11 November 2018 (Dubai – United Arab Emirates): Moorfields Eye Hospital Dubai (Moorfields) has saved the sight of a patient by changing the silicone oil that had previously been implanted in his left eye as part of treatment undergone in Europe for a recurring retinal detachment. The patient – 40-year old Dut Jok Chalic Jok from Sudan – had a history of retinal detachment in the left eye, which had been treated in Europe in 2015 when silicone oil had been implanted in the eye. Typically the silicone oil needs to be removed three to six months after implantation to avoid further complications.
The original silicone oil injected into the patient’s eye had become emulsified and full of bubbles which reduced its effectiveness in helping to prevent retinal detachment and this led to a further total retinal detachment and also resulted in a very high pressure in the eye and the onset of glaucoma which also threatened to damage the optic nerve at the back of the eye, which would ultimately result in blindness.
The Moorfields Dubai team had to move quickly to treat these multiple complications to save the patient’s vision. The surgical results were an immediate improvement in the patient’s vision and the pressure within the eye returning to normal.
The retina is a thin layer of light sensitive nerve cells that lines the inside of the back of the eye and is essential to be able to see. The retina may become detached because it has one or more holes (retinal tears) forming in the outer part of the retina that allows the vitreous (the jelly-like fluid substance within the eye) to pass underneath it and lift it off. Detachment is considered a medical emergency and urgent treatment is needed to prevent damage. Without treatment, a retinal detachment usually leads to blindness in the affected eye. Most retinal detachments occur as part of the natural ageing process in the eye.
The most common treatment for retinal detachment is a ‘vitrectomy’ operation, in which the surgeon removes the vitreous from inside the eye and then finds and treats
the tears in the retina. A bubble of gas or silicone oil, depending on how the retina behaves during surgery, is then injected into eye to act as a ‘splint’ to hold the retina in position until healing takes place. Silicone oil injection has become a standard technique and improves the results for complex retinal detachment. However, as silicone oil leads to long-term complications (such as emulsification), the removal of the silicone oil from the eye is recommended.
Commenting on the patient case, Dr. Ammar Safar, Medical Director, Consultant Vitreoretinal Surgeon at Moorfields Eye Hospital Dubai, said: “The patient presented with a recurrent total retinal detachment and emulsification of the silicone oil which means that the one large bubble of oil had now broken down into literally millions of tiny bubbles, causing multiple complications. The surgery removed most of these tiny silicone bubbles from the eye (including under the retina) and we were able to reposition the retina successfully. The team was very pleased with the fast improvement in Dut Jok Chalic Jok’s vision and the normalization of his eye pressure again.”
Dut Jok Chalic Jok added: “I am very grateful to the Moorfields’ team led by Dr. Ammar for the quick intervention that saved the retina and the vision in my left eye. It was a challenge to find the expertise to treat the complications I faced and I was relieved to find that Moorfields had all the capabilities to perform the surgery required.”
Moorfields Dubai supports community and workplace health events to highlight the need for screening and exercise in preventing and controlling diabetes
Vision loss is one of the most common and serious complications of uncontrolled diabetes
14 November 2018 (Dubai, United Arab Emirates): Eye experts at Moorfields Eye Hospital Dubai will be on hand at community and corporate health events in the Emirate to mark World Diabetes Day 2018. According to Moorfields, vision loss is one of the most serious complications of uncontrolled diabetes and given that many people will be unaware they have diabetes until serious symptoms show, this means diabetes remains a serious health risk across the community and highlights the importance of regular vision screening.
Diabetes is a chronic disease and lifelong condition in which the absence or low levels of the hormone insulin, causes abnormally high levels of blood sugar in the body, damaging vital organs.
According to the International Diabetes Federation (IDF) there were over a million people living with diabetes in the UAE in 2017, although the prevalence is reported to be falling due to effective public health awareness campaigns. People living with the condition still face the daily challenge of managing their lifestyle to control their blood sugar levels and avoid serious complications. Many people in the community will already have diabetes but be unaware of this until symptoms show, which may be too late for effective prevention of serious complications such as diabetic retinopathy, which can lead to blindness.
The Moorfields community health outreach programme is supporting the ExpatWoman Festive Family Fair at the Dubai Polo & Equestrian Club, and The Women’s Show (Health Awareness and Ladies Event, held under the patronage of Dubai Health Authority) at the Waldorf Astoria Dubai, on November 17th, where Moorfields consultants will explain more about the impact of diabetes on the eyes. In addition, a team from the hospital will provide guests at The Women’s Show with a medical history review, intra-ocular pressure tests and visual acuity checks.
Moorfields Dubai is also working with several corporate and governmental entities to provide awareness and support for employees.
Vision loss is one of the most common and frightening complications of diabetes and prevention starts with regular eye examinations with good diabetic and blood pressure control, but physical exercise can also play an important role. Research has shown that regular physical activity helps to reduce the risk of a range of diseases and health conditions, including diabetes, and improves the overall quality of life.
Once diagnosed, families need to try and build a healthy lifestyle and environment that includes a good diet with plenty of exercise for all family members, in order to help the patient manage the condition.
Commenting on the importance of World Diabetes Day, Dr. Ammar Safar, Medical Director, and Consultant Vitreoretinal Surgeon at Moorfields Eye Hospital Dubai, said: “The good news is that the UAE is doing very well at creating public awareness of the risk of diabetes and World Diabetes Day helps to get this message into the community and the workplace. People living with diabetes need to control their condition very carefully through lifestyle adjustments and regular monitoring in order to avoid serious complications such as Diabetic Retinopathy. The other good news is that with new advances in treatment, vision loss caused by the effects of diabetes on the retina can be treated and even restored, if diagnosed early.”
Moorfields recommends regular eye screening from an early age, and annual eye examinations for all people with diabetes, regardless of whether there are vision symptoms or not. More frequent eye examinations are needed if the patient has active Diabetic Retinopathy that may require treatment.
Excessive Blinking in Children
This week’s blog on excessive blinking in children has been contributed by Dr Darakhshanda Khurram, Consultant Paediatric Ophthalmologist.
Blinking is a normal protective reflex of the eye. It helps lubricate the front of the eyeballs, as well as shields the eyes from bright light, dust and other debris.
The normal blinking rate in a newborn is as low as twice a minute and it increases to 14-17 times per minute in teenagers. This rate will normally increase if the eyes are exposed to bright light, temperature variation and humidity. Eyestrain caused by reading in poor light, lack of sleep or too much screen time – especially in children – can lead to excessive blinking.
Other causes of excessive blinking include inflammation of the eyelids, an irregular front surface of the eye, ocular allergy, habitual tics, refractive errors (the need to wear glasses), divergent squint or turning out of the eye. A rare cause of excessive blinking can be an undiagnosed neurological disorder.
Parents describe their concerns about excessive blinking in a variety of ways, such as an increased frequency of blinking, shutting eyes tightly, awkward rolling and widening of the eyes, and too much rubbing of the eyes.
The management of excessive blinking includes treating the underlying cause. A paediatric ophthalmologist should carry out a thorough eye examination to rule out the major concern: visual problems. The treatment could be as simple as getting glasses for any significant refractive error to reduce the visual stress or using topical lubricant eye drops regularly for dry eyes and ocular allergy.
In rare cases, eye twitching can be a sign of certain brain and nervous system disorders, especially if it is accompanied by other signs and symptoms like multiple tics or auditory (vocal) tics. In such cases, an appointment with a paediatric neurologist is recommended.
Healthy visual habits can prevent excessive blinking in children:
- Wear sunglasses or a wide brim hat outdoors.
- Avoid reading in poor light.
- Take frequent breaks from digital screens.
- Wash your hands before you touch your eyes.
- Eat a balanced diet and stay hydrated.