1. About therapeutic electrical stimulation

How does therapeutic electrical stimulation (TES) work?

Therapeutic electrical stimulation is a relatively new technology developed in the 90s and has been used clinically since 1991. Repeated transorbital alternating current stimulation (rtACS) doesn’t require an operation or the implantation of electrodes in the eye. Therapeutic electrical stimulation isn’t aimed at the replacement of damaged cells, but is focused on an increase in the usefulness of preserved neurons on the retina and on the improvement of conductivity along the optic nerve. Research has shown that, if such stimulation is performed over a period of several weeks, there’s significant activation of the visual system at all levels and throughout the brain. This new, functional state of the visual system is referred to as “ induced plasticity.” Such plasticity is strongly needed to restore sight when there’s deterioration as a result of optic-nerve damage.

Has TES’ effectiveness been officially proven, and is it recommended for public use?

In a large, multi-center trial, the technology was proven at clinical centers like Charite in Berlin and other major universities in Germany. These trials have been designed as randomized, double-blind, and placebo-controlled evidence class Ib studies. You can read more about the details of how the trials were conducted on our publication page.

Does TES require surgery or any invasive procedures?

Therapeutic electrical stimulation is a non-invasive and non-surgical way of the natural restoration of visual function, done by applying weak currents around the eye.

Is the procedure painful?

Absolutely not. Normally, (for more than 90% of patients), the sessions of electrical stimulation are tolerated well and without any painful sensations. For highly sensitive people, some type of sensation like moderate tingling can happen.

2. Accommodation and other facilities during the treatment

How long will I stay in Berlin?

The therapy normally requires a stay in Berlin of 14 days, generally beginning on a Monday.

Could I stay at the center?
No. We do not have accommodation available for our patients. We do recommend the Holiday Inn Berlin which is 200 m away from our center.
Do you provide any help with obtaining a visa?

We provide our patients with the invitation letter that’s necessary when you apply for a visa.

Can you provide transportation?

We can organize transportation from the Berlin airports to the hotel or to our center on request, but it will be at your own expense.

3. Safety of therapeutic electrical stimulation

How safe is the procedure?

The safety of the therapy was confirmed in clinical trials conducted in Germany in 2007 to 2013 and in a large group of patients treated in Russia in 1991 to 2004.

What are the possible side effects or complications?

Side effects of therapeutic electrical stimulation may result when a patient has contraindications. If such contraindications are excluded – there’s no risk of adverse effects on vision or any other functions. Some undesired effects such as tiredness, weakness, a short-lived headache, and sleep disturbances have been observed, but they don’t require any therapy.

Are there any risks to the therapy?

In case of severe, structural, anatomical changes of retina, gentle treatment is provided to eliminate any possible risks.

4. Results of therapeutic electrical stimulation

I have advanced damaged nerves. Is there any chance my vision will improve with therapy?

The results of the treatment depend on many individual factors. Advanced optic-nerve damage requires several courses of therapeutic electrical stimulation in combination with visual training to produce improvement. More than half of our patients have advanced damage, and, with our collective experience, we’ve been able to help them. Severe optic-nerve damage limits the possibility of significant improvement, but doesn’t exclude it. After your request, we’ll provide you with the list of medical records that we need to review your case.

When can I expect to see a positive change to my vision?

Initial positive changes can be observed during the first 10 sessions of treatment. With repeated visual-field tests, the degree of change can be estimated after two weeks. In most cases, you should see a stable improvement within four to eight weeks after the treatment. In the case of progressive vision deterioration (e.g. glaucoma), therapeutic electrical stimulation is able to significantly slow down its progression or even stop it.

Can therapeutic electrical stimulation help me to fully regain my vision or would it only be a partial restoration?

Complete improvement is possible only if there is minor damage to the optic nerves. In the case of moderate or severe damage, partial improvement is possible, but most still enjoy a significantly improved quality of life. Repeated courses allow a patient to regain more vision.

Does therapeutic electrical stimulation improve quality of life?

The improvement of quality of life is our main goal. We reach this through a combination of different medical approaches, such as therapeutic electrical stimulation, visual training, and medications. Once the vision restoration treatment starts, many of our patients have a positive response. Keep in mind that increased quality of life can be achieved only if the patient follows our prescribed recommendations. If you entrust your treatment to us, a Personalized Care Plan will be provided, and following our tested guidelines can increase your chances of significant vision restoration.

Is there anything I can do at home to improve the results of the therapy?

After you undergo the treatment, we offer you a vision-training program that we developed at our center. This program encourages stronger and more functional eyesight and is a valuable tool that will help in the process of regaining your eyesight.

Is the effect of the treatment permanent, or is there a waning effect over time?

The improvement is typically stable. Follow-up results one year after the treatment have shown 80 to 85% stable improvement. Instability can take place if there are factors that affect vision negatively, like elevated eye pressure for glaucoma patients.

Where can I read the stories from your patients who benefited from the treatment?

You can access all our patient stories here.

https://www.restore-vision.com/patient-stories-testimonials/

https://www.restore-vision.com/restore-vision-facebook-reviewes/

https://www.facebook.com/pg/restorevisionberlin/reviews/

5. Follow-up of results

What kind of follow-up is necessary?

The first positive change can usually be seen during the two weeks of your stay in Berlin, but stable results take place four to eight weeks after the treatment. A follow-up exam should be done in your country of residence two months after the therapy. You then send us the results, and we’ll make a comparison to see how much improvement there has been since your visit.

How many times should the treatment be applied?

Follow-up results let us make a conclusion about how well you’re responding to the treatment and whether you can benefit from a second course. Usually, significant improvement of vision requires two to three courses of treatment.

If several courses of treatment are recommended, how often should they be done?

Typically, the therapy should be done every six months or at least once per year. In particular cases (glaucoma, retinitis pigmentosa), we recommend supportive therapeutic electrical stimulation, which can be done every 12-18 months.

6. What else should I know about the treatment offered by your center?

What’s are the components of the treatment?
  1. Before treatment begins, we have a comprehensive discussion with you about your options, and we also perform a vision exam. Once we have the test results and understand the condition of your eyesight, we’ll provide you with a treatment plan. The possible results of the stimulation are discussed at that time.
  2. Therapeutic sessions are performed for two weeks from Monday to Friday. Each session’s duration is 60-90 minutes.
  3. After the treatment, you’re thoroughly examined and your results are discussed.
  4. We provide you with a Findings Report that includes the results of your ophthalmological exam. We also develop a Personalized Care Plan with possible strategies for the upcoming months to suit your specific needs.
Are there any restrictions connected to eye strain, like not using a PC or no reading, that I should follow during and after the treatment?

There are no specific restrictions connected to eye strain - you can use a computer and read. But you should not spend more than three hours a day in front of a computer during your stay in Berlin.

Some patients feel tired after the therapy, but a few hours of rest allows them to overcome it completely.

After the course of the treatment, it’s very important to follow our suggested regime for two to four weeks.

Can therapeutic electrical stimulation be used at home?

No, it’s not possible since this can be harmful. Therapeutic electrical stimulation can be performed only in a clinic and under a physician's supervision.

Can the therapy be done only for one eye?

When there’s damage to one eye, the treatment focuses on that particular eye. But some electrical currents are sent to the healthy eye because both eyes are a part of one visual system that’s developed to provide communication between them. The healthy eye is used to getting more activation in the visual cortex, which is connected with the damaged eye. Stimulation of the non-affected eye has a more significant activation on the brain, which will support the affected eye.

Before we start therapeutic electrical stimulation, your healthy eye is checked with retinal tomography (OCT) to rule out any abnormalities. If they’re ruled out, there’s no risk of any deterioration to the healthy eye. Of course, if you’re concerned about your unaffected eye, the therapy can be done only for the damaged eye.

Do you have anyone else offering your treatment outside of Germany, like in the USA, Australia, or the Middle East -- or would I need to come to Germany?

There are no our branches or facilities outside of Germany where such therapy can be received, and patients from different countries should be willing travel to Berlin.

Is there any way I can contact one of your previous patients who benefited from therapy?

We would recommend visiting our website, where patients stories are published. We update this list to publish more and more successful cases. Direct contact with a particular patient is possible, but it can be done only after his or her permission is provided. Once they give permission for you to contact them, we’ll forward you their information.

How can you evaluate if your medical services are right for me?

Our evaluation about the suitability of our medical services for you is free of charge.

To review your case, we need all available medical records of the patient. If you have relevant paperwork at home, please scan and email them to secretary@restore-vision.com.

Before they’ll be processed, we need to rule out possible contraindications to our therapy. For that a checklist must be completed; it will be sent to you upon request. 

Once we study the information in your checklist, and if there are no contraindications, we start to review your medical records. 

Usually, the case is processed within two to three working days. At the very least, a completed package should contain the following:  (a) ophthalmological reports with detailed results of eyesight evaluation; (b) visual field charts. In cases of extremely low vision VF (vision vision fields получается?) this may not be available; (c) other relevant records and test results such as optic nerve and retina OCT, brain MRI, or CT reports; (d) a narrative of the history of the vision problem written by you.

If you don’t have copies of your history, you’ll need to obtain copies of your medical files from the clinic. Our referral form will be provided on demand.

If you aren’t able to send us the required package of medical information, but you feel that you are a candidate for this treatment, we can still help. We will help to collect the required evaluations, ophthalmological tests, and exams to determine if this therapy is right for you. You will be charged for that service.

We have found that often our services aren’t covered by insurance. We suggest that patients should be prepared for the out-of-pocket expense for the treatment.

We can provide upon your request the price for our services, testing and the costs of our therapies.

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