Sight-saving drug approved on NHS

"A sight-saving drug that could prevent thousands of people from going blind has been approved for use on the NHS across England and Wales.

The National Institute for Health and Clinical Excellence (NICE) today (August 27) issued its final guidance on Lucentis, recommending the anti-VEGF drug for the treatment of wet-AMD.

The approval follows a collaboration between NICE, the Department of Health and, the drug’s manufacturer, Novartis. The agreement involves the implementation of a Ranibizumab Reimbursement Scheme (RSS) which will provide patients with universal access to the drug.

Under the scheme the first 14 injections will be funded by the NHS, with the cost of any additional treatment being met by the Swiss-based drug manufacturer.

Having already launched an interim version of the scheme in a bid to provide immediate access for patients to the drug on the NHS, the issuing of the final guidance means it can be rolled out nationwide."

Keratoconus

"Keratoconus is a vision disorder that occurs when the normally round cornea becomes thin and irregularly cone shaped. This abnormal shape prevents the light entering the eye from being focused correctly on the retina and causes distortion/blurring of vision.

In its earliest stages, keratoconus causes slight blurring and distortion of vision and increased sensitivity to glare and light. These symptoms usually appear in the late teens or late twenties. Keratoconus may progress for 10-20 years and then slow in its progression. Each eye may be affected differently. As keratoconus progresses, the cornea bulges more and vision may become more distorted. In a small number of cases, the cornea will swell and cause a sudden and significant decrease in vision. The swelling occurs when the strain of the cornea's protruding cone-like shape causes a tiny crack to develop. The swelling may last for weeks or months as the crack heals and is gradually replaced by scar tissue. If this sudden swelling does occur, your doctor can prescribe eyedrops for temporary relief, but there are no medicines that can prevent the disorder from progressing.

Eyeglasses or soft contact lenses may be used to correct the mild near sightedness and astigmatism that is caused by the early stages for keratoconus. As the disorder progresses and cornea continues to thin and change shape, rigid gas permeable contact lenses can be prescribed to correct vision adequately. In most cases, this is adequate. The contact lenses must be carefully fitted, and frequent check-ups and lens changes may be needed to achieve and maintain good vision.

In a few cases, a corneal transplant is necessary. However, even after a corneal transplant, eyeglasses or contact lenses are often still needed to correct vision."

Thyroid Eye Disease - Treatment

"Your Ophthalmologist will want to check a few points. A special x-ray called a CT scan may be done to confirm the diagnosis and make sure there is no other cause for your eye problem. An Ophthalmologist may use a special chart to record how your eyes move and will ensure that the pressure in the eye is not high (glaucoma). He will also want to make sure that the optic nerve is not affected. In mild cases, your doctor may not wish to do more than give you lubricating eye drops (artificial tears). Sometimes taping down the lid overnight with a mild adhesive strip like micropore helps to reduce the discomfort next morning. It avoids the eye drying out. You could try propping yourself up on more pillows or tilting the head end of the bed up on one or two bricks (about 6 inches: 15 cm). Some doctors will prescribe a diuretic to offload water to help reduce the swelling. Double vision is annoying, and special spectacles with prisms can be made to help correct this problem. If the eyes are getting worse, your doctor may suggest steroids (anti-inflammation tablets). These may need to be taken for some months, but often in reducing dosage. They are usually very effective. Some doctors will also suggest radiotherapy to the eyes. This is not because you have any sort of cancer cells, but because radiotherapy can dampen down this type of inflammation. The treatment is given daily over a couple of weeks. Other so-called immune-blocking drugs may also help sometimes.

Operations are necessary in certain cases, either because of severe protrusion of the eyes or because of affected vision. Sometimes they are done just for cosmetic reasons. One operation is done through the nose or gums. Bone is nibbled away from around the orbit of the eye to make more space for it. Another type of operation is done on the tendons of the eye muscles. One benefit of this is to allow the upper lid to "hang" lower and close more easily: other types of operation are done to reset the muscles into the eyes and improve double vision. Sometimes even "simple" plastic surgery to the lids can be done, since they tend to get rather baggy when the inflammation has settled."

Routine eye test saved Young Boy's Life

"IT SHOULD have been a routine eye test – but it turned out to be an appointment which saved 14-year-old Andy McNulty's life.

During the examination, optometrist Alister Blockley found serious haemorrhaging and swelling at the back of Andy's eyes and sent him straight to casualty.

Within days he was undergoing emergency surgery to drain fluid from his brain, and weeks later he had to have a second, six-hour operation in Leeds.

Doctors removed a tumour which, although was not big, was attached to his short-term memory nervous system, made the whole procedure fraught with danger.

His mum Sandra, of Scarborough Crescent, Bridlington, said: 'This has completely turned our world upside down – never did we expect to be sent to Scarborough's A&E department following a trip to the opticians.

'To be told your son's life is a ticking time bomb is the most distressing news any mother has to hear. I wouldn't wish that on any family.

'Andrew is a club swimmer so he is a fit and healthy youngster which has really helped him with his recovery as he amazingly spent just over a week in hospital following his operation.

'Doctors were stunned with the speed in which he has recovered and he's back at school already.'

Remarkably, Andy, who is a pupil at Headlands School, only went for an eye test after he had been to see his doctor to get his athlete's foot cured!

He mentioned in passing that he had been having headaches and his eyes were puffy, so the GP advised him to go for an eye exam."

Retinopathy of Prematurity Management

"Currently, treatment relies on the destruction of the areas of the retina that are without blood vessels. This becomes necessary only if the disease has reached a certain, well defined stage, as the milder forms often regress spontaneously. By destroying the retina, the stimulus for the growth of the abnormal blood vessels is removed. The destruction is achieved by cryotherapy (literally freezing the retina, using a small pulse) or photocoagulation with laser energy. Rarely, surgery is undertaken in an attempt to remove the scar tissue. To prevent ROP, Paediatricians attempt to minimise the amount of supplemental oxygen the infant is receiving."

A Mobile operating theatre has been brought to Tewkesbury

"A Mobile operating theatre has been brought to Tewkesbury.In a UK first the NHS has teamed up with the independent sector in Gloucestershire while the town's main hospital theatre is refurbished throughout January.

The mobile unit is the result of a partnership deal between Gloucestershire Hospitals NHS Foundation Trust and Vanguard Healthcare.

Knee surgery, cataracts, hand surgery, urology and pain management procedures will all be carried out at the unit in the grounds of the hospital.

Up to 20 patients will be treated each day in the unit, which expands hydraulically to 40ft by 30ft to house an admissions suite, anaesthetic room, full operating theatre and recovery unit.

The unit will contain all the equipment found in Tewkesbury's day surgery unit and additional x-ray machinery.

All operations will be carried out by Gloucestershire Hospitals Trust medical staff.

Patient's appointments will be managed as though they were being seen in the hospital.

The mobile unit will be on the hospital site in Barton Road for six weeks while the permanent operating theatre has air conditioning equipment upgraded.

Health bosses say the mobile unit will ensure patients in Tewkesbury receive surgery close to home instead of travelling to Cheltenham and Gloucester during the refurbishment.

Managers are also keen not to fall behind with surgery waiting times as they continue to clear a backlog left over from cancellations during last summer's floods."

12 lose eyesight

"Several persons, most of them senior citizens, who were operated upon on January 11 at a cataract surgery camp in Barabanki district here have lost their vision a few days after operation.

An FIR has been lodged by the health department of Barabanki district against Kanpur-based NGO Maa Vashnavi Charitable Chikitsa Sewa Sansthan, that had conducted the camp. The organisation has even been blacklisted.

Nearly two-dozen patients have been admitted at the Balrampur hospital here with swelling in the eyes and loss of vision. “The vision loss seems to have happened due to infection. A team of three eye surgeons has been deputed to look after these patients,” said Dr MK Saxena, chief medical superintendent of the hospital.

The NGO was reportedly only given permission for conducting screening of patients at the camp and the operations were to be performed at the Primary Health Centre (PHC) in Trivediganj.

However, the operations were conducted at the camp site, a college, without informing the Medical Officer (In Charge) of the Trivediganj PHC or the concerned health officials."

Payout hope for people with eye disease

"More than a hundred people across Norfolk could be in line for a refunded for medical treatment they should have received for free.

Some people who suffer with the degenerative eye disease wet, age related macular degeneration (AMD) were forced to pay for their treatment which can cost more than £1,000 per session.

Now, anyone who fits the criteria and paid for treatment of Avastin or Lucentis after May last year will get their money back and will not have to pay for treatment in the future, after the Norfolk Primary Care Trust (PCT) board held a review.

Health bosses said it was impossible to tell how much they would have to pay out because it would depend on how many people had been using the drugs, how many treatments they were given and whether one or both their eyes were affected.

But, if 150 people do turn out to be eligible, depending on the treatment they have had the cost could range from £450,000 to £1.3m......."

Treatment For Squint

"Treatment varies accordingly to the type of squint. An operation is not always needed. The main forms of treatment are:

• Spectacles - to correct any sight problems, especially long sight.
• Occlusion - patching the good eye to encourage the weaker eye to be used. This is usually done under the supervision of an orthoptist.
• Eye drops - certain types of squint can be treated with the use of special eye drops.
• Surgery - this is used with congenital squints, together with other forms of treatment in older children, if needed. Surgery can be performed as early as a few months of age."

What Treatment Are Given For Choroidal Melanoma

"For 100 years or longer, the usual treatment for choroidal melanoma has been removal of the eye, or enucleation. If the tumor has not spread to other parts of the body, then removal of the eye rids the patient of the tumor.
Since World War II, radiation treatment has been used for choroidal melanoma. During the past 20 years, this method of treatment has been refined. Radiation, at the appropriate dose rates and in the proper physical forms, is intended to eliminate growing tumor cells without causing damage to normal tissue sufficient to require removal of the eye. As the cells die, the tumor shrinks, but it usually does not disappear entirely. The most promising widely available method for irradiating medium choroidal melanoma involves constructing a small plaque with radioactive pellets glued to one side. Doctors who take care of patients who have choroidal melanoma are enthusiastic about the possibilities for this treatment, but satisfactory information about long-term results is not available. Your doctors recognize that they have a responsibility to current and future patients with choroidal melanoma to test radiation in a clinical trial.
High energy particles (helium ion or proton beam radiation) from a cyclotron also can be used to irradiate tumors. Surgery is performed first to sew small metal clips to the sclera so that the particle beam can be aimed accurately. Treatment is given over several successive days. The equipment needed for these treatments is available only in a few centers in the world. Good results have been reported in some patients, but many patients treated in this way have been followed for only a few years. Therefore, the long-term results of these forms of radiation therapy compared with the more commonly used plaque are unknown.
Over the years, other treatments have been used for a small number of patients. Photocoagulation using white light or laser light has been used to burn small tumors, and cryo-therapy has been used to kill the tumors by freezing them. These techniques are believed to work only for very small tumors. Some doctors have combined laser or cryotherapy with radiation, but such treatments are experimental. A few patients have had eye wall resection or a related procedure to remove tumors from their eyes. These methods of treatment are considered experimental by most doctors and have been used only for a small number of tumors. No treatment is available that can guarantee to destroy the tumor, to preserve vision, or to assure a normal lifespan"

icWirral - Ground-breaking eye op gives Edith new hope

"A GREAT grandmother from Wallasey who has been facing up to blindness can look forward to the future after revolutionary surgery.

Edith Parry, 82, has become one of the first people in the UK to have a “telescope” fitted inside her eye.

The revolutionary “Intraocular lens for Visually Impaired People” (IOL VIP) operation is the latest success for Heswall’s Som Prasad, who is now only the second man in the UK to have performed it.

Unlike the cataract procedure, which sees one lens inserted into the eye, two lenses are fitted, one behind the iris and one in front, making a classic “Galilean” telescope.

It is “angled” to direct the image to a healthy part of the macula, and on to the optic nerve and the brain."