called hydroxypropyl methylcellulose (HPMC).
It is already used in some types of eye surgery.
But instead of administering it once, the team at this hospital decided to inject it into the main part of the eye as a new type of therapy.
When she developed vision problems in 2017, immediately after the birth of her son, she initially received large amounts of silicone oil in her right eye, which began to deteriorate.
He says that eye has lost its normal shape and has "kind of collapsed" or "crumpled up like a paper bag" due to hypotony.
That treatment didn't help her much.
And a few years later, the left eye began to deteriorate in the same way.
"After losing the vision in my left eye, I thought, 'There must be something else we can try,'" she explains.
"It's pure determination."
"I just said, 'I'm not giving up.'"
Her ophthalmologist, Hari Petrushkin, says that together they decided to do something completely new - to fill the eye with something that can be seen through.
"The thought that we could harm someone who basically only has one functional eye by administering a therapy that may or may not work was terrifying," he recalls.
"We designed this as a solution and amazingly - it worked."
"Honestly, we couldn't have even dreamed that this would be the outcome."
"Someone who by all accounts should have lost the sight in both eyes... is now living a normal life."
"It's truly incredible. We couldn't have asked for a better result."
He says the same therapy could potentially help hundreds, even thousands, of people every year in the United Kingdom (UK).
It all depends on whether they still have preserved cells in the back of the eye that enable vision.
"We knew with Nikki that there was vision that could be restored and that she would be better off if we could make her eye round and firm again."
They have treated 35 patients so far, thanks to funds from the charity. Moorfields Eye Charity, and now they are in a scientific journal British Journal of Ophthalmology published the results of the first eight patients.
The therapy is given once every three to four weeks for a total of about 10 months.
Researchers hope that over time they will be able to better assess who this therapy might be beneficial for.
"This is a truly fantastic story.
"The results are very promising, but this is just the beginning," says Petrushkin.
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