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In this section, we have leaflets for the Ophthalmology department. Please only read the materials on the advice of your clinician.

The leaflets are in two PDF versions:

  • Booklet - for printing (double-sided, flip on short edge)
  • Handout - for viewing online or downloading

The Recite Me accessibility tools can be used if you need assistance.

 

 

Advice to parents of children having dilating drops

When your child comes to the eye clinic, it is usually necessary to look at the back of their eyes and to check whether they have a refractive error (long or short sightedness).

To do this, we will need to put some dilating drops into their eyes, which will make the pupil (black part of the eye) bigger. This does not hurt your child but may sting a bit as the drops go in. He / she will need to stay still while we do this. The nurses are very experienced in putting eye drops in children’s eyes and we have different ways of doing this using toys, bubbles etc.

 

 

Avastin Intravitreal Injections

Your eye doctor has recommended treatment with an injection of a drug called Avastin (Bevacizumab) into your eye. This leaflet will help you to understand how the injection will help with your condition. A separate leaflet may be provided that gives you further information about your condition. You might want to discuss the information with a relative or carer.

 

 

Amblyopia and Patching Treatment

Your child has a condition known as Amblyopia (lazy eye) which occurs when the sight of one or both eyes is under developed causing reduced vision.

Approximately 4% of children will need to wear a patch over one eye in order to encourage better vision in their amblyopic eye. This treatment is called patching (occlusion therapy).

 

 

Atropine Eye Drops

Your child has had their vision checked by either a nurse or an orthoptist.

Now, to enable us to check the health of the inside of the eye and to test for glasses accurately, the pupil (the black spot in the centre of the eye) must be dilated (enlarged.) This will be done using eye drops.

 

 

Atropine Occlusion

Your child has been diagnosed with an eye condition called Amblyopia (reduced vision in one eye, sometimes known as a lazy eye).

Atropine eye drops may be used as an alternative to patching treatment. The main aim of Atropine occlusion is to temporarily blur the vision in the good eye (when viewing close objects) to promote the vision in the weaker eye.

 

 

Blepharitis

Blepharitis is an inflammatory condition of the eyelids. It is not sight threatening and is usually found during a routine examination of the eye. It is a common condition and usually causes mild irritation of the eyelids.

 

 

Botulinum Toxin for Adult Squint

Botulinum Toxin, is a chemical produced by the bacterium Clostridium Botulinum. It can be used to temporarily weaken a muscle within the body.

To move a muscle, your brain sends an electrical signal through your nerves to the muscle. This signal is passed between nerves and muscles by a chemical messenger called acetylcholine. When injected into a muscle, Botulinum Toxin temporarily stops the nerves close to the muscle from releasing acetylcholine and instructing the muscle to move, thereby the muscle is temporarily weakened.

 

 

Care of your eye after your injection

Today you received an injection into your eye, the purpose of this injection is to deliver medicine into the back of the eye to treat your eye condition and help protect your vision. Please let the Doctor / Nurse know if you have glaucoma. If you have glaucoma, we can check your pressures after the injection.

 

 

Cataract Information

In a young eye, the lens is usually clear. As a cataract develops, the lens becomes opaque, and it blocks light rays passing through the lens to the retina. Therefore, the vision gradually worsens.

Most people develop cataracts as they age. However, some conditions, such as diabetes, certain medications or a significant injury to the eye can contribute to earlier development of cataracts.

 

 

Convergence Insufficiency and Treatment

Convergence is the ability to turn both eyes inwards smoothly towards the nose when looking at a near object.

Good convergence is important for comfortable binocular vision (vision with both eyes) for any close work, including reading.

 

 

Corneal Cross-Linking (CXL)

Corneal cross-linking (CXL) is a treatment for patients with keratoconus which can prevent their condition getting worse. It is successful in more than 90% of cases. After treatment, you will still need to wear spectacles or contact lenses. Your eye will be sore for about one week after the procedure. Although vision is often hazy at first, most patients can resume contact lens wear and return to work after one week. As with all operations, there are risks: CXL is safe, but there is a small chance (about 1:30) of worse vision afterwards.

 

 

Corneal Transplantation: Deep Anterior Lamellar Keratoplasty (DALK)

The cornea has three layers (thin outer and inner layers and a thick middle layer). In some diseases, only the middle layer or part of the middle layer is affected. The treatment of choice is Deep Anterior Lamellar Keratoplasty (DALK).

DALK is a technique whereby the outer two layers of the cornea are removed and replaced with the outer two layers of a donor cornea to give a partial-thickness transplant.

 

 

Corneal Transplantation: Endothelial Keratoplasty

The cornea has three layers (thin outer and inner layers and a thick middle layer). In some diseases, only the inner layer (endothelium) is affected, causing corneal oedema (swelling) and clouding of vision.

Endothelial Keratoplasty is a technique to replace the inner layer of your cornea with the inside layer of a donor cornea through a small incision.

 

 

Cyclopentolate Eye Drops

Your child has had their vision checked by either a nurse or an orthoptist.

Now, to enable us to check the health of the inside of the eye and to test accurately for glasses, the pupil (the black spot in the centre of the eye) must be dilated (enlarged.) This will be done using eye drops.

 

 

Diabetic Retinopathy

Diabetes affects the blood vessels which supply the retina (the light sensitive layer at the back of the eye). The blood vessels grow abnormally due to high blood sugar levels.

These can then leak or bleed causing reduced vision.

 

 

Diabetic Retinopathy Surgery

When diabetes starts to affect the retina in your eye it is called diabetic retinopathy. Diabetes can damage the retina in two main ways either causing vessels to leak (leading to swelling or diabetic macular oedema) or it can close down blood vessels.

When the blood vessels start to close down in the eye because of the diabetes, this can cause new blood vessels to grow. This is the advanced type of diabetic retinopathy (proliferative diabetic retinopathy). These new blood vessels can bleed easily and can cause bleeding into the gel of your eye (vitreous haemorrhage) which can cause floaters or reduced vision.

 

 

Digital Surveillance Clinic: AMD

As a regular patient attending the AMD (Age-related Macular Degeneration) clinic, you will have noticed how busy we are. There may have been times when you have waited a long time for an appointment and then had a long wait in the clinic.

To improve your care, we now offer a more streamlined ‘Digital Surveillance Clinic’. These clinics have proved effective in other NHS hospitals and are a very efficient way of providing as many patients as possible with the best care available.

 

 

Digital Surveillance Clinic: Cornea

As a regular patient attending the cornea clinics, you will have noticed how busy we are. There may have been times when you have waited a long time for an appointment and then had a long wait in the clinic.

To improve your care, we now offer a more streamlined ‘Digital Surveillance Clinic’. These clinics have proved effective in other NHS hospitals and are a very efficient way of providing as many patients as possible with the best care available.

 

 

Digital Surveillance Clinic: Diabetic Macular Oedema

As a regular patient attending the retina clinic, you will have noticed how busy we are. There may have been times when you have waited a long time for an appointment and then had a long wait in the clinic.

To improve your care, we now offer a more streamlined ‘Digital Surveillance Clinic’. These clinics have proved effective in other NHS hospitals and are a very efficient way of providing as many patients as possible with the best care available.

 

 

Digital Surveillance Clinic: Glaucoma

As a regular patient attending the glaucoma clinic, you will have noticed how busy we are. There may have been times when you have waited a long time for an appointment and then had a long wait in the clinic.

To improve your care, we now offer a more streamlined ‘Digital Surveillance Clinic’. These clinics have proved effective in other NHS hospitals and are a very efficient way of providing as many patients as possible with the best care available.

 

 

Driving and Diplopia

Diplopia (double vision) means seeing two images of the same object at the same time.

You cannot drive with diplopia. The DVLA must be informed immediately if you have diplopia and you must stop driving. Continuing to drive with diplopia will invalidate your car insurance and you may incur a fine of up to £1000.

 

 

Dry Eye

Our eyes are covered by a film of tears. This is to keep the surface of the eye wet, preventing damage to the eye or bacteria entering the eye. Dry eye is a condition in which the eye has an insufficient tear film or poor quality tear film.

 

 

Ectropion

Ectropion is a condition where the eyelid turns outwards or “droops”. It can be caused by the muscles becoming lax, or scarring pulling the lid out of alignment, or may follow conditions such as Bells Palsy. As a result, the eye waters, because the tears cannot run into the tear duct. The eye then becomes dry and feels irritable.

 

 

Entropion

Entropion is a condition where the eyelid turns inwards. This can happen to either the top or bottom eyelid. When this happens the eye lashes can rub against the eye causing discomfort.

 

 

Epiretinal Membrane Surgery

An Epiretinal Membrane is a condition where a very thin layer of scar tissue forms on the surface of the retina, where the vision is sharpest. The part of the eye affected by the Epiretinal Membrane is called the Macula, which is made of special nerve cells and it provides our sharp central vision needed for seeing fine detail (reading and driving etc.).

When an Epiretinal Membrane forms over the Macula, it may contract and crumple up the Macula resulting in distorted and / or blurred vision.

 

 

Eye Clinic Appointments

Please bring with you any distance or reading glasses you currently use. Also bring a copy of your repeat prescription or any medications you use in their original containers.

During your consultation you may need certain tests and the administration of eye drops. Please allow up to 2 hours for your appointment.

 

 

Fluorescein Angiography and Indocyanine Green Angiography

Fluorescein Angiography is referred to as FFA (Fundus Fluorescein Angiography). It is a test to look at the fine blood vessels and circulation within the retina at the back of the eye.

Indocyanine Green Angiography is referred to as ICGA. It is a test to look at the blood vessels and circulation of the choroid which is the layer below the retina in the eye.

 

 

Gas in Eye and Posturing after Retinal Surgery

At the end of your eye operation your eye was filled with a medical gas. Gas is commonly used in vitrectomy eye operations to keep the retina in place whilst it is healing.

For the gas to have the right effect, it is necessary for you to keep your head in a certain position. You will have received instructions as to what your individually prescribed head posture is. This will depend on where in your retina the problem is. You must posture in such a way that the gas in your eye rises to cover the retinal problem. This is the only way for the retina to heal properly and for your sight to improve. The commonest postures are right side, left side, or face down.

 

 

How to instil your eye drops

Eye drops are a means of instilling medicine directly into the eye.

There are a number of conditions we do this for including glaucoma, dry eye, infections, after surgery and many others.

 

 

How to instil your eye ointment

Eye ointment is a means of instilling medicine directly into the eye. There are a number of conditions we do this for including, dry eye syndrome, infections, after surgery and many others.

 

 

Laser / Cryo Retinopexy for Retinal Tears

Your eye doctor has told you that you have a retinal tear. This leaflet will help you to understand what has happened to your eye and the treatment that we can offer. You might want to discuss the information with a relative or carer. We will ask you to sign a consent form, so it is important that you understand the information in this leaflet before you agree to go ahead with the treatment. If you have any questions, you might want to write them down to help you remember to ask one of the hospital staff.

 

 

Laser Iridotomy

Laser iridotomy is a procedure whereby a laser is used to make a small hole in the periphery of the iris (coloured part of the eye).

The eye is constantly producing an internal fluid called aqueous humour and this fluid leaves the eye through the pupil and drains away through a space called the angle. This is a ring shaped, coral reef structure around the outer limit of the iris.

 

 

Laser Treatment For Diabetic Macular Oedema (DME)

Your specialist has informed you that you have Diabetic Macular Oedema (also called Diabetic Maculopathy). Please read this information sheet and, if you have any questions, discuss this with your specialist before you have the treatment.

Diabetes can damage small blood vessels (capillaries) in your retina. Damaged blood vessels leak fluid causing swelling of the retina. If the middle part of the retina (Macula) becomes swollen, your sight may be severely damaged.

 

 

Laser Treatment for Proliferative Diabetic Retinopathy (PDR) Pan Retinal Photocoagulation (PRP)

Your specialist has informed you that you have proliferative diabetic retinopathy and recommended laser treatment. Please read this information sheet and, if you have any questions, discuss this with your specialist before you have the treatment.

 

 

Macular Hole Surgery

A macular hole is a small, circular gap which opens up at the centre of the retina. This causes blurred vision and often distorted vision where straight lines or letters look wavy or bowed. There may also be a patch of missing vision at the centre.

 

 

Obtaining Children's Glasses

Children are tested once a year for glasses at the hospital unless the eye care professional advises otherwise.

A voucher (HESP1) will be given to you if a new prescription is required when the doctor tests your child’s eyes for glasses (refraction).

The voucher is issued to children under 16, or under 18 and in fulltime education. It is worth a fixed amount of money to help towards the cost of purchasing the glasses. The amount of money is dependent on the strength and / or type of lenses needed.

 

 

Posterior Vitreous Detachment (PVD)

A PVD usually presents with flashing lights and floaters. Floaters may look like specks, hairs, tadpoles or spiders. They move as your eye moves and may appear to dart away if you try to look straight at them.

Floaters occur due to changes in the vitreous jelly (the clear jelly-like fluid that fills the eye) and are more noticeable when you are looking at a blue sky or white background.

 

 

Post-Op Cataract Instructions

Please use both Maxidex eye drops and Chlorampenicol four (4) times daily at least 5 mins between each drop, as instructed by the nurse in the clinic before discharge.

Further bottles of drops can be obtained from your GP if you run out before the end of six weeks.

 

 

Post-Operative Retinal Surgery / Laser Instructions

Use your eye drops as prescribed and continue until instructed by the ward nurse when to stop.

Further bottles of drops can be obtained from your GP if you run out before the end.

 

 

Retinal Detachment

The retina is the light sensitive film at the back of the eye and retinal detachment is a condition where the retina peels away from the inner wall of the eye. In most cases the retina detaches because a hole or a tear has formed in the retina allowing fluid to pass underneath the retina.

Most retinal detachments occur as a natural ageing process in the eye but certain people are at higher risk than others. These include people who are short sighted, those who have had cataract surgery in the past and those who have suffered a severe direct blow to the eye. Some types of retinal detachments can run in families but these are rare.

 

 

SLT Laser

Glaucoma is a degenerative disease that, if left untreated, can cause permanent damage to the optic nerve resulting in gradual vision loss and eventual blindness.

Damage to the optic nerve, due to Glaucoma, is usually caused by an elevated pressure (IOP). Clear fluid called aqueous humour, circulates through the eye providing nourishment to the tissues and helps to maintain the pressure to help retain the shape of the eye. Primary Open Angle Glaucoma (POAG) occurs when there is an increase in fluid production or a decrease in fluid drainage. Over time, as the optic nerve fibres are destroyed, peripheral (side) vision is lost.

 

 

Squint Surgery for Adults

You have an eye muscle imbalance that has resulted in one of the eyes turning in, out, up or down. The squint may be present some of the time or all of the time. It can be in one eye or alternate between the eyes.

The eye doctor has now decided that you may benefit from an operation to straighten the eyes. There are a number of reasons that surgery for a squint may be discussed. These include poor appearance of the squint (with glasses, if required), to help the eyes work better together, to treat a compensatory head posture or to alleviate double vision or eye strain. More than one operation may be needed to achieve the desired results.

 

 

Squint Surgery for Children

A squint is one of the commonest eye conditions affecting children. It means that when a child is looking at something the two eyes are not both pointing at that object. One eye can turn in, or out or less commonly up or down. The squint may be present some or all of the time. It can be in only one eye or it can alternate between the eyes.

 

 

Yag Laser Capsulotomy

The treatment is called Yag laser capsulotomy. This is a common procedure, which is carried out in the outpatient department. Laser is applied to the thickened capsule to make a small hole in the centre of the capsule for you to see through.

 

 

Your Child's Appointment in the Eye Clinic

Please allow between 2 and 3 hours for your appointment in the eye department. The reason for this amount of time is that your child may need to see the Orthoptist first, have eye drops instilled and wait for these to work before seeing the Eye Consultant.

It may be that your appointment finishes much sooner.

 

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