Sallie Pollak didn't give much thought to her worsening vision. She simply attributed it to getting older and to a need for a stronger prescription for her glasses.

So it came as quite a shock to the 59-year-old librarian when her optometrist told her she needed to go to a retina specialist immediately. It came as an even bigger shock when Pollak was told she was suffering from diabetic retinopathy, a complication of diabetes that affects vision and is the leading cause of blindness in Americans under the age of 65.

"I have no family history of diabetes, so it came as a surprise to me," said Pollak, who works at the Tequesta branch of the library, where she reads to children.

In fact, she never even suspected she had diabetes. She attributed some of the symptoms, such as tingling in her hands and feet and her increased thirst, to stress.

Pollak, who suffered from swelling of the retina, was "at one point fairly blind," said Dr. Mark Michels, her ophthalmologist in Palm Beach Gardens. She underwent laser surgery, which is the current standard of care. But the standard may change, said Michels, who recently began taking part in a clinical trial that uses a novel drug delivery system.

"We are trying to bring patients new technology that they may not be able to avail themselves of," said Michels, referring to Posurdex, which is being touted as the first biodegradable micro-size drug delivery system designed to provide continuous drug therapy to the eye for a month at a time.

The implant is injected directly into the eye after it is numbed. It is made up of a mixture of polylactic and polyglycolic acid, which are mixed with a steroid. When the body begins to break down the implant, it delivers the steroid in small amounts that help reduce swelling without the side effects of "off-the-shelf steroids," said Michels.

According to Allergan Inc., the California company that makes Posurdex, early studies show few complications. Michels said the product has a lot of potential.

"The nice thing about this is that it may be the way we deliver all kinds of medicine to the eye in the future without having to go to the operating room," he said.

Dr. Julia A. Haller, a Katharine Graham professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins in Maryland, has participated in the first two phases of the Posurdex study and is seeing patients in Phase III. She says diabetic retinopathy is one of the major diseases of interest to drug companies because it's such a huge market.

"The problem is getting worse because the population is aging and people are getting fatter. It's epidemic," Haller said.

Michels has six patients enrolled in the three-year study. The data still must be gathered and submitted to the Food and Drug Administration, so approval is a few years off.

Pollak, whose eyesight was so bad she had to stop driving for about four months, has since regained her vision, but not before having to undergo three separate procedures.

"Sallie is a great example of how traditional advanced surgical techniques work," Michels said. "Posurdex provides a niche for those patients who would not benefit from traditional treatment."

susan_miller@pbpost.com