Month: June 2020

Moorfields Eye Hospital Dubai shares applied measures for long term patient benefit and sustainability

While best practices were once considered as generally accepted and set based on experience and outcomes, in today’s environment, what may have been considered best practices in a healthcare environment or setting as recently as a few months ago, may need to be reassessed and adapted to the current and the future healthcare landscape.

Over the past several months, we have periodically changed the way we practice eye care, as part of both the short and long term strategy to help our patients and in order to help sustain our organization as a whole.

Initiatives such as virtual consultations were introduced and rolled out in next to no time, as a short term measure to allow delivery of necessary eye care to patients without their physical attendance required. This initiative now helps us continue to provide an option to attend a consult with a visiting doctor for example that is otherwise still unable to travel to UAE, it also helps our overseas based patients consult with one of our permanent doctors.

Operationally, the challenges and regulatory changes have led us to assess our patient journey time (the time spent by a patient in the hospital), and improve on this without compromising the quality of care provided. The Paediatric Ophthalmology team for example reviewed the dilation protocol, and new criteria were set, lowering the age at which dilation is mandatory for certain conditions.

In parallel, more stringent infection control was a key priority for the hospital, with changes in policies and monitoring controls for hand washing and sterilizing, equipment cleaning, in addition to rearrangement of all seating areas for patients within the hospital to maintain safe distancing between all areas. Appointments have been spread out to avoid crowding, and while multiple family members were once welcomed to attend appointments, this has been reduced to only one accompanying escort to ensure safety of staff and other patients in the waiting areas, with masks to be worn as a mandatory measure by all. At check- in, pens are now single use only, until disinfection of each is completed, along with limited paper contact. 

During a time when, globally, investing in what would be regarded as an ‘unnecessary expenditure’ has been reduced, Moorfields Eye Hospital Dubai carefully considered the long term benefit and our ongoing commitment to patient and staff safety. In order to further improve infection control, Moorfields Eye Hospital Dubai has invested in more permanent additional protective measures for patients and staff.

Thermal body temperature scanners have been installed at the main entrance of the hospital, and all patients and staff temperatures are monitored daily, in addition to the investment and installation of new protective screens at all main patient facing areas including registration, cashier, pharmacy and all doctors’ offices, to maintain safe distance between staff and patients. The hospital has also invested in the addition of cameras complimenting the conventional method of examining patient’s eyes, which allows a magnified view of the eye safely from a distance.

Moreover, weekly disinfection with an approved third party is a key investment to be considered. The entire hospital premise disinfection is now completed by a Dubai Municipality approved and accredited company from top to bottom, the entire disinfection process may take up to 2 hours at a time, scheduled weekly.

The new normal and best practice for most clinical staff at the hospital are now to wear scrubs. These are changed into on arrival to and out of prior to departure from the hospital and sent out daily for professional cleaning.

Patients that require general anaesthesia now complete a wellness test by an external hospital before any procedure is confirmed, and sedation is recommended in some cases as an alternative. Full Personal Protective Equipment (PPE) is worn by all staff in theatre during general anaesthesia procedures, and deep cleaning is completed in the theatre area after each and every case. Will open plan offices and impressive conference rooms become obsolete and a thing of the past? Or will they slowly be reintroduced and in the future used as frequently as they once were not long ago? These are the types of questions many industries are being forced to ask recently and unfortunately cannot answer yet. However, what we know in the healthcare industry is that we are proficient at learning, adapting, and re-examining our best practices and adapting them for the long run. Through this practice we can all help keep one another as safe as possible and continue to improve on our quest to provide the best possible care to our patients.

In line with Cataract Awareness Month (June 2020), Moorfields Eye Hospital Dubai’s expert team of ophthalmologist warn MENA residents of the two major risk factors for cataracts: age and diabetes.

Cataract, the leading cause of blindness in the world, affects roughly 25% of the population living in the MENA region. An ageing population combined with the high incidence of diabetes raises concerns and yields an environment with an elevated prevalence of cataracts across the MENA region.

Cataract is generally a slow age-related process where the transparent natural lens gradually loses its transparency resulting in cloudy or dull vision. The word ‘cataract’ comes from the Greek word meaning ‘waterfall’ – in Arabic it translates into ‘white water’ as with advancing severity, the lens appears white.

Symptoms

Initially, there may be no symptoms of cataracts, but over time the quality of the vision deteriorates. The sharpness of vision may be lost, and colours may appear washed out and lack definition. Glare, myopia (near-sightedness), and rapid changes in the spectacle prescription are key indicators a patient may be developing cataracts.

Treatment

Intraocular lens implants a treatment for cataracts is a highly effective yet simple procedure that has become one of the most common and most successful procedures performed worldwide. The procedure causes minimal discomfort and takes about 15-20 minutes to be completed and often can be done under local anaesthesia. During procedure, the cloudy lens is removed, and an artificial lens is implanted.

While, modern medicine has provided a hassle-free solution to this condition, if left untreated cataract can become very dense and surgery becomes riskier. In severe cases, there can be inflammation and a rise in eye pressure, which can damage the vision. Therefore, it is advised that patients over 40 have regular screenings for cataracts so that the condition can be treated promptly.

Risk (Age & Diabetes)

Age

Most patients become aware of cataracts after the age of 60. However, cataracts can develop much earlier and affect people of any age, including children and young adults. However, in adults, symptoms may not appear until the age of 40. The causes are not clear but could include hereditary factors, illness, eye trauma and smoking.

With this in mind, cataracts still disproportionally affect people over the age of 65. As the region’s naturally ageing population grows, it will lead to more age-related health issues, including cataracts. Although there is no way to prevent age-related cataracts, a healthy lifestyle – including healthy eating, not smoking and wearing sunglasses with proper UV blocking filters – can slow their progression.

Diabetes

The risk of cataracts is much higher amongst the large community of people with diabetes in the GCC – those with type 2 diabetes statistically face a 60% greater risk of developing cataracts and research has also shown that people with type 2 diabetes who lower their HbA1c level by just 1% can reduce their risk of cataracts by 19%.

In a 2018 study published in the journal, Eye, research found that the risk of cataracts in diabetic patients is double that of individuals who do not have the disease. This relates to the connection between uncontrolled glucose and the impact it has on the nourishing properties of the aqueous humor (watery fluid located in the anterior and posterior chambers of the eye), which can cause lens opacity.

The good news is that cataracts can be treated very effectively with modern surgery to remove the cloudy lens and insert a high-quality lens implant and once treated, cataracts do not return. While many factors contribute to cataracts, age and diabetes are the most prominent. The best way to prevent early-onset cataracts is to monitor your blood sugar and have regular check-ups with your eye doctor.

Why smoking-related eye ailments are rising in prevalence across the GCC  

By Dr. Ammar Safar, Consultant Ophthalmologist and Vitreoretinal Surgeon, Medical Director at Moorfields Eye Hospital

The World Health Organization (WHO) estimates tobacco use in the Eastern Mediterranean Region to be nearly 25%, compared to the worldwide prevalence rate of 22.7%. A number that is even higher when non-cigarette tobacco products like shisha and dokha are included. While these non-traditional tobacco devices are on the rise, so is the prevalence of smoking in the United Arab Emirates, as the country reigns in among the leading countries in the region in terms of Self-reported tobacco use. 

Most people are very aware that smoking in all forms can cause cancer, lung and heart disease, as well as many other chronic health ailments. But did you know that smoking is one of the most harmful habits for the eyes? A study by the British Medical Journal found that smokers are up to four times more likely to go blind in old age; however, many smokers are not aware of the risk. Below, I will discuss four eye-related risk factors that smokers and those frequently exposed to tobacco smoke should know.

Dry Eye Syndrome

Dry eye syndrome is a common condition, especially in the gulf area, where the dry climate can severely aggravate the eyes. Dry eye syndrome occurs when your eyes do not have enough amount, or the right kind of tears. Cigarette smoke is known to have over 7,000 chemicals, many of which can irritate and damage in the setting of dry eye syndrome. Symptoms of dry eye syndrome include burning sensation, scratchy eyes, redness, sandy sensation and severe irritation. Experts recommend that people prone to dry eye avoid smoking and contact with smoke all together as smokers are twice as likely to develop dry eye syndrome.

Cataracts 

A cataract is clouding of your eye’s naturally clear lens. It causes blurry vision and makes colours look dull, faded, or yellowish.  Cataracts are the leading cause of blindness and moderate visual impairment worldwide. Therefore, preventing cataracts carries the potential for significant health benefits, removing the financial and clinical burden of the disease. Thus, identifying risk factors for cataracts is important and may help to establish preventive measures.

If you smoke, you are at an increased risk of developing cataracts. Smoking alters the cells of the eye lens through oxidation and aids the build-up of heavy metals on the lens, contributing to the formation of cataracts.

Age-Related Macular Degeneration (AMD)

AMD occurs when a part of the retina called the macula is damaged. You lose your central vision and cannot see fine details, but your peripheral (side) vision stays normal. In some cases, certain medical treatments can help reduce AMD complications, but there is no cure. 

While age is the number one risk factor for the disease, smoking is a close second. Smokers are four times more likely to get this condition than non-smokers, and people who live with smokers are two times as likely to develop it as well.

Recent medical improvements have introduced a treatment for the severe form of AMD in the form of injections in the eye to restore vision loss. Research has proven that smokers are much less likely to respond to these injections than non-smokers.

Diabetic Retinopathy

Smokers who also have diabetes risk getting diabetic retinopathy. Diabetic retinopathy is when blood vessels in the eye are damaged. Smoking causes vasoconstriction or narrowing of the blood vessels, which reduces the blood supply to the eyes. The condition can lead to diabetic retinopathy, a disease characterized by symptoms such as blurry or distorted vision and possibly blindness. Treatment includes medication or surgery. Additionally, smoking raises blood sugar and can cause your body to become more resistant to insulin, which can lead to higher blood sugar levels. Uncontrolled blood sugar can lead to serious complications from diabetes, including diabetic retinopathy.

Smoking is the single most controllable risk factor that contributes to the development of many eye-related illnesses. The risk factors listed above are just a few of the many risks that smoking imposes. We advise patients to participate in programs to support them in their journey to quitting this harmful habit. Removing smoking from your lifestyle is one of the many healthy habits associated with optimal eye health. Quitting smoking will not only reduce the likelihood of patients developing eye issues throughout their lives, but it will also aid in the improvement of their overall lifestyle.