Neuro Ophthalmology

About

Neuro-ophthalmology is a subspecialty of both neurology and ophthalmology. Neuro ophthalmologists specialise in vision problems that relate to the nervous system.

Such issues include vision problems due to brain injuries or diseases, such as trauma, a stroke, or infection and defects in the visual fields, involuntary spasms of the face and eyelids.  Sometimes, these issues might not be a serious cause for concern, but other times, they can lead to more serious complications, such as vision loss.

Treatment

Most neuro-ophthalmologic disorders require the interaction of the neuro-ophthalmologist with other physicians, particularly general neurologists, neurosurgeons and radiologists.

We provide treatment for the below conditions:

  • Blepharospasm and other involuntary facial movements
  • Double vision
  • Eyelid abnormalities
  • Myasthenia gravis
  • Nystagmus
  • Optic nerve disorders, such as optic neuritis, ischemic optic neuropathy, compressive optic neuropathies, Leber optic neuropathy
  • Orbital tumours
  • Papilledema
  • Pupillary abnormalities (e.g., anisocoria)
  • Strabismus
  • Thyroid eye disease
  • Unexplained vision loss
  • Visual field defects related to stroke, brain tumours or multiple sclerosis

Progressive Myopia

About

Myopia or short-sightedness is the difficulty in seeing objects far away. This difficulty is because the light is not correctly focusing on the retina. It is a common eye condition and can progress as the child grows.

Treatment

There is currently  no cure for myopia, however Glasses or contact lenses are prescribed to aid your child’s vision and allow them to see clearly.

There is growing evidence in the medical literature to suggest that Atropine 0.01% eye drops can reduce the rate of myopia progression in children.

Atropine 0.01% treatment

Atropine 1% is currently used as a diagnostic eye drop in some clinics to dilate the pupils and relax the focusing components of the eye to aid examination.  For Myopia management a much lower concentration of Atropine (0.01%) is used which is 100 times weaker than the dose currently used in clinic.

The exact mechanism of how Atropine 0.01% works on slowing myopia progression is unknown. Many studies from different countries around the world such as the united States, India, Singapore and Australia have shown high success rates in slowing myopia progression

Are there any side effects of Atropine 0.01%?

Side effects are much less that the drops used in clinic and may include:

  • Slight irritation upon instillation
  • Mild light sensitivity
  • Dilated pupils

Important points

  • This is not a cure for myopia, but the aim of this management option is to slow the rate of progression.
  • Glasses must always be worn to improve vision
  • There is no guarantee this treatment will definitely reduce the progression of myopia
  • Atropine 0.01% eye drops must be administered every night, missing doses may affect the efficacy of the treatment

Who to contact for any queries?

Please send any enquiry to [email protected]

International Patients

International Patients

As a result of our distinguished best practice in care and treatment for patients in the region, Moorfields Eye Hospital Dubai, the first overseas branch of Moorfields Eye Hospital NHS Foundation Trust, has attracted patients from all over the world. The trust of our patients in our medical facilities, and their satisfaction in the levels of service we provide, motivates us to continue to maintain our reputation as the world leading experts in eye care.

Our 22,000 sq. ft. hospital in Dubai Health Care City was inaugurated in 2007. Our facility boasts consultation rooms, surgical theatres, pharmacy, in house optical shop and the latest diagnostic equipment to provide a comprehensive, world class level of eye care for both adults and children.

We cover all major aspects of eye care from basic screening and examination, to ocular oncology, genetic eye disease testing and counseling, through our 20+ permanent and visiting consultant eye doctors. In addition, we have access to 200+ eye doctors in Moorfields London if the need ever arises.

For enquiries and appointment booking, please complete the form at the bottom of this page.


Locations

Moorfields Eye Hospital Dubai is conveniently located in Dubai Health Care City (DHCC), only 5.4 km away from Dubai International Airport (DXB). Patients can reach us by taxi, metro or rent a car directly from the airport.

Moorfields Eye Hospital Dubai is close to several facilities, including multispecialty hospitals, several shopping malls, and luxury hotels. The hospital is also in close to proximity to several beaches, entertainment venues, outdoor and indoor venues including the Dubai Mall, the largest mall in the world.

For more information about tourism in Dubai, visit: Visit Dubai – Official Tourism Board in Dubai


Airlines

Internationally recognised for their service and accessibility from most major cities worldwide, these Dubai based airlines website can be visited here:


Hotels

Moorfields Eye Hospital Dubai is walking distance to several hotels, some of these include:


 

Moorfields Eye Hospitals UAE Medical Departments

Retina & Uveitis

Paediatrics & Squint

Cornea

Laser & Refractive Surgery

Glaucoma

Cataract

Genetic Eye Disease

Oculoplastics

Neuro Ophthalmology

Ocular Oncology

Aviation Ophthalmology

General


Comprehensive assessments:

We offer a comprehensive range of eye care assessments, diagnostics, surgical and non-surgical treatment services.

Please click here to view all services offered at Moorfields Eye Hospital Dubai.

Assessment services: (evaluation examinations may differ depending on outcome of consultation) (expandable links below)

 

Please fill the form below and our team will contact you shortly. Thank you for choosing Moorfields Eye Hospitals UAE.

    Moorfields Optics

    For over 200 years, Moorfields Eye Hospital London has been a world leading expert in eye care, offering the full range of diagnosis, management and treatment for all eye related concerns. Our branch in Dubai Healthcare City reflects the same quality of care and commitment to our patients as our parent hospital in London.

    Now, and for the first time ever, in order to provide an even more comprehensive approach to your and your children’s eye care needs, Moorfields Eye Hospital Dubai is thrilled to announce the launch of Moorfields Optics.

    Moorfields Optics offers the highest quality comprehensive range of eyewear and vision care products for both children and adults including frames, glasses and sunglasses, in our newly established modern facility, within our hospital in Dubai Healthcare City.

    You can now benefit from having both your comprehensive eye tests done and prescriptions issued by our world class team of optometrists and consultants, along with your designer eyeglasses fitted and your advanced contact lenses provided, in one convenient location, with the unparalleled service provided by your trusted world leading eye care hospital.

    Brands for kids


    Brands for adults


    Visual Electrophysiology

    When we look at something, a picture of the object is projected onto the retina at the back of our eye. The retina changes this optical picture into little electrical signals, which pass along the optic nerve to the brain, where the sense of ‘seeing’ happens. Visual electrophysiology measures these small signals created by the eye and the brain.

    Visual electrophysiology assesses how the visual system processes visual information. The tests support the diagnosis of the visual problem. They are also useful for monitoring the progression of a visual disorder or the effects of any treatment. These tests are particularly useful in young infants and children as they sometimes are unable to communicate or describe in detail any problems they might have with how they see.


    How are the tests conducted?

    Small electrical signals from the eye are recorded in response to a flashing light or a pattern on a computer screen. These signals are recorded by small contacts that are placed on the surface of the head and near the eye. The area under the eye will be gently cleaned with a gel before the contact is applied. This may be slightly uncomfortable but not painful. For some of the tests, we may need to use dilating eye drops, similar to those used in the clinic, or very occasionally, anaesthetic (numbing) drops.

    How should I prepare myself for the tests?

    The tests are noninvasive but require small contacts to be placed around or in the eyes as well as around the head. Before attending your appointment, please ensure your face and skin are free of creams, oils and makeup.


    Services offered

    Visual evoked potential (VEP):

    Recording the brain’s activity is called the visual evoked potential (VEP). To record the VEP, small contacts are placed on the patient’s head, using some paste. You will be asked to look at a moving black-and-white pattern on a TV screen and a light which will flash twice a second.

    Electroretinogram (ERG):

    The recording of the retina’s activity is performed using the electroretinogram (ERG). To record the ERG, dilating eye drops are used. In adults and older children, small contacts are placed at the side of the eye and over the lower eyelid. In babies and young children, the contacts are placed at the side of the eye and below each eyelid and are held by some tape. You will be asked to look at a light that flashes at different speeds and brightness levels.

    Pattern Electroretinogram (PERG)

    The pattern electroretinogram (PERG) records the activity of the central macula. To record the PERG, small contacts are placed at the side of the eye and over the lower eyelid. Anaesthetic (numbing) drops will be instilled before applying the contacts over the lower eyelid. You will be asked to look at a moving black-and-white pattern on a screen.

    Multi-focal Electroretinogram (mfERG)

    The multifocal electroretinogram (mfERG) test examines specific areas or focal points within the retina. Small contacts are placed at the side of the eye and over the lower eyelid, similar to the ERG and PERG. Anaesthetic (numbing) drops will be used before applying the contacts over the lower eyelid. You will be asked to look at a moving hexagonal pattern on a screen.

    Electro-oculogram (EOG)

    The electrooculogram (EOG) test specifically measures the function of the retinal pigment epithelium layer (RPE). This very important layer nourishes and supports the normal functioning of the retina. Small contacts are placed around the side of the eyes, and you will be asked to follow a moving light from side to side. Dilating drops will be used, and the test is performed in the dark and the light.

    Adult Squint (Strabismus)

    About

    Adult squint is a misalignment of both eyes and effects about 4% of the adult population

    The squint may be present all or only part of the time, in only one eye or alternating between the two eyes.

    Adult squints are of three main types: non-paralytic, paralytic and restrictive.

    • Non-paralytic squints: They are usually a longstanding from childhood. The most common pattern is that an eye that was straight after childhood squint surgery later drifts out and causes concern over its appearance.
    • Paralytic squint: The eye does not move normally because one or more eye muscles are weak or paralysed. This problem may have developed as a result of other health problems, such as damage to cranial nerves, following head injury or as a complication of diabetes or stroke. Such people will, most likely, suffer from troublesome double vision.
    • Restrictive squint:  One or both eyes do not move fully because of scarring or tethering of one or more muscles.

    Symptoms

    Symptoms of adult squint problems include fatigue, double vision, difficulty with near vision and loss of stereo vision. To compensate for this, some individuals will adopt an abnormal head position. Many adults with squint are concerned about the appearance of their eyes and the impact this has on social relationships and work

    This information aims to answer some of the questions you may have about squint surgery. However, it does not cover everything as every patient and squint is different. Your surgeon will discuss your particular case with you. Please ask the clinical staff about anything you want to be made clear.

    What is the aim of surgery?

    • To improve the alignment of the eyes, to make the squint smaller in size.
    • In some patients, to reduce or try to eliminate double vision.
    • Occasionally to improve an abnormal position of the head.

    How is the surgery done?

    Squint surgery is a very common eye operation. It usually involves tightening or moving one or more of the outside eye muscles which move the eye. These muscles are attached quite close to the front of the eye under the conjunctiva, the clear surface layer. The eye is never taken out of the socket during surgery. Stitches are used to attach the muscles in their new positions.
    Squint surgery is nearly always a day case procedure so you should be in and out of hospital on the same day.
    There are two kinds of squint operation – adjustable and non-adjustable:


    Non adjustable surgery

    The operation is usually carried out under general anaesthetic. The operation usually takes up to 60 minutes depending on the number of muscles that need surgery. When you have recovered from the anaesthetic and the nurses are happy for you to be discharged, you are free to go home – usually a few hours later.


    Adjustable surgery

    Squint surgery using an adjustable suture may give a better result in certain types of squint e.g. patients who have had a squint operation before, patients with a squint due to injury or patients with thyroid eye problems.

    Part 1 – The main operation

    The main part of the operation is carried out in the operating theatre usually under general anaesthetic (with you asleep).

    Part 2 – Adjusting the stitch

    Once you have woken up from the anesthetic the final position of the muscles is adjusted when you are awake and able to look at a target. This is particularly useful for treating double vision. If you wear glasses for distance or near, these will need to be brought in with you for this part of the operation. Adjustment is usually done on the ward, after drops of anaesthetic have been put into the eye to take away any pain. You may however feel a pressure sensation.

    Before the day of surgery

    A pre-assessment is performed in the weeks leading up to the operation date.


    What happens on the day of surgery?

    You will be asked to come early so that you can be prepared for surgery. You should not drink or eat before the operation: the exact timings of this will be given before the day of the operation. Before being discharged after the operation, you will receive eye drops with instructions and a follow up appointment.


    Does the surgery cure the squint?

    Overall about 90% patients feel some improvement in their squint after surgery. The amount of correction that is right for one patient may be too much or too little for another with exactly the same size squint, so that the squint may not be completely corrected by the operation. Although the eyes may be straight just after surgery, many patients require more than one operation in their lifetime. If the squint returns it may drift in either the same or opposite direction. We can’t predict when that drift may occur.


    What are the risks of the operation?

    Squint surgery is generally a safe procedure. However, as with any operation, complications can and do occur. Generally these are relatively minor but on rare occasions they may be serious.

    Under and overcorrection

    As the results of squint surgery are not completely predictable, the original squint may still be present (undercorrection) or the squint direction may change over (overcorrection). Occasionally a different type of squint may occur. These problems may require another operation.

    Double vision

    You may experience double vision after surgery, as your brain adjusts to the new position of the eyes. This is common and often settles in days or weeks but may take months to improve. Some patients may continue to experience double vision when they look to the side in order to achieve a good effect when the eyes look straight ahead. Rarely, double vision whilst looking straight ahead can be permanent in which case further treatment might be needed. If you already experience double vision, you might experience a different type of double vision after surgery. Botulinum toxin injections are sometimes performed before surgery to assess your risk of this.

    Allergy/stitches

    Some patients may have a mild allergic reaction to the medication they have been prescribed after surgery. This results in itching/irritation and some redness and puffiness of the eyelids. It usually settles very quickly when the drops are stopped. You may develop an infection or abscess around the stitches. This is more likely to occur if you go swimming within the first four weeks after surgery. A cyst can develop over the site of the stitches, which occasionally needs further surgery to remove it.

    Redness

    The redness in the eye can take as long as 3 months to go away. Occasionally the eye does not completely return to its normal colour, particularly with repeated operations.

    Scarring

    Most of the scarring of the conjunctiva (skin of the eye) is not noticeable by three months, but occasionally visible scars will remain, especially with repeat operations.

    Lost or slipped muscle

    Rarely one of the eye muscles may slip back from its new position during the operation or shortly afterwards. If this occurs, the eye is less able to move around and, if severe, further surgery can be required. Sometimes it is not possible to correct this. The risk of slipped muscle requiring further surgery is about 1 in 1,000.

    Needle penetration

    If the stitches are too deep or the white of the eye is thin, a small hole in the eye may occur, which may require antibiotic treatment and possibly some laser treatment to seal the puncture site. Depending on the location of the hole, the sight may be affected. The risk of the needle passing too deeply is about 2%.

    Anterior segment ischaemia

    The blood circulation to the front of the eye can very rarely be reduced following surgery, producing a dilated pupil and blurred vision. This usually only occurs in patients who have had multiple surgeries. The risk is about 1 in 13,000 cases.

    Infection

    Infection is a rare complication but the risk  increases if drops are not instilled as directed and treatment not sought promptly. Significant infection is extremely rare but in the worst cases can cause loss of vision or the eye (endophthalmitis, orbital cellulitis).

    Loss of vision

    Although very rare, loss of vision in the eye being operated can occur from this surgery. Risk of serious damage to the eye or vision is approximately 1 in 30,000.

    Anaesthetic risks

    Anaesthetics are usually safe but there are small and potentially serious risks. Unpredictable reactions occur in around 1 in 20,000 cases and unfortunately death in around 1 in 100,000.
    Remember: these complications are detailed for your information and that the vast majority of people have no significant problems. After the operation the eye(s) will be swollen, red and sore and the vision may be blurry. The eye may be quite painful.
    Start the drops you have been prescribed that evening, and painkillers such as paracetamol and ibuprofen can be taken. The pain usually wears off within a few days. The redness and discomfort can last for up to 3 months particularly with adjustable and repeat squint operations.
    You should not sign any legal documents or drive for 48 hours after the general anaesthetic.
    We would advise that you may need one or occasionally two weeks off work. Work and normal activities including sport can be resumed as soon as you feel comfortable to do so. It is quite safe to use the eyes for visual tasks, for example reading, watching television. You should return for follow up as advised.


    Summary of care after the operation

    • Use the eye drops
    • Use painkillers such as paracetamol and ibuprofen if the eyes are painful
    • Use cooled boiled water and a clean tissue or cotton wool to clean any stickiness of the eyes and avoid water entering the eyes from the bath or shower for the first two weeks
    • Don’t rub the eye(s) as this may loosen the stitches
    • No swimming for 4 weeks
    • Attend the postop clinic appointment
    • Continue using glasses if you have them
    • Avoid contact lens wear in the operated eye(s) until advised it is safe by the doctor or orthoptist

    Wasfati – Online Medication Delivery – Abu Dhabi

    About

    “Wasfati” is a new online medication and prescription delivery service in Abu Dhabi, launched by our sister facilities Danat Al Emarat and HealthPlus Pharmacies. With “Wasfati”, we will deliver your medications to your doorstep!

    To avail this service, upload a copy of your prescription and complete the electronic form by visiting: www.wasfati.ae/

    Moorfields Dubai Pharmacy

    About

    For the convenience of our patients, and to better meet their needs, Moorfields Eye Hospital Dubai has an in-house pharmacy within the hospital premises, open 6 days a week during normal hospital hours, and licensed by the Ministry of Health.

    From lubricating eye drops to formulating specialty medications in a highly sterile, temperature controlled environment, our team of expert pharmacists are highly qualified and available to happily assist our patients with their customised eye care related medication needs.

    Uveitis

    About

    Uveitis is not a single disease but a clinical spectrum of symptoms and signs caused by a variety of medical conditions. Although it accounts for about 1% of all eye diseases, Uveitis is the cause of 10-15% of blindness and so it must be managed very carefully. Prompt and appropriate treatment is needed to ensure good visual recovery, which is very often achievable.  In most cases, a uveitis specialist – an eye doctor with specialist training in diagnosing and managing these diseases, should manage uveitis.


    Causes

    The cause of uveitis can be infection (like TB, Toxoplasmosis or viruses like herpes and CMV) or autoimmune conditions ( sarcoidosis, arthritis, inflammatory bowel disease etc). In about half the cases, we may never find a specific cause but prompt treatment is always needed.


    Symptoms 

    Symptoms can include red eye, light sensitivity, loss of reduction of vision, glare, floaters and pain. 


    Treatment 

    Uveitis can be in the anterior segment (front part of the eye), which usually can be treated with drops and sometimes injections to get a quick response. When uveitis affects the back of the eye, more aggressive treatment may be needed. This usually consists of a high dose of oral steroid medications for several weeks. Antibiotics are given in case of infection. Long-term treatment or more serious cases may need steroid sparing immune suppressant medication. This scan be in the form of tablets like mycophenolate or methotrexate or newer biologic medications, which are given in the form of injections. Steroid injections in to the eye may be needed as well. Although protracted, early, aggressive and appropriate treatment can achieve good control of this condition and patients can maintain good vision.


    Examination

     Clinical examination by a uveitis specialist who will then determine what further testing is needed to establish a cause. About 50% of time, a cause can be identified but all cases require treatment. 


    Investigation 

    Initially, patients will often need to have a variety of blood tests to look for infection or auto immune conditions, chest X-rays and other imaging. In the eye clinic patients may need an OCT scan of the retina and a fluorescein angiogram to look for leakage from the blood vessels in the retina. Patients may also be referred to other specialists like rheumatologists, gastroenterologists or neurologist to help diagnose a systemic cause of the uveitis.

    Retinal Vein Occlusion

    About

    Blocking of the retinal vein which reduces the vision is known as Retinal Vein Occlusion. This results in the accumulation of blood (retinal hemorrhages) and fluid (macular edema) in the retina and leads to a drop in the visual acuity (clarity of vision).

    There are two types of Retinal Vein Occlusion:

    • Central Retinal Vein Occlusion (CRVO)
    • Branch Retinal Vein Occlusion (BRVO)

    Causes 

    A blockage forms in the vein, usually due to a blood clot, and obstructs the blood flow.  The exact cause is unknown, but several conditions make the condition more likely. These include:

    • High blood pressure
    • High cholesterol
    • Glaucoma
    • Diabetes
    • Smoking
    • Certain rare blood disorders

    Symptoms

    Retinal vein occlusion sometimes may not have any symptoms. However, some symptoms to observe are:

    • Blurry or missing vision in part or all of an eye
    • Dark spots or lines floating the vision
    • Pain and pressure in the eye

    Diagnosis 

    Retinal Vein Occlusion is diagnosed clinically with a dilated eye examination. Additional imaging such as fluorescein angiography and ocular coherence tomography (OCT) may be needed to confirm the diagnosis and monitor the progression of the disease.


    Treatment

    Treatment of Retinal Vein Occlusion includes:

    Ocular treatment:

    • Observation if only a small vein is involved and does not affect the macula (central part of the vision).
    • Intravitreal injections of either anti-vascular endothelial growth factor (anti-VEGF) agents or steroid injection to treat the macular edema.
    • Laser photocoagulation may be administered to the peripheral ischemic retina.

    Systemic treatment:

    • Management of systemic factors (close control of blood pressure and blood sugar levels).