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Consultants corner: Ophthalmology

Doctors at BMI Healthcare share their expertise.

6 December 2018

We have been speaking to some of the Consultant Ophthalmologists from The Chiltern Hospital about the types of conditions that they see on a daily basis and the importance of getting your eyes checked regularly.

What is retinal detachment and what are the symptoms?
Retinal detachment is the separation of the retina (photographic film in the eye that allows you to see), from the inner wall of the eyeball (a little like the inner lining of a football peeling off).  As the retina needs oxygen and nutrients from the underlying tissues, when it peels off, it can no longer function and the person experiences loss of vision in that eye if the retinal detachment extends.  The early signs of retinal detachment are a sudden increase in floaters in the eye with associated flashing lights.  Any person of any age suffering from these symptoms acutely should have a detailed retinal examination to look for retinal tears.  If you can treat retinal tears early they prevent retinal detachment and thus loss of sight.

Who is most at risk of suffering from retinal detachment and is there anything we can do to reduce the risk?
Most retinal detachments occur spontaneously.  Some are due to trauma and a minority happen after extreme sports that involve sudden acceleration/deceleration of the forces such as boxing and Bungee jumping.  Anyone at any age can get a spontaneous retinal detachment however, the risk of contracting it increases with increasing age. The risk of developing a retinal detachment can be reduced by having a detailed retinal examination, should anyone experience a sudden change in floaters or flashing lights in their eye.

Cataracts and glaucoma are quite common conditions but are they treatable?
Both cataracts and glaucoma are treatable.  A cataract can be treated by a 20-minute operation under local anaesthetic.   Glaucoma can be treated with drops to lower the intra-ocular pressure.  Sometimes laser treatment and surgery are needed to control the intra-ocular pressure in patients with glaucoma.

If someone has a history of cataracts or glaucoma in their family how likely is it that they will contract the same condition?
If someone has a family history of glaucoma then that person has an increased risk of developing glaucoma.  This is why the government has a scheme where anyone over the age of forty with a first degree relative who suffers with glaucoma can get free yearly intra-ocular pressure checks at their optician.

What are some other common eye conditions that you see and treat patients for?
At the Chiltern we cover a wide range of treatments but the most common conditions that we see and treat are:

  1. Eye surface disease, dry eyes and blepharitis: These conditions are all related to the lubricating film of tears that allows the eyelid to slide over the eyeball and keep the clear window of the eye (the cornea) clear and moist.
  2. Age-related macular degeneration: Ageing process of the retina (the photographic film of the eye) can lead to reduction in vision.  This process can be classified into either wet or dry types. Wet type progresses rapidly but has treatment, whereas the dry type progresses slowly and currently has no treatment.
  3. Posterior vitreous detachment with or without tears: The peeling of the vitreous (the jelly inside the eye) from the retina is called a posterior vitreous detachment. The symptoms of this include a sudden increase in floaters with associated flashing lights. When the vitreous peels off the retina, it tears the retina and this is not treated with laser or cryotherapy, the tear can lead to a retinal detachment.
  4. Epiretinal membranes: This is where scar tissue forms over the retina, causing contraction and wrinkling of the retina and leading to symptoms of distortion and blurring of vision in that eye.
  5. Macular holes: This is due to the mechanical formation of a hole in the area of the retina that deals with the central part of the vision called “the macula”. With Macular holes a patient can experience sudden decrease in vision associated with increase in distortion of straight lines in that eye.

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