A-Z of Health: E for Eyes

Date Posted: 18th June 2019

Most of us will experience a problem with our eyes at some point in our lives. Mr Michael Andrew Roberts, Consultant Ophthalmologist with St Joseph's Hospital, talks about some of the most common problems, how to spot them and how they're treated... 

"Ophthalmologists are medically trained doctors who have completed specialist training in the diagnosis and management of eye conditions. This includes microsurgery to the eye and eyelids. The most common problems I see are cataracts, watery eyes, dry eye, glaucoma and macular degeneration.

"Cataracts are an incredibly common eye problem. They occur when the lens inside the eye becomes cloudy with age, although they can be caused by diabetes, trauma and some medications. They cause clouded, misty vision and glare around bright lights. Many patients with cataract have to stop driving, if their vision drops below the legal standard, until their cataract can be removed. 

"The only way to treat cataract is to have surgery. Cataract surgery is the most commonly performed operation in the UK, with over 300,000 procedures carried out every year. The procedure is relatively straight-forward and is performed as a day-case operation under local anaesthetic. We use ultrasound waves to break down the opacified, cloudy lens and remove it from its capsule through a very small incision. A new, plastic lens is then implanted through the same incision to focus the eye. 

"At St Joseph's Hospital we use state-of-the-art VERION technology to aid in cataract surgery. It is particularly useful in patients with co-existing astigmatism. Astigmatism is a common eye condition that occurs when the cornea isn't a perfectly curved shape. Instead of having a regular, 'football-shaped' curve, the cornea is shaped more like a rugby ball and results in blurred vision without glasses. 

"Astigmatism can be corrected during cataract surgery with the aim of minimizing the need for glasses after the operation. We use VERION to place a special toric lens into the eye with a precision and accuracy that was previously impossible."

The VERION Image Guided System by Alcon is designed to add greater accuracy and efficiency during cataract surgery. The VERION System is comprised of three main components. The first takes key measurements of the eye. The second enables the surgeon to utilise those measurements to determine an optimised surgical plan, including what power replacement lens to implant. The third features a digital overlay that enables the surgeon to determine accurate replacement lens alignment based on the unique anatomy of the patient's eye. All of these components come together to help the surgeon consistently achieve their refractive targets.

"Only a handful of hospitals in the UK currently use VERION, so the St Joseph's Ophthalmology centre of excellence is really leading the way in new and pioneering ways of treating these problems that such a high number of us will experience at some point in our lives. Advances are being made all the time, and we are constantly looking to improve and adapt our services in line with the latest research and world leading technology.

"Another very common eye problem is glaucoma. This is a condition where the optic nerve becomes damaged, often due to a build-up of fluid putting pressure on the eye, resulting in partial loss of sight and even blindness if left untreated. It's a silent disease that can develop slowly over many years and tends to affect peripheral vision first, which is not always noticeable to the patient. This means that many people don't realise they have it until irreversible damage has already occurred. Glaucoma is more common in people aged over 70, but can affect people of all ages. Although it isn't possible to reverse any loss of eyesight, an Ophthalmologist can take steps to prevent any further loss through use of eye drops, laser treatment or surgery. 

"As well as treating problems with the eye itself, I also perform oculoplastic surgery to treat problems of the eyelids and tear apparatus. This includes surgery to correct eyelids that are drooping/inturning and the removal of growths and skin tags from the eyelid. The NHS in Wales no longer covers removal of benign lumps on the skin so many people might be living with these unnecessarily. What they may not know is that these can be dealt with quickly and relatively inexpensively at a private hospital. This also includes a pathologist examining the specimen to confirm that the growth isn't a cause for concern.

"Other conditions like watery eyes are often symptomatic of other problems, such as blocked tear ducts, that can be corrected through oculoplastic surgery. 

"The best advice I could give to anyone who is experiencing problems with their eyes is to book in an eye test with an optician. Opticians are an excellent first port of call for any eye problem, they're highly trained and will spot signs of common diseases before you would notice any problems yourself, particularly when it comes to conditions like glaucoma that have no symptoms until damage has already been done. They refer patients to an Ophthalmologist when necessary and they will see people with urgent problems swiftly.

"If a referral is required, you can rest assured that St Joseph's Hospital is at the forefront of Ophthalmic care in the UK. We offer the services of a leading team of Ophthalmologists working in the private hospital sector in Wales, each a senior consultant who will conduct your treatment personally, so you know that you are in the best possible hands.

"The expertise and experience of our consultants is matched by our entire team's end-to-end patient care, along with state-of-the-art technology."

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