Why the 3-D experience is not for everyone

[:en]2 August 2010 (Dubai, UAE): Three-dimensional (3-D) entertainment is now exploding across our cinema and television screens (and even laptop computers) transforming the viewing experience and creating a new wave of entertainment led by block buster movies such as Avatar. However, not everyone can enjoy the 3-D experience. According to the Royal College of Ophthalmology, approximately 2-3 per cent of the general population cannot perceive 3-D images because of the early onset of squint, or an eye problem that develops later in life.
The principle behind 3-D imaging is that we have binocular vision, with two eyes separated by a space of 2-3 inches, explains Dr Chris Canning, Medical Director of Moorfields Eye Hospital Dubai: “This separation causes each eye to see the world from a slightly different perspective; when combined, this single image enables us to perceive depth and distance, and to see the world and media content in ‘3-D’. If there are multiple objects in our field of view, we can tell their relative distance. If you look at the world with one eye closed, you can still perceive distance, but your accuracy decreases and you have to rely on other visual cues.”
The brain combines these two images from our eyes into one composite image. “A simple way of testing this is to look at the same object with each eye covered alternately; the image shifts very slightly from eye to eye. In a cinema, the reason we wear 3-D glasses is to feed different images into our eyes.”
The cinema screen actually displays two images, and the glasses cause each image to enter a different eye. At many 3-D venues, the preferred method is to use polarized lenses because they allow color viewing. Two synchronized projectors project two views onto the screen, each with a different polarization. The glasses allow only one of the images into each eye because of the different polarization of the glasses.
“In order to see in 3-D we must have good vision in both eyes and they must work together simultaneously,” adds Dr Canning. “However, for people who have a vision misalignment or those who have severe eye conditions, viewing in 3-D is difficult – if not impossible.”
Some of the severe vision conditions which prevent people seeing in 3-D include amblyopia (lazy eye), strabismus (crossed eye), convergence insufficiency (unable to maintain the correct alignment of the eyes for near targets) and diplopia (double vision).
For those of us lucky enough to be able to enjoy the miracle of 3-D technology, there is still a concern that watching 3-D entertainment can cause side effects, with claims that these can include headaches, dizziness, nausea and eye strain. According to Dr. Chris Canning: “3-D technology is a remarkable concept which has added depth and enjoyment to our viewing experience. Watching 3-D does not damage the eyesight; however, if any symptoms or side effects should appear and persist then it is recommended to visit an eye care professional.”
Contact: Jonathan Walsh/Vanessa Payne
WPR Limited
Dubai
050 4588610
jon@wprme.com

Moorfields Eye Hospital Dubai offers free eye consultations to TECOM staff and partners, in support of Dubai Healthcare City’s health check campaign

[:en]14 September 2010 (Dubai, UAE): Moorfields Eye Hospital Dubai (Moorfields), the Dubai branch of the world renowned London hospital for eye treatment, teaching and research, is offering free eye consultations in support of the health check campaign by Dubai Healthcare City.
Dubai Healthcare City’s Health Check program 2010 will offer free lunchtime consultations with doctors covering a range of health-related matters in different TECOM Business Parks, for a total of eight weeks. The consultations will be by appointment on a first response basis.
Moorfields has committed to providing free eye care checks through the full day on Wednesday 15th September 2010, from 0900-16.30pm, at Dubai Knowledge Village (Block 2A. room 4). Dr Imran Ansari, General Ophthalmologist at Moorfields Eye Hospital Dubai, will be conducting the eye checks. All appointments for the day have been booked.
Executive Director of Dubai Healthcare City, Dr. Ayesha Abdullah said: “Dubai Healthcare City is committed to health prevention not just treatment. This is a commitment I know our healthcare partners share and I am delighted that Moorfields Eye Hospital Dubai is supporting our initiative today to increase public engagement on health by offering free eye consultations. Every week, for the next eight weeks we will be working with DHCC clinics and hospitals to provide free expert advice and care to the community. We want people to put their health first and are delighted to be launching this initiative with one of the world’s oldest and most admired eye hospitals.”
Dr Chris Canning, Medical Director at Moorfields Eye Hospital Dubai, added: “Moorfields welcomes this initiative by Dubai Healthcare City for the benefit of staff and partners at TECOM. Education and screening are prime objectives of ours and this programme delivers both. Healthcare should be as much about screening and prevention as well as treatment; and a regular health check up – including an eye check – is a vital habit to instil in the community.”
Contact: Jonathan Walsh/Vanessa Payne
WPR Limited
Dubai
050 4588610
jon@wprme.com

Moorfields Eye Hospital Dubai unlocks the secrets to younger eyes this summer

[:en]2 June 2013 (Dubai, United Arab Emirates): Beauty is in the eye of the beholder and when it comes to anti-aging, cosmetic facial surgery around the eyes (‘periorbital rejuvenation’ as it is known to the experts) is the most common procedure. But results can be erratic with low patient satisfaction.  The best results are achieved when patients are operated on by Oculoplastic Surgeons who regularly operate on the eyelid and periorbital region, say the Consultant Oculoplastic Surgeons at Moorfields Eye Hospital Dubai, the first overseas branch of the world renowned Moorfields Eye Hospital in London.
The most common procedure in facial cosmetic surgery is performed on the upper and lower eyelids – ‘blepharoplasty’. Around 250,000 procedures are performed every year around the world. However, whilst it is a common procedure, the results can vary significantly from patient expectations.   “Traditional Blepharoplasty has an enormous potential for disaster,” says Dr Andrea Sciscio, Consultant Oculoplastic Surgeon at Moorfields Eye Hospital Dubai. “There is no perfect aesthetic procedure and it is very much a case of understanding each patient’s exact problem and address it accordingly.”
Blepharoplasty has evolved enormously since it was first developed 70 years ago.  Over the decades, the techniques have developed to yield the best aesthetic outcome for each patient individually. The eyelids have to be evaluated in the context of the eyebrow and the mid-face appearance – its overall ‘height’ and structure, adds Dr Qasiem Nasser, Consultant Oculoplastic Surgeon at Moorfields Eye Hospital Dubai: “An analysis of the soft tissues from the eyebrows to the mid-face, and from the surface to the deeper structures up to the orbital rim (eye socket and surrounding structure), allows the surgeon to establish the aging changes that have occurred with the patient and helps direct the blepharoplasty surgery to deliver the optimal aesthetic outcome.”

From June-August 2013, Moorfields Eye Hospital Dubai is offering a special summer rate on consultations for aesthetic eye surgery.

Moorfields Eye Hospital Dubai supports Dubai Healthcare City’s ‘World Diabetes Day campaign’, a public health screening event offering more than 10 tests for children and adults

[:en]Vision experts will provide complimentary consultations to explain some of the most common and serious complications of diabetes
12 November 2014 (Dubai, United Arab Emirates): To mark World Diabetes Day 2014, Moorfields Eye Hospital Dubai will support Dubai Healthcare City’s public health screening campaign aimed to educate the community about diabetes through consultations and health checks.
The event, organized by DHCC, the world’s largest healthcare free zone, will take place on Thursday, November 13, 4pm-8pm, at The Executive Towers, Business Bay, Dubai. A team from the hospital will provide residents seeking consultations with medical history review, intra-ocular pressure tests, visual acuity checks, and retinal imaging. The vision tests will use state-of-the-art technology.
Retinal diseases, such as diabetic retinopathy, are some of the most common complications caused by diabetes and can lead to permanent loss of vision if not treated. To help the UAE’s large population of people with diabetes manage the disease, Moorfields has established a specialist team of three retinal consultant surgeons and ophthalmologists in Dubai focusing on medical retinal diseases, such as diabetes. Dr. Avinash Gurbaxani, Consultant Ophthalmic Surgeon at Moorfields Eye Hospital Dubai, comments: “Vision-related problems are some of the most common and serious complications of diabetes. Of course, the single most effective treatment for diabetic eye disease is prevention – good control of diabetes and any associated high blood pressure can delay or avoid significant eye problems. Prevention of diabetic eye disease starts with regular eye examinations which can so often provide an indicator of the diabetes or blood pressure control. Regular screening should begin from an early age, regardless of whether there are vision symptoms or not.”
Diabetic retinopathy
Every cell in the eye (and, indeed, the body) is affected by the biochemical changes of diabetes. In practice, however, retinopathy is a disease of blood vessels – sometimes they wither away, sometimes they leak fluids when they shouldn’t and sometimes they grow where they do not belong. The blood vessels in the retina are uniquely prone to going wrong in this way, although the same changes can be found elsewhere in the body.
Treating diabetic retinopathy
According to Dr Edoardo Zinicola, Consultant Vitreoretinal Surgeon and Medical Retina Specialist at Moorfields Eye Hospital Dubai, once retinopathy is present, direct eye treatment may be needed and the type of treatment depends on the problem. “There is no effective treatment for the parts of the retina where blood vessels have disappeared,” he comments. “Laser photocoagulation remains the first line of treatment for both new and leaking vessels. Injections of steroids and medicines known as VEGF blocking agents also have a role and where the eye disease is advanced then surgery can help.”
Prevention tips for patients at risk of diabetic retinopathy

  • Control the diabetes as well as you can
  • Control high blood pressure
  • Do not smoke
  • Get regular eye checks
  • Take charge of your own health

The Moorfields Eye Hospital Dubai specialist team of retinal consultant surgeons and ophthalmologists comprises: Dr Avinash Gurbaxani; Dr Edoardo Zinicola; Dr Jana Sheqem.

Dr. Muralidharan Upendran

[:en]MBBS, MS (Ophth), MRCOphth, FRCOphth
Consultant Ophthalmologist
Vitreo-Retinal Surgeon
GCAA Approved Specialist Medical Examiner]Dr. Muralidharan Upendran is a Consultant Ophthalmologist with sub-specialist training in Vitreo-Retinal surgery. He specialises in the surgical management of retinal disorders including retinal detachment, macular disease, diabetic retinopathy and ocular trauma. He also specializes in the medical management of retinal vascular disease and macular disorders. He is also an experienced cataract surgeon and can manage complex cataract surgery.
Dr. Upendran obtained his medical degree and a basic ophthalmology degree in India. He then moved to the UK where he received further higher specialty training in Ophthalmology in Belfast before becoming a Fellow of the Royal College of Ophthalmologists, London. He received his initial Vitreo-Retinal surgical training at the Royal Victoria Hospital in Belfast. He then received his fellowship training in Vitreo-Retinal surgery at the Birmingham & Midland Eye Centre, UK. He has recently worked as a Consultant Ophthalmologist with a special interest in retinal disease at the Royal Victoria Hospital and Macular Service in Belfast.
Dr. Upendran has an interest in research and teaching. He has a portfolio of published research and has delivered scientific presentations to his peers. He has been involved in teaching programs for medical students. He is a fellow of the Royal College of Ophthalmologists London and a Life member of the All India Ophthalmological Society.
Click here to read more on Common Eye Conditions.
Return to Ophthalmologisits Homepage[:ar]بكالوريوس في الطب والجراحة، ماجستير في
طب العيون
عضو الكلية الملكية لأطباء العيون، زميل الكلية
الملكية لأطباء العيون
استشاري طب العيون
أخصائي في جراحة الشبكية والجسم الزجاجي
أخصائي فحص عيون معتمد من الهيئة العامة للطيران المدني]

لدكتور مواليداران أوبندران استشاري في طب العيون باختصاص فرعي في مجال جراحة الشبكية والجسم الزجاجي. ويختص الدكتور أوبندران في الإدارة الجراحية لاضطرابات الشبكية بما في ذلك انفصال الشبكية ومرض الضمور البقعي واعتلال الشبكية الناجم عن مشاكل السكري وإصابات العين. كما يتخصص في علاج وإدارة أمراض الأوعية الدموية بالشبكية واضطرابات الضمور البقعي، وله خبرة واسعة في جراحة إعتام عدسة العين ومؤهل لتنفيذ الجراحات المعقدة في هذا المجال.درس الدكتور أوبندران الطب والاختصاص الأساسي في طب العيون في الهند، وانتقل بعدها إلى المملكة المتحدة حيث تلقى تدريباً متخصصاً في طب العيون في بيلفاست، قبل أن يحصل على زمالة الكلية الملكية لأطباء العيون في لندن. وفيما بدأ تدريبه الأولي في مجال جراحة الشبكية والجسم الزجاجي في مستشفى رويال فيكتوريا في بيلفاست، فقد واصل رحلته في هذا المجال وحصل على تدريب الزمالة في جراحة الشبكية والجسم الزجاجي من مركز بيرمنغهام وميدلاند للعيون بالمملكة المتحدة. عمل الدكتور أوبندران مؤخراً ك أخصائي في طب العيون مع التركيز على أمراض الشبكية لدى مستشفى رويال فيكتوريا وقسم أمراض الضمور البقعي في بيلفاست.
تشمل اهتمامات الدكتور أوبندران أيضاً مجالات الأبحاث والتدريس، ونشرت له مجموعة من الأبحاث كما قدم العديد من الأوراق العلمية في مؤتمرات متخصصة وشارك في برامج تعليمية موجهة لطلاب كليات الطب، يذكر أن (AIOS) الدكتورأوبندران زميل الكلية الملكية لأطباء العيون في لندن وعضو مدى الحياة في جمعية طب العيون لعموم الهند.
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العودة إلى صفحة أطباء العيون

[:]

Dr. Osama Giledi

[:en]]MBBch, FRCSEd
Consultant Ophthalmologist
Specialist in Cataract, Cornea and Refractive Vision Correction Surgery
GCAA Approved Specialist Aeromedical Medical Examiner
Associate Professor of Ophthalmology (Adjunct) Dr Osama Giledi is a highly experienced consultant ophthalmologist who specialises in Cornea, Anterior Segment, Cataract and Refractive Surgery. He is also skilled in managing ocular surface problems including severe dry eye and Stem cell deficiency.  He performs small incision phacoemulsification for his cataract surgery and is experienced in using toric and multifocal premium intraocular lenses. Dr Giledi expertise in managing complex corneal conditions includes all types of modern corneal graft procedures, such as DALK and DSAEK. He has performed more than 23,000 refractive surgeries including Lasik, LASEK, Intralase LASIK and Trans PRK, as well as phakic IOLs. He delivers the latest treatment for keratoconus including Intracorneal ring segments, corneal cross-linking and complex laser treatment.
Dr Giledi graduated from Libya and completed his ophthalmic training in the UK, attaining a Fellowship in Ophthalmology from The Royal College of Edinburgh in 1996. He completed 2 years of higher subspecialty training fellowship on the anterior segment, Cornea and refractive surgery on 2003 at the prestigeous Corneoplastic Unit and Eye Bank at Queen Victoria Hospital, East Grinstead. He worked as a Consultant Ophthalmologist at the Centre for Sight London and also at the Corneoplastic Unit and Eye Bank at Queen Victoria Hospital.  Dr Giledi relocated to Dubai on 2013 after 22 years’ experience in the UK, providing anterior segment, Cornea, Refractive and cataract surgery services.
In addition to his clinical commitments, Dr. Giledi has extensive experience in teaching and training, he is a noted presenter at national and international meetings, and he has an extensive body of research published in peer-reviewed scientific journals. He is a member of the Royal College Surgeons of Edinburgh, the United Kingdom & Ireland Society of Cataract and Refractive Surgeons, and the European Society of Cataract and Refractive Surgeons.
Click here to read more on Common Eye Conditions.
Return to Ophthalmologisits Homepage[:ar]بكالوريوس في الطب والجراحة
زميل الكلية الملكية البريطانية للجراحين
استشاري طب العيون
أخصائي جراحة الكتاراكت والقرنية وتصحيح البصر
أخصائي فحص عيون معتمد من الهيئة العامة للطيران المدني
استاذ مشارك في طب العيون (ملحق)الدكتور أسامة الجليدي هو استشاري في طب العيون ويملك خبرة واسعة في مجالات جراحة القرنية والجزء الأمامي من العين وعلاج إعتام عدسة العين وجراحة تصحيح البصر. وهو أيضاً خبير في علاج مشاكل سطح العين، بما في ذلك جفاف العين الشديد ونقص الخلايا الجذعية. وتشمل خبرته إزالة إعتام عدسة العين بتقنية استحلاب عدسة العين أو phacoemulsification” “، بالإضافة استخدام العدسات المحدبة والعدسات الفائقة متعددة البؤر. يملك الدكتور الجليدي خبرة واسعة في تشخيص وعلاج مشاكل القرنية المعقدة، بما في ذلك إجراء عمليات زراعة القرنية الحديثة مثل زراعة القرنية الأمامية العميقة (DALK) و الزراعة الداخلية لخلايا القرنية (DSAEK). أجرى ما يزيد على 23,000 جراحة لتصحيح البصر بما في ذلك عمليات التصحيح بالليزر LASIK وLASEK وIntraLase LASIK وTrans PRK، إلى جانب زراعة عدسات العين (Phakic IOLs). ينفذ د. الجليدي أيضًا أحدث الأساليب لعلاج القرنية المخروطية، بما في ذلك الحلقات القرنية وتصليب القرنية والعلاج المعقد بالليزر.
تخرج الدكتور الجليدي في ليبيا وأنهى تخصصه في طب العيون في المملكة المتحدة، حيث حاز على زمالة طب العيون من الكلية الملكية بإدنبره سنة 1996. وفي عام 2003 أنهى عامين من متطلبات تدريب الزمالة في تخصص فرعي لجراحة الجزء الأمامي للعين والقرنية وجراحة تصحيح البصر، وذلك في وحدة الجراحة التجميلية للقرنية وبنك العيون في مستشفى الملكة فيكتوريا في إيست غرينستيد. شغل منصب استشاري طب العيون في مركز البصر بلندن وكذلك في في وحدة الجراحة التجميلية للقرنية وبنك العيون في مستشفى الملكة فيكتوريا. وانتقل الدكتور الجليدي إلى دبي في عام 2013 بعد خبرة 22 عامًا في المملكة المتحدة، ويجري حاليًا جراحات الجزء الأمامي للعين والقرنية وتصحيح البصر وإعتام عدسة العين.
وبالإضافة إلى مجال اختصاصه، يتمتع الدكتور أسامة الجليدي بخبرة واسعة في مجال التدريس والتدريب، كما يشارك كمتحدث في العديد من اللقاءات المحلية والدولية وله أبحاث ومؤلفات في مجلات طبية مرموقة. وهو عضو في الكلية الملكية للجراحين في إدنبرة، وفي جمعية المملكة المتحدة وإيرلندا لجراحي إعتام عدسة العين وتصحيح البصر، وفي الجمعية الأوروبية لجراحي إعتام عدسة العين وتصحيح البصر.
انقر  هنا لقراءة المزيد عن حالات العين الشائعة
العودة إلى صفحة أطباء العيون[:]

Cyclodiode Laser Treatment

The diode laser is a highly concentrated beam of light, which can be used to target and treat a selected area. Sometimes, laser treatment is recommended in order to avoid or delay the need for more invasive surgery. The diode laser is used to produce very small burns in the ciliary body, which produces the watery fluid called aqueous humour, and is situated behind the iris (coloured part of your eye). The reduced production of aqueous humour causes the eye pressure to fall.

Vitrectomy Surgery

A vitrectomy surgery is microsurgery performed to remove the jelly and replace it by a saline solution, gas or a special type of silicone oil. The most common reasons for operating on the retina are retinal detachment, diabetes and scarring on the retina.
For more information about vitrectomy surgery in Dubai, contact us today.

Trabeculectomy

The operation to control the pressure within your eye is called a Trabeculectomy (trab-ec-u-lec-tomy). A Trabeculectomy operationis recommended for patients whose glaucoma continues to progress despite using eye drops and/or having laser treatment.The goal of the Trabeculectomy surgery is to help lower and control the eye pressure. The eye pressure is known as intraocular pressure. If this remains high, then further irreversible loss of vision from glaucoma may occur. This operation will not improve your vision or cure glaucoma, but aims to prevent or slow down further visual loss from glaucoma damage.

Squint Surgery In Children

This information aims to answer some of the questions you may have about squint surgery. The information 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 are the aims 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 or to protect or restore binocular vision.
  • Occasionally to improve head posture.

What happens 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?

Squint surgery is nearly always a day case procedure. Squint surgery is a common eye operation. It involves weakening or strengthening or altering the action of one or more of the extraocular muscles which move the eye. The muscles may be recessed (to weaken), resected (to strengthen), their insertions moved (to alter their action) or less commonly altered in some other way (advanced, plicated, tucked, belly sutured permanently to the globe etc).
The muscles are sutured into their new positions. The operation is carried out under general anaesthetic. The operation usually takes up to 60 minutes depending on the number of muscles that need surgery. Parents can go down to the operating theatre with your child and stay until he/she is asleep but cannot come in to watch the surgery. Remember to discuss which eye(s) is/are being operated on and why.

What are the success rates?

Overall about 90% patients/parents perceive some improvement in the squint after surgery. However, there is some unpredictability in the procedure, so that the squint may not be completely corrected by the operation. Many patients require more than one operation in their lifetime. If the squint returns it may be in the same or in the opposite direction and may occur at any time. The operation does not change visual acuity or refractive error. More patching may be needed after the operation.

Does the surgery cure the need for glasses or a lazy eye?

No, the operation does not aim to change the vision or need for glasses.

What are the risks of the operation?

Parents can be informed that 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

The original squint may still be present (undercorrection) or the squint direction may change over (overcorrection). Occasionally a different type of squint may occur. Some patients may require another operation.

  • Double vision

Double vision after surgery is normal and often settles in days or weeks. Some patients may continue to experience double vision on side gaze. Permanent primary position diplopia is very rare in children.

  • Allergy/stitches

Mild allergy to postop drops: itching/irritation/ redness/puffiness of the eyelids. It usually settles quickly when the drops are stopped. Infection or abscess around the stitches. Cyst or granuloma related to the wound or sutures: occasionally needs further surgery.

  • Redness

Can take up to 3 months to resolve, occasionally the eye remains discoloured (red, yellowish) permanently, particularly with repeated operations.

  • Scarring

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

  • Lost or slipped muscle

Muscle may slip back from new position during the operation or shortly after, limiting eye movements. May require further surgery and not always possible to correct. The risk of slipped muscle requiring further surgery is about 1 in 1,000.

  • Scleral perforation

If suture passed too deep or thin sclera: may require antibiotic treatment and laser/cryo treatment. Can affect sight (via endophthalmitis, vitreous haemorrhage, retinal detachment). Risk is up to 2%.

  • 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 in the eye (endophthalmitis, orbital cellulitis).

  • Loss of Vision

Very rare, loss of vision in the eye being operated can occur. Risk of serious damage to the eye or vision is approximately 1 in 30,000.

  • Anterior segment ischaemia

The blood circulation to the front of the eye can 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.

  • Anaesthetic risks

Unpredictable reactions occur in around 1 in 20,000 cases and death in around 1 in 100,000.

What will it be like after the operation?

Eye(s) will be swollen, red and sore and the vision may be blurry. Start the drops that evening, and painkillers suitable for age of the child, such as paracetamol and ibuprofen suspension, can be taken. The pain usually wears off within a few days. The redness and mild discomfort can last for up to 3 months particularly with repeat squint operations.

Care after the operation

  • Use the eye drops as directed
  • Attend your follow up appointment(s) to ensure the eye is healing well
  • Use cooled boiled water and a clean tissue or cotton wool to clean any stickiness from the eyes
  • Don’t rub the eye(s)
  • No swimming for 4 weeks
  • Continue using glasses if have them
  • Your child will need a few days to one week off nursery or school.

Squint Surgery in Adults

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

Selective Laser Trabeculoplasty

Selective Laser Trabeculoplasty (SLT) is a procedure used to reduce the pressure in the eye (also known as intra-ocular pressure). A laser beam is applied to the drainage channels, which helps to unclog them. This means the aqeous humour flows through the channels better, reducing the pressure in the eye. This is not a permanent treatment, and may need to be repeated in the future to control the eye pressures adequately. The procedure does not require admission to hospital and is carried out in the outpatients department.