I was first introduced to the concept of gene therapy during experiments performed during my D Phil in the Department of Human Anatomy in the 1990s Gene therapy has since rapidly established itself as a viable treatment for patients with inherited retinal degenerations. In this talk I will outline some challenges we have met in dealing with large genes and genes need to be recoded using codon optimisation. We are currently running several gene therapy trials across a number of centres worldwide. We are also developing other treatments for retinal disease, such as the electronic retina and also a robotic system for operating safely in the back of the eye.