19 March 2019 (Dubai – United Arab Emirates): Moorfields Eye Hospital Dubai, the first overseas branch of the Moorfields London hospital, has introduced a new advanced treatment for retinal conditions – some of the common eye problems facing people in the Middle East.Photodynamic therapy (PDT) is a treatment that involves the use of light-sensitive medication and a cold laser to destroy abnormal cells. It can be used to treat some eye conditions – especially those of the retina, including age-related macular degeneration – and skin conditions, as well as certain types of cancer.
Photodynamic Therapy is a highly specialised treatment and painless procedure used to destroy abnormal blood vessels in the eye. PDT has been around since the early 2000s but it is finding new applications and has become an established form of treatment for certain ophthalmologic conditions, including Age-related Macular Degeneration and others.
The Moorfields Dubai team used PDT for the first time to treat a patient with Central Serous Retinopathy. This is a condition in which fluid builds up behind the retina and affects the vision – it can even cause a partial detachment of the retina. If left untreated, it can also cause permanent loss of central vision and some treatments can lead to tissue scarring, which in turn may also lead to impaired vision.
Dr. Ammar Safar is Medical Director and Consultant Vitreoretinal Surgeon at Moorfields Eye Hospital Dubai, commented: “Moorfields Dubai is committed to investing in the latest and most advanced equipment and procedures to ensure the highest standard of patient treatment and care. PDT currently represents the state-of-the-art in terms of a non surgical treatment for certain retinal conditions and offers a new option for patients in the region. These retinal conditions are relatively common in the very diverse population of the UAE, where residents from Asia and other regions are more predisposed to these conditions. We believe that Moorfields
Dubai has become the first and only hospital in the Emirate to introduce PDT as a treatment option – and with good reasons.”
The PDT procedure starts with the slow injection of a drug – visudyne (verteporfin) – through a vein in the patient’s arm. Once completed, a low power ‘cold’ laser is then shone into the eye, focusing on the treatment area for just over a minute to activate the visudyne. On their own, the medication and light source are both harmless but by combining the two and applying the cold laser light, the medication becomes active and causes a reaction that damages the vessels. PDT is generally used to treat the smallest tumours (choroidal melanoma) with very good results, treating small areas of tissue without the need for surgery.
The PDT therapeutic approach can be used to treat abnormal cells in all the areas of the body that a light source can reach, including the skin, mouth, oesophagus (gullet) and lungs and the eyes.
Reasons Why You Shouldn’t Rub Your Eyes
This week’s blog on Reasons Why You Shouldn’t Rub Your Eyes has been contributed by Dr Luisa Sastre, Specialist Ophthalmologist in Medical Retina
5 Reasons Why Rubbing/Touching Your Eyes Is Not A Good Idea
Many of us tend to rub or touch our eyes frequently (consciously or not) during the course of every day. But did you know that every time we do this, we are taking serious risks?
Here is a list of eye diseases that have a connection with touching or rubbing your eyes:
- INFECTIOUS CONJUNCTIVITIS – Adenoviral conjunctivitis is the most common cause of ‘red eye’ in the world and is very easily transmitted by someone who is infected. The virus moves around through direct contact with eye and nasal secretions or by indirect contact with contaminated surfaces (door handles, elevator buttons…). You can even get the virus from someone who has no symptoms but is incubating the disease, days before the symptoms appear. This is one of the reasons why touching your eyes is not a good idea.
- KERATOCONUS – Keratoconus is an eye condition which results in a deformed and progressive thinning of the cornea, at the front of the eye. Keratoconus can cause severe loss of vision and surgery might be needed to stop it progressing. Rubbing your eyes is a known risk factor in the development of keratoconus and can make the condition worse.
- ALLERGIC CONJUNCTIVITIS – Allergic / atopic conjunctivitis is caused by allergens (irritants such as dust, pollen, pollution) in the environment or in the foods we eat. It causes itching which can sometimes be severe and our natural reaction is to rub our eyes. However, this rubbing action also stimulates the release of histamine, which causes even more itching and the desire to keep rubbing. The process can result in even more allergens and irritants, including bacteria, fungus and viruses, getting into to the eye.
- CORNEAL ULCERS – Dry eye syndrome is uncomfortable and feels like you have something in your eye and leads to rubbing. Rubbing can help produce tears that will soothe the irritation temporarily. However if left untreated, dry eye syndrome can eventually cause small wounds in the surface of your eye (keratitis) and rubbing can turn a mild keratitis into a corneal ulcer. Furthermore, rubbing your eye to remove something entered into it, can cause corneal ulcers and worsening of the condition (e.g. small metal splinters from grinding or cutting machines lodged on the cornea or conjunctiva are one of the most common emergencies seen by ophthalmologists). Finally, ‘fighting with a contact lens that won’t come out’ or that you think is ‘lost in your eye’, can cause significant irritation and corneal ulcers.
- AFTER SURGERY – No matter how much you would like to rub your eyes, rubbing them after eye surgery is extremely dangerous. Rubbing your eyes can open surgical incisions causing leakage and transmission of bacteria and viruses, weeks or months after surgery. It can also move or dislodge a flap after LASIK surgery or an intraocular lens.
What are the alternatives to rubbing?
No matter how much pleasure and relief you find in rubbing, compressing or touching your eyes, it can be dangerous.
Although we know that rubbing the eyes creates tears that moisturise the eyes, it is always much safer to use artificial teardrops, whenever you have the desire to rub. There is no limit to the use of artificial teardrops and you can use them hourly or even every 15- 30 minutes, if you have significant discomfort. Preservative-free artificial teardrops are the best option. And of course, visit your ophthalmologist if the itchiness or the need to rub continues, as it can be a symptom of a condition that might need treatment.
World Glaucoma Week: 10-16 March 2019
New micro-surgery techniques raise the bar in Glaucoma treatment at Moorfields Dubai
According to the World Glaucoma Association, glaucoma is the second most common cause of blindness worldwide. There are no symptoms and so most people with glaucoma are unaware they have it. However, the disease is treatable and blindness can be prevented through early diagnosis. Moorfields Eye Hospital Dubai has introduced a new generation of micro-surgery treatment options – Minimally Invasive Glaucoma Surgery (MIGS) – to combat glaucoma in the Middle East, providing patients with a faster, safer surgery and better outcomes.
Glaucoma is a group of eye diseases that cause progressive damage of the optic nerve. It is called ‘the sneak thief of sight’ because there are no symptoms and once vision is lost, it is permanent. As much as 40 per cent of the field of vision can be lost without a person noticing. Although medical treatments are often effective, many patients need surgery. For glaucoma, surgery is becoming a minimally invasive (or even micro) procedure.
Today, eye surgery is following the broader trend in medical surgery and developing new minimally invasive techniques. In the UAE, Moorfields Eye Hospital Dubai now provides a range of glaucoma treatment options, including MIGS techniques.
Treatments
There is a range of new glaucoma surgical techniques that can be used to reduce the pressure within the eye and help stop or slow any progression of glaucoma and so preserve vision. These new techniques help minimise any risks associated with surgery. MIGS comprise two main surgery types:
iStent – A small 1mm mesh tube made from titanium (known as an iStent) is surgically inserted into the eye’s natural drainage channel to help the eye’s natural ability to drain fluid and so reduce pressure inside the eye. This minimally invasive glaucoma surgery (MIGS) is safe and can reduce the need for patients to use eye drops every day.
Xen Gel Stent – the insertion of an Xen Gel Stent also reduces pressure inside the eye by draining fluid via a small drainage tube (stent) connecting the anterior chamber of the eye to a bleb (or reservoir) positioned below the conjunctiva.
Dr. Mohammed Sohaib Mustafa, Consultant Ophthalmic Surgeon, Specialist in Glaucoma and Cataract Surgery, Moorfields Eye Hospital Dubai, said: “New Minimally Invasive Glaucoma Surgery (MIGS) is giving patients with mild to moderate glaucoma very good results with improved safety. In fact, ‘Micro’ seems a more appropriate term because these microscopic ophthalmic procedures are different from other minimally invasive surgical procedures. Most MIGS procedures are an alternative to medical therapy and offer patients an improved quality of life compared to living with the daily use of eye drops, for example.”
Generally, successful MIGS surgery takes no more than 30 minutes and is usually performed under local anaesthesia, although general anaesthesia is also possible under certain circumstances. Complications are extremely rare and MIGS have excellent safety records. Patients are usually discharged from hospital on the day of surgery with an examination the following day. It takes about one month for the eye to feel completely normal in most cases. Most glaucoma surgical studies show high success rates over a five-year period. The I-stent and XEN gel implant show good results with most patients achieving good pressure control without the need for continued glaucoma medication.
Signs that your child has a vision problem
This week’s blog on Signs that your child has a vision problem has been contributed by Dr. Ayesha Khan, Consultant Paediatric Ophthalmologist.
A child’s education, development, future job, self-esteem, and confidence are all linked to good vision. 80% of a child’s learning takes place visually, and 1 in 5 of them has a vision issue that interferes with their ability to learn, according to the American Optometric Association.
Following are some learning impairments linked to eyesight issues:
- spoken language – delays in speech development and speech disorders.
- written language – the ability to read, write, and spell.
- mathematics – the ability to reason.
When diagnosed and treated in the early stages of development, notably between the ages of 2 and 5, as well as up to the age of 7, the majority of visual impairments that affect young children’s learning can be successfully treated.
Parents, teachers and paediatricians should focus on the early detection and identification of the signs that a child might have a visual problem. These early signs include:
- holding a book close to face to be able to read
- covering one eye to focus more clearly
- tilting the head to see more clearly
- seeing double images
- rubbing the eye or blinking a lot
- an eye that turns in or out
- regular headaches
- struggling with hand writing
- avoiding reading
- poor performance in school
- short attention span
- difficulty in remembering things
- emotional and developmental immaturity
- high levels of frustration and irritability
If the child displays or complains about any of these symptoms, please take your child to a paediatric ophthalmologist (children’s eye doctor) for an assessment and appropriate treatment.