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Cataract Surgery
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Eyelid Surgery
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Socket surgery
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Lacrimal surgery
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Eye conditions
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A cataract is a cloudy lens within the eye leading to blurring of vision, haloes, glare and sometimes double vision.
Cataract surgery is the commonest operation performed in the UK. The cloudy lens is removed and replaced with a clear plastic lens. It is an incredibly successful procedure usually done under local anaesthetic drops or an injection as a day procedure to restore sight for the vast majority of patients. General anaesthesia can be given too- and this will be discussed before the surgery.
Before the operation
At your initial consultation a detailed eye assessment and measurements will be carried out where I will be able to discuss both the general risks and benefits of the procedure and any specific to you. As with every procedure, there are some risks. There is around a 1 in 1000 risk of infection which can lead to loss of sight and about a 1 in 100 risk of reduced vision or a further procedure. Although these can seem worrying, these risks are very infrequent. Your glasses will change after the surgery and we'll have a detailed discussion about this at your initial assessment. Often the aim would be to achieve clear distance vision without glasses and to use reading glasses for near. If there is imbalance of focus, the other eye may need surgery later.
On the day
On the day of surgery, once you've been admitted, you'll have dilating and anaesthetic drops instilled in your eye. During the operation you'll need to lie flat and still. A drape will be placed over your face. Oxygen is given under the drape to keep you comfortable. If there's a worry of claustrophobia we can help make the procedure less stressful. You may feel the surgeon's hands resting gently on your forehead. You'll probably see a bright light initially and hear some background noise from the procedure, staff or even soothing music. The operation itself usually takes around 10 - 20 minutes.
Aftercare
Afterwards, you'll be given drops to use - usually 4x day for a month. A light plastic shield dressing is applied to protect the eye whilst the wound is healing. This should be worn until the following morning and then at night for the following week or so. The wound is usually watertight after 5 days (and so usual hair washing can be resumed then)- although swimming should be avoiding for around 3 weeks. You should see your optician about 3 weeks after the operation to get a new glasses prescription. Bring this with you to your review appointment, where I can confirm it's ok to proceed with getting the new glasses made.
Cataract surgery is the commonest operation performed in the UK. The cloudy lens is removed and replaced with a clear plastic lens. It is an incredibly successful procedure usually done under local anaesthetic drops or an injection as a day procedure to restore sight for the vast majority of patients. General anaesthesia can be given too- and this will be discussed before the surgery.
Before the operation
At your initial consultation a detailed eye assessment and measurements will be carried out where I will be able to discuss both the general risks and benefits of the procedure and any specific to you. As with every procedure, there are some risks. There is around a 1 in 1000 risk of infection which can lead to loss of sight and about a 1 in 100 risk of reduced vision or a further procedure. Although these can seem worrying, these risks are very infrequent. Your glasses will change after the surgery and we'll have a detailed discussion about this at your initial assessment. Often the aim would be to achieve clear distance vision without glasses and to use reading glasses for near. If there is imbalance of focus, the other eye may need surgery later.
On the day
On the day of surgery, once you've been admitted, you'll have dilating and anaesthetic drops instilled in your eye. During the operation you'll need to lie flat and still. A drape will be placed over your face. Oxygen is given under the drape to keep you comfortable. If there's a worry of claustrophobia we can help make the procedure less stressful. You may feel the surgeon's hands resting gently on your forehead. You'll probably see a bright light initially and hear some background noise from the procedure, staff or even soothing music. The operation itself usually takes around 10 - 20 minutes.
Aftercare
Afterwards, you'll be given drops to use - usually 4x day for a month. A light plastic shield dressing is applied to protect the eye whilst the wound is healing. This should be worn until the following morning and then at night for the following week or so. The wound is usually watertight after 5 days (and so usual hair washing can be resumed then)- although swimming should be avoiding for around 3 weeks. You should see your optician about 3 weeks after the operation to get a new glasses prescription. Bring this with you to your review appointment, where I can confirm it's ok to proceed with getting the new glasses made.
Eye removalSometimes, despite the best treatment efforts, eyes can become blind, painful and unsightly. Eye removal is an option.
There are two broad techniques to remove eyes depending on how much is left behind. They both work well to remove pain but have pros and cons depending on individual circumstances. An orbital implant is often used to replace the volume lost by eye removal to improve the appearance. An artificial eye sits on the implant. I work with ocularist (ocular prosthetic) colleagues who make excellent matching artificial eyes. |
Socket reconstructionRarely after eye removal people can have changes in lid position, changes in socket volume or changes in the lining of the eye socket. There are options available to help treat these conditions and they depend on a detailed assessment of the individual factors and an open discussion about what is desired. |
Watery eyes
Eye watering has many causes. The tears are produced in the lacrimal glands and are drained by the tear ducts that begin in the inside corner of the eyelids and drain into the inside of the nose.
Eye watering can be due to problems with the tears, the lids or the tear ducts. This can be a difficult problem to solve and needs a careful assessment of the contributing factors with a realistic discussion about what can be achieved.
There are a number of different medical and surgical options available to address this issue and often a combination of strategies is needed to get the best outcome- a comfortable, dry eye.
Eye watering can be due to problems with the tears, the lids or the tear ducts. This can be a difficult problem to solve and needs a careful assessment of the contributing factors with a realistic discussion about what can be achieved.
There are a number of different medical and surgical options available to address this issue and often a combination of strategies is needed to get the best outcome- a comfortable, dry eye.
Dry eyesThe eyes are lubricated by nourishing tears which are evenly distributed by the eyelids and drained by the tear ducts. A healthy turnover of tears is important to ensure a healthy eye. The symptoms of dry eye include gritty, burning eyes and visual symptoms such as blurring and a ‘film’ across the vision. Paradoxically, watering can occur due to irritation from the underlying dry eye state stimulating production of a different type of tear. This is a chronic condition. The aim of treatment is to control the symptoms to achieve comfortable healthy eyes. The assessment of dry eyes can be challenging in judging whether the tears, lids or tear ducts are best targeted to improve the symptoms of dry eyes. Both surgical and non-surgical options are available and an individual treatment plan is the best way to address this complex condition. FloatersFloaters are usually due to changes within the jelly of the eye. These can be due to a diverse range of conditions. By far the commonest is age related degeneration within the jelly which leads to condenstations which are seen as floaters. Although this can be annoying, it usually improves over time and is not threatening to vision. Less common causes include retinal detachment, bleeding and inflammation. Floaters from all these causes can seem identical and so it is important to be accurately assessed soon after developing the problem so that if there is a more serious cause, it can be identified and treated. GlaucomaGlaucoma is a group of different diseases that have damage to the part of the optic nerve (nerve of sight) within the eye itself in common. This damage can lead to loss of the visual field (how widely you are able to see). This is usually related to excess pressure within the eye. It is usually a very slowly progressive disease and so, it is a disease predominately of the elderly. It is important to start treatment early and to try and regularly take the treatment. Once damage occurs, it cannot be reversed and visual loss will continue to some degree as you age regardless of the pressure control at that time. Higher pressures in the eye increase the rate of age related wear of the nerve of sight. Treatment to reduce the pressure can slow the rate of damage. Treatment is initially by eyedrops, but laser treatment and surgery can also play a part. |
Blepharitis (red/gritty eyes)Red, gritty, burning eyes with a ‘film’ over the vision are often due to problems with the health of the surface of the eye. This is extremely common.
Blepharitis is a condition which affects the quality of the tears. The tears are composed of watery, mucoid and oily components. If these components are out of balance then the tears become less stable leading to poor lubrication of the eye. Blepharitis can occur due to chronic infection of the eyelid glands or due to abnormal secretions from these glands affecting the balance of the tear components. Treatment options are targeted to address these issues and often include lid hygiene measures, drops and tablets. I feel lid hygiene is best used frequently and is made part of you daily routine. I suggest taking some hot water from the tap onto your fingertips and then wiping the edges of your eyelids with your finger tips firmly to help squeeze the oil out the the glands. Lots of heat helps melt the oils and improves the effectiveness. This should be done frequently- whenever you shower, wash the dishes or even just see a hot tap. There are many other methods to clean the eyelids. These can include using cooled boiled water, baby shampoo, cotton wool, microwaveable eye compresses.....Many of these methods will probably achieve a more effective clean, but they are inconvenient and so I feel on balance, something quick and easy is a good compromise if done frequently. There are many different types of lubricating eye drops available now. These can be variously classed as preserved vs preservative free and by their thickness. I will help find the one best suited to you. Lubricating eye ointment I usually advise to use just before you go to bed as it lubricates extremely well (and is non-preserved), but it does blur the vision. Antibiotic tablets help change the composition of the gland secretions and change the bacteria that live in the eyelids too. These are usually well tolerated, but side effects such stomach upset and rashes can occur. This tablet is usually given at a low dose taken once a day for a long time (at least 3 months). |