Ophthalmologists at Moorfields Eye Hospital Abu Dhabi restore vision for patient with Down Syndrome

4 September 2021 – Abu Dhabi, UAE: Ophthalmologists at Moorfields Eye Hospital Abu Dhabi, part of United Eastern Medical Services (UEMedical) and a Mubadala Health Partner, succeeded in restoring the vision of a 40-years old Emirati patient with Down Syndrome. The patient had one of her eyes removed at a younger age due to complications caused by a glaucoma surgery. Her vision in her only seeing eye began gradually deteriorating over the last 3 years and has recently lost almost all functional vision.

Since childhood, the patient has suffered from eye problems, and has experienced learning difficulties associated with Down syndrome. She underwent multiple surgeries to treat glaucoma in both eyes 15 years ago at one of the medical centers, but unfortunately, she suffered from some complications and lost vision in the left eye completely. The eye decreased drastically in size and was extremely painful, due to previous eye surgeries she had; thus, she underwent an eye removal procedure for her left eye.  

“The patient came to Moorfields Eye Hospital Abu Dhabi as her sight was worsening in her right eye – the only seeing eye. Her case was very complex as she was suffering from cataract, glaucoma, recurrent uveitis and lens iris adhesions from previous eye surgeries,” Dr. Igor Kozak, Clinical Lead and Ophthalmology Consultant at Moorfields Eye Hospital said. “At Moorfields Eye Hospital Abu Dhabi, we are fully equipped with the most advanced technologies according to international standards, and have top-notch ophthalmologists with the needed experience to treat the full spectrum of eye diseases in both adults and children with the best clinical outcomes. The hospital has always been providing care to people of determination and provides them with the care needed. This comes as part of UEMedical’s inclusion strategy, that ensures all our clinical and non-clinical members are fully trained to care for people of determination.”

Dr. Syed Ali, Consultant Ophthalmologist at Moorfields Abu Dhabi, who performed the surgery for the patient Aida, said, “Aida recently became completely dependent on her sisters due to severe sight impairment. She was unable to see her food on the plate. Walking in new places without help was also not possible for her.”

“The patient needed a cataract surgery and had severe lens iris adhesions. This required a surgical intervention to restore her vision and to enable ophthalmologists to monitor her optic nerve and retina which was not possible with her dense cataract. The surgery was performed at Moorfields Eye Hospital Abu Dhabi recently under general anesthesia as we needed to calm her down and make her comfortable. As a patient with Down syndrome who underwent several surgeries before, she developed fear of hospitals and procedures. The 1-hour surgery included removing her opaque natural lens and implanting an artificial lens inside the eye which helped in restoring her sight in the right eye completely. The procedure was complex because of the adhesions of the pupil and lens as a reaction to previous glaucoma surgeries and inflammation (recurrent uveitis). The latest techniques were used during the surgery. The pupil was detached from lens, then very dense cataract was removed and replaced with a new artificial lens which helped in restoring her sight to 6/6. She also required strong anti-inflammatory treatment after surgery. Her family members were worried about the surgery because it was the only hope that she sees them again because her left eye was removed long time back, otherwise she would’ve been left blind,” Dr. Syed Ali added. “Performing cataract surgery in patients with uveitis and previous intra-ocular surgery with lens and iris adhesion are always challenging and need meticulous care and planning before, during and after surgery. They require frequent follow for first 8 weeks after surgery to recognize any relapse of uveitis and treat early to avoid sight threatening complications.”

Ms. Asmaa Ahmed, the patient’s sister expressed her happiness and gratitude after the successful procedure which allowed her sister to see again. “Restoring her vision has helped her with her daily routines without depending on the help of others. For the past 2 years, she has required help in the most basic things such as walking, eating and moving around. Her reaction when the bandage was removed from her eye after surgery was very touching. She was extremely happy to see us again. She brought tears to the eyes of everyone in the room! On behalf of my family and sister, I would like to deeply thank the medical, technical and nursing teams at Moorfields Eye Hospital Abu Dhabi for their efforts with Aida since day one.”

Moorfields Eye Hospital highlights eye care Innovations at Arab Health

Dubai UAE: At the recent Arab Health 2021 conference, Moorfields Eye Hospital Dubai highlighted their upcoming research and innovation strategy and the hospital’s current and future plans.

Moorfields Eye Hospital Dubai, which opened in 2007, focused on the theme of this year’s conference which is ‘Research and Innovation’, a theme the hospital in Dubai and in London are continuously contributing towards to advance eye care.

At the conference, Dubai Healthcare City held an interview with Mr. Elhadi Hassan, Managing Director, Moorfields Eye Hospital Dubai, to learn more about the hospital’s current and future research and innovation plans.

During the interview, Mr. Elhadi said ‘Providing world class healthcare is one of the six pillars of the National Agenda of UAE and Moorfields Eye Hospital Dubai is continuously working towards applying the best practices in healthcare through its own research plans, involvement in higher education and providing access to world –renowned professionals in eye care’.

He added: ‘To support undergraduate ophthalmology education, research, and lifelong learning, Moorfields has a strategic partnership with the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU). Moorfields’ ophthalmology physicians who hold adjunct academic titles at MBRU support students’ education by providing supervised clinical rotations and overseeing the ophthalmology curriculum.

Furthermore, on the topic of research, Mr. Elhadi highlighted:  ‘Moorfields is actively involved in research and our results have been presented at both national and international meetings and have been published in scientific ophthalmology literature. Research continues in the field of ocular epidemiology, imaging and therapy collaborating with national authorities to identify main causes of blindness and visual impairment in the UAE’.

And to end the interview, he spoke on the support the hospital provides patients ‘The Hospital has also formed support groups for patients with complex and lifelong eye problems. The groups acts as a safe place for patients to share their experiences and support one another’

For now, Moorfields Eye Hospital Dubai remains a leading hospital for eye health with a comprehensive range of eye care services offered through a team of specialist doctors and allied health professionals. The hospital occupies a  22,000 sq ft facility, housing three operating theatres and laser suite and 10 key departments equipped with the latest technology for diagnosis, management and treatment of all eye conditions The hospital also provides in-house pharmacy services and optical services in order to provide a truly holistic approach to their patient’s eye care needs.

MUBADALA HEALTH ACQUIRES A CONTROLLING STAKE IN UEMEDICAL

Abu Dhabi, United Arab Emirates, 16th June 2021: Mubadala Health, the integrated healthcare network of Mubadala Investment Company, today announced the acquisition of a 60% stake in United Eastern Medical Services (UEMedical) from Jadwa Investment and United Eastern Group (UEG). UEMedical owns and operates multiple hospitals and clinics specializing in women’s health, family medicine, pediatrics, fertility, eye care, dentistry and dermatology in the UAE and KSA.

Through this acquisition, Mubadala Health adds Danat Al Emarat Hospital for Women & Children; the HealthPlus Network of Specialty Centers; HealthPlus Fertility, the largest IVF provider in the region; Moorfields Eye Hospital Abu Dhabi; and a stake in Al Meswak Dental Group to its network. The new services added to the Mubadala Health network include fertility & IVF, obstetrics, neonatology, and pediatric subspecialties.

Hasan Jasem Al Nowais, Chief Executive Officer of Mubadala Health, said: “Over the past decade, UEMedical has witnessed tremendous growth and success, operating facilities that have raised the bar in patient care across multiple specialties. This acquisition enhances Mubadala Health’s network in the UAE and the wider GCC region, while demonstrating our unwavering commitment to transforming the regional healthcare landscape by delivering a full range of healthcare services covering every phase of a patient’s life.”

Ahmed Ali Al-Shorafa Al-Hammadi, Managing Director of UEG, added: “As founders of UEMedical, we are proud of what UEMedical represents, and of our role in the evolution of the health sector through well-established accredited hospitals and clinics in various specialties. While it is not easy to exit what we have built, I believe Mubadala Health provides the best ecosystem to allow it to flourish. We wish Mubadala Health all the success in achieving their vision of a world-class healthcare ecosystem in the region.”

Tariq Al-Sudairy, Managing Director and CEO of Jadwa Investment, commented: “Our acquisition of UEMedical in 2016 came following an extensive assessment that revealed high growth potential for specialized health services, especially in the women and children space. We worked closely with the management team to realize the company’s ambitious growth strategy in the UAE and Saudi Arabia. We are very proud of our partnership with UEMedical shareholders and management, and wish Mubadala Health and the management team continued success in capturing the next phase of growth.”

Majd Abu Zant, CEO of UEMedical, said: “We are delighted to join Mubadala Health’s network of world-class healthcare providers. This acquisition drives innovation and clinical excellence, while expanding the continuum of care across the UAE and Saudi markets as part of an integrated healthcare ecosystem. UEMedical has always been patient-centric and embraces international partnerships that advance our expertise and attract healthcare professionals of the highest caliber. This approach aligns perfectly with that of Mubadala Health, and we look forward to the next phase of our journey.”

The transaction is anticipated to close by September 2021. Mubadala Health’s network currently includes Cleveland Clinic Abu Dhabi, Healthpoint, Imperial College London Diabetes Centre, Amana Healthcare, National Reference Laboratory, Capital Health Screening Centre, and Abu Dhabi Telemedicine Centre. Following completion, Mubadala Health’s portfolio will include more than 10,000 world-class caregivers delivering 100+ service lines across 15 prominent healthcare providers in the UAE and KSA.

Experts at Moorfields Eye Hospital Dubai share Six Effective Ways to Protect Your Eyes during summer

Dubai, UAE – May 15, 2021: Whilst sun exposure is an excellent source of vitamin D, not taking the necessary protective measures during the summer can have damaging effects on the eyes.  Spending a lot of time under direct sun light and heat may accelerate the aging process of the eyes and lead to conditions such as cataracts and macular degeneration.

With temperatures reaching as high as 48°C in the UAE, our eyes are at risk of developing corneal burns, also known as photokeratitis. Therefore, it is extremely important to take the necessary precautions while enjoying summer activities in the sun.

Ophthalmologists at Moorfields Eye Hospital Dubai share Six Effective Ways to Protect Your Eyes during summershares six effective tips to protect your eyes in the summer.

  1. Wear sunglasses with full UV protection – Increased exposure to UV radiation can damage the macula, a central part of the retina at the back of the eye, which gives us the ability to have the perfect, colored vision. UV radiation may also harm the front part of the eye (cornea and lens) leading to cataracts (clouding of lens), macular degeneration, pterygium (benign growth on the white of the eye) and corneal sunburn, which is painful and might cause temporary vision loss. Thus, medical grade tinted glasses that can block up to 100% of the sun’s UV radiations are essential for protecting your eyes in the summer.

  2. Lubricate your eyes – High temperatures and dry winds outdoors can lead to increased dry eye. Air conditioning use increases during summer which also leads to dry eye symptoms worsening. The best and most immediate way to address eye dryness is by using artificial tears to keep the eyes moist and refreshed.

  3. Nourish your body with antioxidants – Constant exposure to the sun’s rays can produce free radicals, roaming atoms in the body that can oxidize and damage the retina. Hence, consuming a diet that is rich in antioxidants will help cancel out the effects of free radicals. Antioxidants such as Lutein, zeaxanthin, and vitamins C can be found in oranges, berries and leafy vegetables and can be easily integrated into your diet.

  4. Stay hydrated – In general, drinking water is extremely important to maintain healthy functioning organs. Considering that the summer heat can make us lose more water through sweat, we need to drink more water to compensate for this loss. Also, if you drink diuretics such as coffee, consider drinking at least 2 litres of water per day. Dehydration is a leading cause of dry eye and irritation, so it is imperative to maintain balanced hydration levels during the summer months.

  5. Always wear swimming goggles – summer is synonymous with swimming. If you enjoy swimming, consider investing in goggles to protect your eyes. Pools are often disinfected with harsh sanitizers such as chlorine. Thus, using goggles can protect your eyes from coming in contact with potent sanitizers and reduce the likelihood of contracting an eye infection such as conjunctivitis, which leaves the surface of the eye red and dry.

  6. Avoid swimming with contacts – Another important precaution to take is to remove your contact lenses before swimming. In fact, swimming with contacts can have sight-threatening effects such as ulcers and infections. Additionally, pool or beach water is home to many microbes such as Acanthamoeba, which can result in infections in the eye and serious complications.

Laser iridotomy (iris hole)

About

A laser iridotomy is generally performed either to lower the eye pressure in chronic narrow angle glaucoma, or to prevent and treat acute angle closure glaucoma (both of which can cause severe and irreversible vision loss if not treated). The treatment is only recommended if the risks to vision from glaucoma outweigh any risks from the treatment itself.

The procedure is done as an outpatient and it is best to have someone along to take you home, as your vision in one or both eyes might be poor for driving or walking, though it isn’t usually badly blurred. We can treat one or both eyes at one sitting. There is no extra preparatory medicine needed on the day before or morning of, but you should take any usual eye drops that were prescribed for daily use. After the preliminary exam, an eye drop of pilocarpine is put into the eye to make the pupil small and the iris thinner. This takes 15-30 minutes. You will get a sensation like sinus pressure, often felt in the eyebrow, and your vision can blur temporarily. The eye is numbed with anesthetic eye drop or ointment and a lens is put on the eye, held by the doctor’s fingers to keep your eyelids out of the way and to magnify the view. You will be sitting up at the instrument called the slit lamp with a chin rest and bright light shining from binoculars that the doctor looks through. You help by keeping the other eye open and staring straight ahead between blinks. It’s OK to blink, since the eye getting treated can’t close with the examining lens in place.

Types

The most commonly used laser is the neodymium: YAG type, which treats the eye so fast that you won’t have a chance to move your eye during laser applications. When the laser fires, you get a sensation that something happened. It’s typically not unpleasant, just a little startling if the doctor doesn’t warn you first. We often need to make several deliveries of laser to produce a hole about one half a millimeter in size, about the size of a ball point pen tip. That’s all it takes to let aqueous flow from behind to in front of the iris and fix the problem. It’s pretty uncommon that you or someone else will see where the hole was made, though if you look closely you’ll later possibly see a black dot where it is. Because the laser is focused down to a point at the iris inside the eye, it doesn’t have concentrated power anywhere in the eye except there, so it doesn’t damage the wall of the eye or anything behind the iris. You won’t have a hole in the outer wall of the eye.

A small number of persons after iridotomy previously reported that they saw an additional line of light around street lights, or, that they see more glare in general. Even those who experienced this glare effect found that it goes away with time. Widely accepted locations for placement of the iridotomy such that the incidence of glare is minimized include at the 3, 9 or 12 o clock positions. Very rarely, debilitating glare may require an operation to close the iridotomy using a stitch.

For the first hour after iris hole treatment, vision is blurred, but it clears quickly. Half an hour after treatment the pressure is checked, since occasionally it rises substantially and needs treatment for a while with drops to make it safe again. No eye patch is used. Some eye surgeons give anti-inflammatory eye drops for a few days. The next visits are one day, one week and one month later. If the laser hole is not open at 4 weeks after the initial treatment, it is retreated, which is typically pretty quick and easy. Making a hole is harder in thicker, brown irises, such as in African- or Asian-derived persons. In these eyes, we can treat with two separate types of lasers in sequence, the first being a continuous wave laser (diode) to thin down the iris, followed by the neodymium:YAG to punch through. About one in ten times in this kind of patient it can take two sessions to make a full hole of the right size, and sometimes the iridotomy may have to be placed at any suitable location to minimize the much higher risk to vision from glaucoma.

Once a laser iris hole is made, it’s open for good. The iris doesn’t heal as do other body tissues, probably because the aqueous fluid that surrounds it contains chemicals that prevent healing under normal circumstances. The exceptions to the no-healing rule are eyes that have new blood vessels growing in them or eyes with inflammatory diseases (neovascular and inflammatory glaucoma). Because the normal situation of no-healing is changed by these processes, laser iris holes in those eyes can close up and are watched more closely.

There is some limited evidence that making a hole in the iris speeds the development of cataract, perhaps because the movement of aqueous is re-routed through the hole and doesn’t uniformly bathe the lens as it normally does. Of course, if the eye develops an acute angle closure crisis because the hole wasn’t made, a cataract is pretty much guaranteed to develop soon. An iris hole, on balance, may wind up preventing more cataract than it might cause if angle closure crisis is avoided.

Depending on the type of glaucoma, laser iridotomy may help facilitate control of the eye pressure, but you may still need to use glaucoma drops long term. In some cases further laser or surgical treatment may be required to control glaucoma, as the iridotomy may be one step in the long term management of the condition. It is important to remember that a laser iridotomy is not done to improve vision or to gain independence from glasses.

Abu Dhabi based UEMedical Group adopts Okadoc solution for appointment booking and telemedicine across eight facilities

Abu Dhabi, UAE – November 23, 2020: United Eastern Medical Services (UEMedical), a leading healthcare group in the UAE, joins the growing list of healthcare providers who have adopted Okadoc’s white label booking and telemedicine solution. In an effort to digitize its healthcare services, UEMedical Group has successfully implemented the Okadoc solution for two of subsidiaries in UAE – HealthPlus Network of Specialty Centers and Danat Al Emarat Hospital and Clinics.

The Okadoc solutions enables patients to book and manage their in-person or video consultation appointments with doctors at HealthPlus Centers and Danat Al Emarat hospital and clinics easily through their respective websites. Patients can view availability of doctors in real time, both on the hospital or clinic’s website as well as through the Okadoc app. Even those with prior bookings via the call center can manage their appointments online.

Majd Abu Zant, Chief Operating Officer at UEMedical Group, UEMedical Group, said, “The COVID-19 pandemic has changed the world in many ways, of which digitization is at the forefront, especially in the delivery of healthcare. At UEMedical Group, we have always adopted the latest technologies to provide the highest standard of care to our patients. With Okadoc’s solution implemented across two of our healthcare subsidiaries, we seek to enhance the patient’s healthcare journey, making it seamless and effortless.”

On benefits of Okadoc’s white-labelled solution, Mr. Abu Zant added, “The platform is directly and fully integrated into our existing hospitals information system, ensuring that we deliver top patient care without interruption. It also helps us with reduced no-shows and optimized bookings, which positively impact our operational efficiencies.”

Healthcare providers can easily embed and deploy Okadoc’s white label booking and telemedicine solution into their websites and mobile applications within a matter of a few hours. It then allows patients to view doctors’ availability in real time, book, reschedule, and cancel an appointment with a practitioner at the hospital. Once patient bookings are made, an automatically generated confirmation and booking reminder is sent to the patients enabling them to connect online to access the information they need easily and effectively. 

“We are excited to be partnering with UEMedical Group, marking our first tie-up with Abu based healthcare providers. Okadoc was founded with the aim of providing convenient and hassle-free access to healthcare. Our white label solution is an important evolution of our solutions to help healthcare providers digitise and optimize their patient care process, especially during the current pandemic when patients are reluctant to visit hospitals”, said Fodhil Benturquia, Founder & CEO, Okadoc.

Okadoc has successfully implemented its white label solution across the UAE’s prominent healthcare groups including the Emirates Hospital Group (EHG) and Medcare hospitals and clinics.

Okadoc’s cloud-based platform connects the patients with their physicians via text or video calls at mutually convenient times. Either party can share or send documents pertinent to the consultation session and send and receive payments without any delay. The system ensures that all transactions, whether financial or informational, shared between the two remains confidential and secured.

Okadoc’s telemedicine platform is TRA (Telecommunications Regulatory Authority) approved, using end-to-end encryption with the cloud data hosted in the UAE, and compliant with UAE regulations.

Top 10 Eye Conditions Affecting Children

This  blog has been contributed Dr. Alaa Bou Ghannam , Specialist in Neuro-Ophthalmology, Paediatric Ophthalmology & Glaucoma, and Adult Strabismus

Children have their own set of eye diseases that are at times different from what we see among adults. Below is a list of ten of the most common pediatric eye problems seen in a paediatric ophthalmologist’s clinic.

  1. Refractive errors: This is by far the most common paediatric eye condition. Usually, it is easily treated with glasses. It can be myopia, hyperopia or astigmatism. Children sometimes cannot verbalize their inability to see, so they might squint, blink, turn their heads or just give up on seeing all together which might affect  their school performance.
  2. Strabismus: This happens when the eyes are not aligned together, with one or both eyes drifting or crossing. This can be congenital or acquired; it is usually treated with glasses or surgery. In some cases we can just observe but sometimes systemic workup is needed to rule out underlying conditions.
  3. Viral conjunctivitis: Eyes are red, watery and have purulent discharge. Typically, it involves one eye and then spreads to the other. Observation is usually the rule as most will resolve uneventfully within 4-10 days. It is highly contagious.
  4. Allergic conjunctivitis: Presents with itching, blinking, red and watery eyes. Typically involves both eyes simultaneously. It can be seasonal or related to a specific allergen. Severe condition is called vernal catarrh. Treatments include lubrication, antihistamine drops, steroids or cyclosporine drops in severe conditions.
  5. Amblyopia/ lazy eye: It happens when the brain favors one eye over the other, causing further decrease in vision in the weaker eye. This might be caused by a difference in refractive error between the two eyes, strabismus, or media opacification preventing clear images from reaching the retina. It must be treated early on with patching of the stronger eye or with atropine drops.
  6. Nasolacrimal duct obstruction: It is usually congenital. Infants have excessive tearing and discharge, treated with nasal massage to open up the nasolacrimal duct. Most resolve by the age of one.
  7. Chalazion/ stye: It is a benign growth on the eyelid caused by a blockage of the meibomian gland due to lid inflammation. Treatment is usually through lid massage. In most cases it resolves uneventfully. Sometimes, it gets infected and will need antibiotics. If it does not resolve in a month then incision and drainage is recommended.
  8. Congenital cataract: Infants are born with unilateral or bilateral opacification of the lens. Parents will see a white reflex in the pupils. It is recommended to remove the lens early on to prevent amblyopia.
  9. Congenital glaucoma: A condition where the pressure in the eye is elevated. Infants with glaucoma will have large eyes (buphthalmous) with tearing and light sensitivity. Surgery is the treatment of choice as drops might not be helpful.
  10. Retinoblastoma: It is a malignant cancer of the retina.  Parents will notice a white reflex in the pupil. It needs urgent diagnosis and treatment that includes chemotherapy, laser therapy and/ or removal of the eyeball (enucleation).

Annual comprehensive eye examinations are recommended for all young children, as many eye conditions may be managed or treated more effectively with early screening and detection.

NYU Abu Dhabi Signs a Memorandum of Understanding with United Eastern Medical Services

October 28, 2020, Abu Dhabi: NYU Abu Dhabi (NYUAD) signed a Memorandum of Understanding (MoU) with United Eastern Medical Services (UEMedical) in Abu Dhabi, the parent organization of Danat Al Emarat Hospital for Women & Children, HealthPlus Network of Specialty Centers, and Moorfields Eye Hospital Abu Dhabi. A major outcome of the MoU is establishing the HealthPlus Diabetes & Endocrinology Center in Abu Dhabi as one of the main clinic sites for the UAE Healthy Future Study (UAEHFS) set to accept participants from November 1, 2020.

The collaboration will also offer support on current and future research, education, innovations, and workshops in the field of health sciences. 

The MoU was signed by NYUAD Vice Chancellor Mariët Westermann and Chief Operating Officer at UEMedical Majd Abu Zant; in the presence of UEMedical’s Chief Medical Officer Dr. Sadoon Sami Sadoon; and Diabetes & Endocrinology Consultant and Director of Academic Affairs at HealthPlus Network of Specialty Centers Dr. Huda Ezzeddin Mustafa. Mandatory health and safety protocols including testing, face masks, and physical distancing were in place throughout the event.

The UAE Healthy Future Study is the first cohort study aimed at understanding the source and cause of the rising cases of obesity, diabetes, and heart disease among Emiratis. The study invites all UAE nationals, between the age of 18 and 40, to participate. Currently, the study clinics are located in Abu Dhabi Blood Bank, Cleveland Clinic Abu Dhabi, Healthpoint, UAE University, and Latifa Hospital- Dubai Blood Donation Center.

Westermann said, “Across the disciplines, NYU Abu Dhabi is investigating and investing solutions to some of the world’s most pressing challenges, including public health concerns such as obesity, diabetes, and heart disease. The UAE Healthy Future Study is mobilizing the scholarly and scientific capabilities of our university along with great local partners such as United Eastern Medical Services towards building a healthier UAE. We are excited at the possibilities afforded by this new partnership and how we might advance our local contributions towards the health sciences.”

Abu Zant stated, “We hope this MoU paves the way to a successful and collaborative partnership that will benefit our community. UEMedical delivers world-class medical services through its various Centers of Excellence, underpinned by a strong medical education and research framework. As accredited research centers by the Department of Health Abu Dhabi (DoH), Danat Al Emarat Hospital, HealthPlus and Moorfields Eye Hospital Abu Dhabi have taken part and have initiated multiple integrated clinical research projects and studies in the past 18 months, and we are truly excited to participate in the UAE Healthy Future Study. We are confident that HealthPlus Diabetes & Endocrinology Center will provide insightful data for the study. The MOU also opens the door for further collaboration with NYUAD in research, education and innovation particularly in the fields of woman and child health, fertility, eye diseases and genomics.”

NYUAD, in association with its Abu Dhabi partner, Tamkeen, is funding and leading the UAE Healthy Future Study in collaboration with the Department of Health – Abu Dhabi,  Dubai Health Authority alongside SEHA – The Abu Dhabi Health Services including Sheikh Khalifa Medical City, Al Ain Regional Blood Bank, Abu Dhabi Blood Bank, Zayed Military Hospital, UAE University, Zayed University, Khalifa University, EBTIC, Higher Colleges of Technology, Healthpoint, Cleveland Clinic Abu Dhabi, Oasis Hospital, Capital Health Screening Center, Daman, and NYU Langone School of Medicine

NYUAD Public Health Research Center Associate Director Abdishakur Abdulle stated, “Given the importance of the UAE Healthy Future Study for the nation, we have developed a partnership with various national institutions in both the public and private sectors. Today marks yet another great milestone which will enable us to work with a key partner in healthcare, namely UEMedical. In part, this collaboration will facilitate accessibility for even more public participation among the nationals of the UAE. We will continue our efforts to engage with the public and ensure that participation in the UAE Healthy Future Study is smooth and easily accessible. Results from this study will not only help improve the health of the community, but will also be in line with national objectives to build a world-class healthcare system through scientific research in understanding the causes and consequences of chronic diseases in the UAE. It is anticipated that results from this study will also help the development of better prevention and treatment strategies.”

In April 2020, UAEHFS shifted to online recruitment in response to the precautions set out by the UAE Government to protect public health and limit the spread of COVID-19. To register, study volunteers now have the opportunity to participate through an online-based platform instead of physically visiting clinics.

Dr. Huda Ezzeddin Mustafa said, “We believe that the partnership between NYUAD and UEMedical is fundamental to build strong bridges between public health and healthcare providers within a framework of academics and clinicians. The collaboration will no doubt nurture community-based medical research through our multispecialty medical services. We are truly proud to open our doors to the landmark UAE Healthy Future Study, and we trust that the UAE population have the vision and understanding of the importance of clinical research. We have learnt from the phenomenal participation of our population in COVID-19 trials that the Emirati community is capable of making informed decisions to participate, with much enthusiasm, in well-designed medical research for building a healthier future for the generations to come.”

About the UAE Healthy Future Study

The UAE Healthy Future Study is the first long-term study aimed at understanding and providing substantive evidence for environmental, lifestyle, and genetic determinants of common diseases in the UAE population, such as obesity, diabetes, and heart disease. All UAE Nationals between the ages of 18 and 40 are invited to volunteer by participating in a confidential health assessment and future follow up that will contribute to a healthier future in the UAE. www.UAEHealthyFuture.ae

Glaucoma: Why early diagnosis is important, and what treatments are available to maintain quality of life

This  blog on Glaucoma and treatment options has been contributed Dr. Salman Waqar, Consultant Ophthalmic Surgeon, Specialist in Adult Glaucoma and Cataract Surgery.

Glaucoma is a term used to describe a group of conditions in which the eye pressure is high, leading to damage to the optic nerve (the nerve that connects our eye to the brain). This can lead to permanent damage to the field of vision. In severe cases can cause tunnel vision and blindness. Even in less severe forms, glaucoma can interfere with independent living and can even affect our ability to drive.

Prevention is the key.

Regular eye exams with your eye specialist, particularly if there is a family history of glaucoma, can detect the condition early.

Fortunately, we now have many very sensitive tests that can diagnose the condition well before it causes any perceptible damage to your vision. These include Visual Field tests and Optical Coherence Tomography scans. Both are done in clinic and only take a few minutes with no discomfort.

Once the diagnosis is confirmed, the key is to lower the eye pressure and preserve vision. While searching for an eye care facility and a Glaucoma specialist, it’s best to look for a location that can offer the comprehensive treatment options shown below and an experienced Glaucoma Consultant, for long term relief and peace of mind.

  • Eye drops: There are a wide variety of eye drops which can be used to lower the eye pressure. They are usually taken once or twice a day but do need to be instilled regularly for the rest of your life.
  • Lasers:
  •  Selective Laser Trabeculoplasty: This is a simple and painless laser treatment that only takes a few minutes to perform and you can go home the same day. It can be done either to supplement the effect of eye drops or to replace them completely. At the time of your consultation, your consultant will discuss how this can help you.
    •  Laser Peripheral Iridotomy: In a particular type of glaucoma (narrow angle glaucoma), a very small channel is created in the iris (the coloured part of your eye) using a special laser. This can not only help lower the pressure but can also prevent future attacks of very high pressure (called acute angle closure glaucoma)
    •  Cyclodiode: If the eye pressure is not being controlled despite best efforts with all other treatment options, this laser can be performed to stop production of fluid in the eye (this is done by a part of the eye called the ciliary body).
  • Surgery: I am trained in all the latest surgical techniques for the treatment of glaucoma. These include:
    •  Cataract Surgery: For some, simply removing a developing cataract can not only lead to improvement in vision but can also lower the eye pressure.
    •  Cataract Surgery with iStent inject implantation: At the time of cataract surgery a very tiny titanium stent can be implanted into the eye which helps to drain fluid out of the eye thus lowering the pressure. This is part of an exciting new type of surgery called minimally invasive glaucoma surgery (MIGS).
    • Cataract Surgery with goniosynechialysis: Sometimes an iStent cannot be safely placed as the drainage angle of the eye is narrow. In such circumstances the drainage area can be opened with a technique known as goniosynechialysis.
    •  Trabeculectomy with antimetabolite injection: This involves creating a flap on the surface of the eye which allows fluid to drain out. A special anti-scarring medication is used to ensure success.
    •  Aqueous Shunt Devices: These devices comprise of a soft footplate connected to a plastic tube. The tube is inserted into the eye whilst the footplate is secured to the surface of the eye and drains fluid out.  Performing either a trabeculectomy or aqueous shunt device insertion is reserved for cases that are not responding to other suitable treatments as listed above.

Early detection and prompt treatment of glaucoma is essential to preserve vision. An ongoing and strong support system surrounding you can make all the difference in living a fulfilling life despite glaucoma.

Choose a location and a doctor that consider individualised treatments to suit your personal needs. This will help you and your family understand and manage the condition whilst also maintaining your quality of life.

Keratoconus and its Modern Treatments

This blog on ‘Keratoconus and modern treatments’ has been contributed Dr. Osama Giledi, Consultant Ophthalmologist, Specialist in Cornea, Cataract and Refractive vision correction surgery.

The cornea is the eye window which controls and focuses the entry of light into the eye, and in cases of keratoconus, there is a pathological decline in the thickness and rigidity of the cornea, which leads to irregular bulging of the cornea to a cone-like shape, which causes reduced vision from irregular astigmatism.

Corneal keratoconus usually affects both eyes and each eye may be affected differently, and usually occurs in people between the ages of 10 to 25 years. The condition may progress for 10 years or more and then slow down or stabilize.  As the condition progresses, vision becomes distorted and blurred, with an increased sensitivity to light and glare.

Keratoconus presents itself in more certain ethnic groups, such as the Arab countries, southern Europe, and southern Asia. Environmental and genetic factors are potential causes, but the exact cause is uncertain.

Eye rubbing is a major risk factor. It is associated with some disease such as atopy and asthma. Also associated with some syndromes such as Down syndrome. If you have a family history of keratoconus, you have a greater chance of developing keratoconus. Pregnancy can make keratoconus progress more.

New corneal scans especially the 3 dimension scan such as pentacam help to diagnose Keratoconus at early stage.

Traditional treatment of keratconus was through glasses, hard contact lenses and corneal grafts. However, modern treatments for keratconus is used to stop the progress of Keratoconus, improve the shape of the cornea, and improve vision as well as avoiding the need for corneal graft.

Glasses or contact lenses can be used to correct nearsightedness and astigmatism in the early stages of keratoconus. As the Keratoconus progress, the patient needs a special solid contact lens.

Corneal collagen crosslinking

It is a procedure designed to halt the progression of keratoconus. The modern approach of accelerated pulsed crosslinking is used to ensure an easier procedure for the patient. We use ultraviolet A (UVA 360 nm), Riboflavin( vitamin B2) to stiffen and harden the cornea about four times and this stops the deterioration of keratoconus. The process is carried out under topical anesthesia and several drops of riboflavin are placed in the eye for about 15 minutes and activated by ultraviolet (UVA) rays for eight to thirty minutes. The corneal cross linakge is considered one of the safest and most successful operations used to stop keratoconus degradation and may lead to some improvement in some cases.

Intracorneal rings ( Ferrara, Kerarings or Intacus)

Intracorneal rings are plastic inserts that are implanted into the cornea to alter the shape of the cornea. It used to restore the regularity of the cornea again or at least reduce the irregularity; it will flatten the steepened section of a keratoconic cornea to achieve better unaided and better corrected vision. This often allows for a reduced prescription of spectacles and/or contact lenses and in some cases, satisfactory vision without glasses or contact lenses.

It is recommended to implant cornea rings in cases where the eyeglasses or contact lens are not able to clearly improve vision.

There ring can add strength to the cornea and it can be removed easily if it does not improve vision much.

The installation of rings using a femtosecond laser (intralase) added a new dimension to this type of operation. The process became safer and more effective and the femtosecond laser enabled the ophthalmologists to place these rings in the most accurate depth and diameter possible within the cornea with great accuracy and are way better than old Manual surgery. There are different sizes and thickness of rings depending on the shape of the keratoconus.

topography-guided laser surgery (TG-PRK).

Using topography guided eximer laser to improve the irregularity for the cornea surface in keratconus is a new method, where the patient who cannot tolerate contact lenses and has bad vision with glasses. The aim is to remove very little tissue so the patient can see clearly with glasses. There is a risk of weakening the cornea with this procedure, so we need to do a corneal cross linkage and minimize the amount of tissue removed by the eximer laser. Patient should be aware it is not to get rid of the glasses.

Implantable contact lens inside the eye.

It is used in patients with very high astigmatism and myopia who can see reasonably with glasses but the glass prescription are very high or has imbalance between the two eyes.  These are placed inside the eye and have the ability to correct high degrees of short-sightedness and astigmatism. It is safe and effective procedure in selective patient, but the daily hard lens often provides for better vision than this lens as it corrects all the irregularity of the cornea.

Treatment with corneal cross linkage and intra corneal ring and topo guided laser all requires a minimum level of thickening of the cornea. Here the role of early diagnosis and treatment is highlighted, and that when the cornea becomes very thin these treatments become not possible, which makes corneal transplantation the only remaining treatment for such cases.

Corneal transplantation

It is recommended in advanced cases of keratoconus.

Out of all types of organ transplant surgeries (heart, lung, and kidney), corneal transplantation is the most widespread and successful of these.

We use modern ways to prepare the cut of both the donor and recipient cornea including using femtosecond laser.

There are various methods used for corneal transplant surgery. The old method includes removing the full thickness of diseased cornea and fixing the healthy cornea with stitches. As for following modern methods, the diseased frontal layers (DALK) is replaced and the patient retains the posterior portion of the cornea, thereby reducing the percentage of corneal transplants complications, especially the rate and severity of the corneal graft rejection.

Future treatment for keratoconus is prevention. Molecular genetics are currently being studied and we hope to identify people who are predisposing for the condition in an attempt to discover early and apply preventive treatment.

Dacryocystorhinostomy

Blocked Tear Duct. The tear ducts start at the inner corner of the eye with two small holes in the corner of the eyelids. Each hole is known as a punctum, they lead into small tubes known as canaliculi, which in turn drains into the lacrinal sac. This lies between the corner of your eye and your nose which has a duct at the bottom, which drains into your nose, which drains nasolacrimal duct. They continue into small channels that join up and reach the lacrimal sac, which leads into the nasolacrimal duct. The tear ducts do not have much spare capacity and this is why we cry. The channels tend to become narrower with age, especially if there has been nose or sinus disease. An obstruction of the tear ducts will give you a watery eye. Syringing of the lacrimal system with a blunt cannula will determine the type and the site of the blockage. Occasionally a special radiograph is necessary. Called a dacrocystogram, which visualizes the locrimal duct at the eye following the injection of an x-ray dye into the duct.

Redefining Best Practices in an Eye Care setting

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.