“With this profound new knowledge humankind is on the verge of gaining immense new power to heal. Genome science will have a real impact on all our lives, and even more on the lives of our children. It will revolutionise the diagnosis, prevention and treatment of most, if not all, human diseases.”Ex-President Bill Clinton, announcing the completion of the first draft of the human genome, 26 June 2000 with Prime Minister Blair.1 2

Ignoring the hype, this was a genuinely monumental achievement, notwithstanding that the map remains in draft form. However, many clinicians remain sceptical about the real benefits for patients. Molecular geneticists have been predicting “significant advances” for years and, despite identifying numerous genes underlying rare disorders, their efforts have shed little light on commoner disorders such as heart disease, glaucoma, and macular degeneration. Sadly, the impact of recent genetic advances on the general ophthalmic communityhas been small, in spite of rising expectations on the part of the media and patients. Sceptics would argue that much has been done for the glory of research and researchers rather than for the furtherance of patient care.

So what are the possibilities for the future? Have expectations been raised unreasonably or will genuine clinical benefits accrue in due course?