Professor Tom Williamson: ophthalmologist in Central London
Professor Tom Williamson

Professor Tom Williamson
Ophthalmology
Central London


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Professor Tom Williamson Ophthalmologist in
London &
Ashtead

MD MBChB FRCS(Glas) FRCOphth

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Professor Tom Williamson areas of expertise:

Professional statement

Professor Tom Williamson is one of the most experienced vitreoretinal surgeons in the UK. Based in London, he has over 25 years' experience in his specialty, and provides high-quality consultancy and surgery from his private clinics. He has worked in the NHS for more than 33 years, working at the prestigious St Thomas' Hospitals in London since 1995. He has an unrivalled clinical academic record in vitreoretinal surgery which has provided him with a genuine international reputation in his field. He is in high demand as an international speaker as a result. Alongside his clinical work, Mr Williamson also devotes time to teaching and training, with his students going on to become international vitreoretinal consultants in their own right. He is the president of the British and Eire Association of Vitreoretinal Surgeons, and was previously director of the Eyehope charity, providing teaching, equipment and research in ophthalmology. He has the largest single surgeon data set in vitreoretinal procedures in the UK with over 10,000 operations. Mr Williamson has authored a number of critically-acclaimed books in ophthalmology and retinal surgery, some of which have become the main text internationally for training in this area. He has also published over 170 peer-reviewed articles in medical journals and is an active member in a number of ophthalmological organisations. 

For more information please visit his website www.retinasurgery.co.uk

 Videos of doctor

Retinal detachment surgery

 Doctor's articles

retina
Retinal detachment: causes, symptoms, a...

 Credentials

GMC: 2937540

 Professional experience

• More than 35 years of experience
• Consultant Ophthalmologist, London Claremont Clinic (present)
• Consultant Ophthalmologist, The Centre For Sight, Surrey (present)
• Consultant Ophthalmologist, Guy's and St Thomas' Hospital Trust (1995 - present)
• Consultant Ophthalmologist, Queen Mary's Hospital, Kent (1997 - present)

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 Sub-specialties

• Retinal detachment
• Macular hole
• Epiretinal membrane
• Diabetic retinopathy
• Cataract
• Vitrectomy

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 Positions in public associations

• President, British and Eire Association of Vitreoretinal Surgeons (BEAVRS)
• Founder and Director, London Claremont Clinic (2013 - 2016)
• Director of Consultants Eye Surgeons Partnership South London (2007-2017)
• Founder and Director, Eyehope Charity (2007 - 2012)
• Grant application member for Fight for Sight Charity (2010-2015)
• Expert training program inspector for Lifeline Express and World Sight foundation, in China (2012-2013)
• St John’s Moorfields Association member, for the St John's of Jerusalem Charity (present)

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 Teaching posts

• Visiting Professor, Faculty of Engineering and Physical Sciences, University of Surrey (present)
• Ophthalmology Training Program Director in London (2010 - 2015)
• Commissioned Trainer, Hong Kong University (2013)
• Commissioned Trainer, Corneal Services Barbados (2015)
• Faculty for the Advanced Vitreoretinal Surgery Course, Duke University, North Carolina, USA, 2017
• Organising committee member for the Vail Vitrectomy Meeting, Vail, Colorado, USA 2019
• Vitreoretinal representative for the Scientific Committee of the Royal College of Ophthalmologists, London, UK, (present)

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 Education

• MBChB, University of Glasgow (1978 - 1984)
• Fellow of the Royal College of Ophthalmologists (1989)
• Medical Doctorate, University of Glasgow (1995)
• Fellow of the Royal College of Physicians and Surgeons of Glasgow (1988)

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 Publications and conferences

• Author of Vitreoretinal Surgery (Springer, ISBN 978-3-642-31871-9) the premier international text for training in vitreoretinal surgery
• Numerous book chapters including for The Atlas of Clinical Ophthalmology, winner of the best medical text book in the British Medical Association 2005 awards
• Published over 170 publications on clinical topics in vitreoretinal surgery and ophthalmology, making him one of the premier opinions in vitreoretinal surgery internationally
• Author of Intraocular Surgery (Springer, ISBN 978-3-319-27988-6, 2016) a text of the fundamentals of ophthalmological surgical technique

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 Prizes and awards

• North of England Ophthalmological Society Medal (2012)
• Commissioned trainer, Hong Kong University, (2013)
• Faculty Member Advanced Vitreous Surgery course, 20th Anniversary, Duke University, NC, USA (2017)
• Invited Speaker, Dutch Ophthalmological Society, 125th Anniversary, Maastricht, Netherlands (2017)

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 Professional membership

• Member of the British and Eire Association of Vitreoretinal Surgeons (BEAVRS)
• Member of the European Retina, Macular and Vitreous Society (EURETINA)
• Member of the Gonin Society of Viteoretinal Surgeons
• Member of the American Society of Retinal Surgeons
• Member of the British Medical Association (BMA)

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Languages spoken

  • English

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Diseases, Medical Tests and Treatments

Cataracts

Cataracts, also known as phacosclerosis, occur when the lens in the eye, whose function is to convert light rays into images on the retina, hardens or ...

Diabetic retinopathy

Diabetic retinopathy is an ocular disorder caused by diabetes causing damage to blood vessels of the retina. This defect often causes leakage of fluid ...

Epiretinal membrane

Epiretinal membrane is a fibrocellular tissue which is found on the inner surface of the retina. When this membrane shrinks and wrinkles, it produces ...

Macular hole

A macular hole is a break or tear in the macula, a very small part of the eye located in the centre of the retina. The macula is responsible for cent ...

Retinal detachment

Retinal detachment occurs when the outer membrane of the retina (called the retinal pigment epithelium) separates from the inner layer (sensory retina). This detachment can occur due to various reasons such as strong myopia or degenerative atrophic processes. Where the retina is detached, fluid accumulates between the layers and segment blindness occurs. Two of the most crucial signs that may alert the patient of a detached retina are flashing lights and floaters. Treatment for most patients is surgery. ...

Vitrectomy

What is a vitrectomy? A vitrectomy is a type of eye operation, in which the vitreous humour, a jelly-like fluid inside the eye is removed and replaced with a saline solution. The operation is usually performed under local anaesthetic. The function of the vitreous humour is to protect the retina; the sensory membrane at the very back of the eye that receives light and sends images of what the eye sees to the brain. The vitreous humour occupies the space behind the lens and in front of the retina.  Why is a vitrectomy performed? In order for the eye to process visual information, the vitreous humour must be clear enough for light to pass through to the retina. Sometimes, this gel-like substance becomes cloudy from various diseases or trauma, making it difficult to see. A vitrectomy is performed if vision has been diminished considerably and inhibits the patient from having a normal life. A vitrectomy can be used to treat the following: Retinal detachment; sometimes the retina pulls away from the tissue around it and a vitrectomy makes it easier for the doctor to get to the retina to repair it. Diabetic retinopathy; a diabetes complication in which the retina becomes damaged due to uncontrolled blood sugars over a long period of time. Macular holes, diseases of the macula or macular degeneration; the macula is the central area of the retina, a hole in the macula can cause distortion of your central vision. Infections or inflammation of the eye, especially the middle eye or uvea (uveitis). Eye injuries or trauma Cataract operations with complications (occasionally) Pathologies related to high myopia, in which light reaches a focus point before hitting the retina, causing blurry vision. What happens during a vitrectomy? To begin with, small incisions are made into the sclera (white part of the eye) and the vitreous fluid is then removed with a needle. Instruments used in the procedure also include a fiber optic light and an irrigation cannula for suction. Once the vitreous fluid has been removed, the doctor will make any other necessary treatments that the eye needs and will then replace the vitreous fluid with saline or liquid silicone oil, depending on the pathology. The doctor may need to inject a tiny gas bubble into the eye to keep the retina in place. The operation usually lasts between one and two hours and, in some cases, further surgery may need to be performed, depending on the purpose of the operation. Preparing for a vitrectomy Before a vitrectomy, a detailed eye examination should be performed, usually accompanied by an ultrasound to provide the doctor with a detailed picture of the back of the eye. The doctor may need to insert drops into the eye to expand the size of the retina during the examination. Other tests that may be performed are the Retinal Optical Coherence Tomography (OCT) which uses light waves to take cross-section pictures of the retina, fluorescein angiography which examines the retina using a special camera and fluorescent dye or a full field electroretinography test. Aftercare Once the surgery has finished, the doctor will cover the eye with a patch, which can usually be removed after a few hours. The main side effect of the operation is eye pain, which can be treated with antibiotic drops or ointment and over the counter pain relievers. It is recommended to have someone accompany you home after the operation as your vision will be blurry until your eye has fully healed and the gas bubble has been dissolved. There are rarely complications with a vitrectomy, but if you experience vision loss, see floaters or experience severe pain, contact your doctor right away.  ...

Amblyopia

What is a lazy eye? Amblyopia, better known as a lazy eye, is a common sight disorder where vision is decreased in an eye, and is not correctable by glasses or contact lenses. The eye suffers reduced vision because the brain is not acknowledging the information sent by that eye properly. It usually manifests in one eye, with the brain choosing to mainly accept visual information from the other, although in certain cases it may manifest as reduced vision in both. It is a childhood disease, so it is highly important that it is corrected during early ages so that it does not end up becoming chronic.   What are the symptoms of amblyopia? Most lazy eyes do not cause symptoms, with many children being unaware that there is a problem, and younger children often being unable to explain what is wrong. Some older children may have difficulty reading, writing, and drawing. Sometimes, the eye may look different, although this is usually a direct symptom of another condition, which may be the root cause of the lazy eye. Such conditions include: The weaker eye may look in a different direction than the stronger one (strabismus) Childhood cataracts Refractive errors, such as myopia and astigmatism Actions such as rubbing the eyes often, winking eyes or constantly blinking eyes are also indications that the child (or adult, in those cases not detected in time) suffers from a lazy eye.   Causes of a lazy eye  The main cause is an underdeveloped nerve pathway from the eye to the brain, formed during childhood. These nerves transmit information from the retina (the light-sensitive layer at the back of the eye) to the brain, which interprets this information as vision. During the first eight years of a child’s life, this connection from the eyes to the brain is built, as the eyes show the brain images, and the brain learns to make sense of them. The brain may not be able to build strong pathways in the following situations: If a low amount of light is entering the eye (caused by cataracts, for example). If the eye is unable to focus light well (refractive errors). Where the images sent by the two eyes aren’t the same (e.g. in the case of strabismus).   Can a lazy eye be prevented? As amblyopia is a predictable and treatable condition, it should be detected quickly. It is advisable that all children have a complete eye exam at least once between 3 and 5 years of age. Parents should watch out for the signs listed above.   What is the treatment for amblyopia? If a lazy eye is a consequence of another condition, that condition must first be treated. Glasses can be used to treat hyperopia, myopia or astigmatism, while cataracts will have to be removed to allow light to enter the eye properly. The child must then be encouraged to use the weaker eye to improve its connection to the brain. This can be done by reducing the brain’s reliance on the stronger eye, either by covering it with an eye patch, or temporarily blurring its vision with eye drops. Treatment is usually effective, but gradual, usually taking months to work, and should not be stopped too soon, as progress can be lost. After 7 or 8 years of age, the effectiveness of this correctional treatment is uncertain. ...

Angiography

Angiography is a test to diagnose and treat diseases of the blood vessels. If done by MRI is called resonance angiography. This test can diagnose aneurysms in the aorta, arteriosclerotic disease of the carotid arteries in the neck, diseases in blood vessels of the brain as small aneurysms or arteriovenous malformations, ... ...

Angle closure glaucoma

Angle closure glaucoma, or acute glaucoma, is caused by increased pressure within the eye as a result of the build up of fluid. Symptoms are severe pain, blurred vision and nausea. ...

Aniridia

Aniridia is a hereditary and congenital eye disorder that usually occurs in both eyes and is characterised by the incomplete development of the iris. Although the term aniridia refers etymologically to the absence of iris, the reality is that this condition is when part of it is missing as it has not yet fully developed. As a consequence, vision is impaired, decreasing up to 20% in some cases. In addition, aniridia can lead to various diseases, such as glaucoma or cataracts. So far, there is no specific treatment for this disease, so the treatment will depend on the degree of side effects that each patient suffers. ...

Astigmatism

What is astigmatism? Astigmatism is a condition where the shape of your eye is more like a rugby ball than a football, causing blurriness in vision. People with astigmatism are generally born with it, but sometimes the condition can develop as the result of surgery, injury, or an illness. Astigmatism usually comes with long- or short-sightedness. Astigmatism is very common – nearly 50% of people in the UK who wear glasses have some form of astigmatism. What are the causes of astigmatism? Astigmatism occurs when the curvature of the surfaces on your eye are irregular, resulting in a refractive error. Your eye has two curved surfaces – the cornea and the lens – which bend, or refract, light. In a perfectly functioning eye, both the cornea and lens have two curves that match each other, resulting in a sharp image. However, if the curves are mismatched in either the cornea or lens, your retina will receive a blurry image. A fault in the cornea is called corneal astigmatism while a fault in the lens is called lenticular astigmatism. Both of these types come under the bracket of regular astigmatism, which is by far the most common form of astigmatism. Irregular astigmatism involves a cornea or lens which is curved in multiple directions, curved asymmetrically, or uneven in other ways. It is much more difficult to correct and not usually possible to correct with eyeglasses. However, irregular astigmatism occurs much more rarely than the regular form, and is usually the result of an injury to the eye or illness. The rest of this article focuses on regular astigmatism. Symptoms of astigmatism The main symptom of astigmatism is blurry vision, which can come with: headache eye strain (especially from reading or looking at a computer for a long period of time) squinting Medical tests to diagnose astigmatism Astigmatism, along with long- and short-sightedness, can be diagnosed by an optician during a comprehensive eye exam. The doctor will be able to determine from this what degree of astigmatism you have, and therefore what your corrective options are. Treatments for astigmatism Astigmatism can usually be corrected with eyeglasses or contact lenses. Both involve the use of artificial lenses to give you clear vision. From your eye exam the optician will produce a prescription, which states what kind of lens you need. Previously it was not possible to buy soft contact lenses for astigmatism, and the only option was the use of rigid lenses. Now, however, a special form of soft lens called ‘toric’ lenses are available. For stronger forms of astigmatism the cost of contact lenses can increase, and the range of frames you can wear may be restricted. If you opt for eyeglasses or contact lenses, it is important to have your eyes regularly tested because the shape of your eyes change gradually over time, and your prescription might change. Finally, laser eye surgery is often an option, but can be more expensive and may carry the risk of complication. ...

Blepharitis

What is it? Blepharitis is an inflammatory condition of the eyelids which, if occurring alongside with conjunctivitis (or pink eye), may also be called blepharoconjunctivitis. In this case, the inflammation will spread to the eyelids and to the conjunctive membrane. Blepharitis can become chronic, thus being recurrent and resistant to treatments. This is why it is very important to prevent it, by following some hygienic and general rules. Chronic blepharitis can cause red eyelids and crusting of the eyelashes and is more common among the elderly. Prognosis Blepharitis usually lasts a couple of weeks; however, the condition may become chronic. In this case, symptoms can be kept under control but you won’t be able to eradicate them completely. Proper eyelid hygiene is extremely important to prevent recurrent blepharitis. What are the symptoms? The most common symptoms of blepharitis show up on the eyelids. These may include: a burning sensation a hot sensation itching The itching usually makes you scratch your eyelid. However, it is essential that you avoid touching the swollen area with your hands, because this may spread the inflammation and, in some cases, cause some skin microlesions. In case of severe blepharitis, symptoms may also include: swelling of the eye localised pain, due to frequent and irregular blinking photophobia (light sensitivity) How is it diagnosed? A diagnosis can be made by looking at some signs on your eyelid - flaking of skin on eyelids, crusting of the eyelids and, in the most severe cases, even ulcers - and by telling your GP about the symptoms you have. Furthermore, an eye specialist may examine your eyes with a slit lamp. What causes it? The most common causes for this condition are: secretion imbalance of the Meibomian glands refractive errors, such as astigmatism and far-sightedness skin disorders (such as seborrhoeic dermatitis) disorders related to the digestive tract (problems with the digestion process or vitamin deficiency) diabetes high levels of fats in the blood allergies and environmental factors (smoking, fine dusts or particles) bacterial infections How can it be prevented? Blepharitis can be prevented by following some general hygienic rules, which can reduce the risk of developing this condition. You should make sure your hands are clean before touching your eyes. If someone in your family starts showing any of the symptoms of blepharitis, you should avoid sharing sheets, clothes or personal hygiene items with them, in order to avoid spreading it. It is also very important to eat a healthy diet with lots of fruits, vegetables and lean proteins (such as fish or chicken) and to avoid eating too much sugar and caffeinated drinks. How is it treated? Blepharitis can be cured with anti-inflammatory eye drops and antibiotics. To make sure you can cure it completely, you should also check your conjunctive membrane, because there could be some signs of keratitis on the cornea. In case of infectious blepharitis, you should avoid using contact lenses, to avoid spreading the infection any further within the eye. Women should avoid using eye cosmetics while treating blepharitis. Which doctor should I talk to? If you think you may have blepharitis, you should see an ophthalmologist. ...

Blepharoplasty

What is blepharoplasty? Blepharoplasty, or dark circles surgery, is a plastic surgery operation aimed at correcting eyelid defects and deformities, or to aesthetically modify the region around the eyes. It often involves the removal of excess skin, muscle, and fat that accumulates around the eyes with age, causing sagging and the appearance of bags under the eyes.   Why is blepharoplasty done? As we get older, our skin loses its elasticity and the eyelids are no exception. As they stretch, creating excess skin, and the muscles that support them weaken, excess fat can start to collect above and below the eyelids, causing drooping eyebrows and upper eyelids and bags under the eyes. If this excess fat and skin prevents your eyes from opening fully, it can interfere with your peripheral vision, meaning that blepharoplasty may be done to improve vision. However, most cases (particularly operations on the lower eyelids) are performed purely for cosmetic reasons, as the removal of bags and dark circles has the effect of rejuvenating the face.   What does blepharoplasty consist of? There are two ways to perform this surgery: External route: A small cut is made under the eyelashes allowing the surgeon to remove excess skin, muscle, and fat. It is then sealed by a very fine suture that facilitates skin tightening. Internal route: A small incision is made in the inner part of the lower eyelid, through which fat is extracted. Some surgeons do not even use a suture to close the incision, since this tissue heals easily by itself. The eyes are protected by an orbital metallic strip, which is inserted after the patient is under anaesthesia (local or general, depending on whether the blepharoplasty is part of a longer procedure). The duration of the surgery is usually between 30 minutes and one hour, depending on the number of eyelids that will be operated on. Preparation for blepharoplasty Before the blepharoplasty procedure, you will meet with an ophthalmologist and/or plastic surgeon, who will take your medical history and discuss your expectations with you. You will also have to undergo a physical examination, an eye test, and photos will be taken of your eye(s). Smokers will have to stop smoking several weeks before the operation.   Care after blepharoplasty Once the surgery is completed, an ointment will be applied to the eyes to lubricate them and in some cases, a soft bandage. Patients may experience blurred or double vision, excessive production of tears, hypersensitivity to light, discomfort or pain, and some swelling and bruising for a short while after a blepharoplasty. Your doctor may suggest that you take steps such as sleeping with your head elevated higher than your chest for a few days and using cold compresses on your eyes in order to reduce inflammation and bruising. You will be informed if you are required to apply eye drops to keep your eyes hydrated. Oedema and bruising will gradually diminish until it disappears completely and you will begin to look and feel much better. ...

Blepharospasm

Blepharospasm is an involuntary and repetitive contraction of the orbicularis muscle (the circular muscle around the eye), which causes abnormal movements in the eyelids. This causes various visual disturbances (uncontrollable blinking, forced eye closure, reduced vision), and abnormal neck, head or mouth movements that only disappear while the patient sleeps (facial dystonia). It is one of the most common ophthalmological pathologies and it can be caused by side effects of some medications, neurological disturbances in the central nervous system or lack of lubrication of the ocular surface (causing increased eyelid activity to try to effect even distribution of moisture). Its treatment includes eye protection with sunglasses, the application of lubricating drops or Botox injections to avoid contraction of the orbicularis muscles. ...

Canthoplasty

What is canthoplasty surgery? Canthoplasty surgery refers to several procedures that reposition the lateral canthus, which is the outer corner of your eyes where the upper eyelids meet the lower eyelids. The end results of canthoplasty surgery is generally a wider-eyed appearance, with the eyes more cat-eye in style (i.e. they slant slightly upwards). This procedure is performed using either local anaesthetic or intravenous sedation. Why is canthoplasty surgery done? This procedure may be carried out for either cosmetic or medical purposes and can create a almond / cat-eye shape or reduce the effect of droopy eyes (ptosis) or eye bags that occur with ageing. Canthoplasty may also be performed to correct a lower lid malposition or laxity caused by either trauma or previous eyelid surgery (blepharoplasty).  What does canthoplasty surgery involve? In canthoplasty surgery, the lateral canthal tendon is detached, shortened and re-attached to the lateral orbital rim. There are two main types canthoplasty surgery. The first is called a lateral canthoplasty. This achieves a ‘cat eye’ appearance. The second is called an epi-canthoplasty which involves the reshaping of the inner corner of the eyes. These procedures take between 1-2 hours, most frequently performed under local anaesthetic where the eye area is numbed. A special clear plastic shield will cover your eyeball, which is removed after the incisions are closed. The eye will then be dressed to protect the wound and reduce swelling. How do you prepare for canthoplasty surgery? After careful examination by a specialist where they will assess your eyes’ anatomy and treatment options, when you are admitted for the procedure the surgeon will usually begin by marking on the eyes with pen where the incisions will be made. Next anaesthesia will be administered. Local anaesthetic is most commonly used for this procedure. Aftercare following canthoplasty surgery Canthoplasty can be performed as a day case procedure, and you can generally return home the same day, but make sure someone can drive you home. You may feel some pain and discomfort following surgery, but over-the-counter painkillers can be used to manage this. Alternatives to this treatment Although it is not strictly an alternative, canthopexy is a less invasive technique that does not cut the tendons, but merely uses carefully placed sutures to tighten and stabilise the lateral canthal tendon. Hence, there is a quicker recovery time than with a canthoplasty. However, it is uncommon for a canthopexy not to accompany another form of lower eyelid surgery and is usually carried out in conjunction with this.  ...

Chalazion treatment

A chalazion is an inflammation of the eyelid, it is caused by a blockage in the meibomian gland.

Childhood glaucoma

Glaucoma can be congenital (present from birth) or occur during childhood. It is the build-up of intraocular eye pressure and left untreated can lead to progressive loss of vision.  ...

Coloboma

Coloboma, also known as coloboma of the iris, is a hole in the iris of the eye. Most are congenital, meaning they are present from birth. In most cases the cause is unknown but sometimes it can occur due to eye surgery, trauma or genetics....

Colour blindness

Colour blindness or colour vision deficiency is a chronic condition and usually inherited, in which the eyes do not have the ability to see certain colours or differences in colour. There is no cure for this condition, but there are alternative treatments to live with the problem without drawbacks. ...

Congenital glaucoma

Glaucoma in children is a congenital or inherited condition, it usually becomes apparent in the first year of life.

Conjunctivitis

Conjunctivitis is an inflammation of the conjunctiva, the mucosa lining the layers of the eyelids, the anterior face of the eyeball and the sacs of the eye. The basic function of the conjunctiva is to protect the surfaces it covers, so when an infection occurs, it tends to become inflamed. The most common symptoms of conjunctivitis are redness, and a burning ensation in the eye, as well as yellow or green rheum. These symptoms also happen very frequently in cases of allergy. The treatment of conjunctivitis includes the application of eye drops or gel, in addition to a thorough cleaning of the area with sterile saline or warm water that has been previously boiled. ...

Cornea

The cornea is the transparent outermost layer of the eye. It acts as a lens covering the iris and is responsible for refracting light. It is essential for proper vision. ...

Cornea guttata

Cornea guttata is an ocular pathology that is characterised by the appearance of droplet-like protrusions in the cornea. A lesion in the cornea, which is the main part of the eye for a clear view of the objects, it causes loss of visual acuity. It is a condition that worsens over time and for which, except in very advanced cases, treatment is not necessary. When cornea guttata prevents patients from living a normal life, they can have a cornea transplant, which is a very common and simple procedure as it is not necessary to treat all the cornea but only that affected part. ...

Corneal cross-linking

Corneal crosslinking is to treat the cornea with ultraviolet radiation to strengthen it and stop keratoconus deformation. In keratoconus, the cornea weakens and tends to shrink. It is the main way to treat this disease and can prevent the need for corneal transplantation.. The procedure is carried out under topical anaesthesia, riboflavin eye drops are applied to the cornea and a focused beam of ultraviolet rays. The procedure takes about 30 minutes and at the end of surgery, the patient must wear a soft contact lens. The results last from 3 to 10 years and the treatment can be repeated. ...

Corneal transplant

What is a corneal transplant? A corneal transplant, also called keratoplasty, is the total or partial replacement of the cornea, which is the transparent external lens located in the front of the eye, which is responsible for our vision. This is one of the most common transplants, in which the cornea of a recently deceased donor is used, whose eyes have been tested to ensure that they are suitable. Local anaesthetic is applied. Why is it performed? A corneal transplant is performed if you have severe vision problems due to a corneal dysfunction: Opacities in the cornea , the most common pathology treated, which can either be present from birth or acquired. In many cases, the opacity of the cornea is caused by Fuchs’ dystrophy. Thinning of the cornea , usually caused by keratoconus, resulting in vision problems. Scarring of the cornea , due to serious injury or infection. What does a corneal transplant involve? Corneal transplant surgery is a minimally-invasive operation. It requires only a local anaesthetic, so you remain awake throughout. The procedure consists of removing the central part of the cornea and inserting a donor cornea of the same size, using stitches to secure it in place. The ophthalmologist may use a femtosecond laser during the procedure. There are three types of transplant, which depend on the amount of cornea being transplanted: Anterior keratoplasty, when the two anterior layers of the cornea are transplanted Endothelial keratoplasty, when only the inner layer is transplanted Penetrating keratoplasty, when the entire cornea is transplanted. Preparing for a corneal transplant: The main guidelines to follow prior to surgery are: Tell the specialist about any medication you are taking or if you are undergoing any other medical treatment. You may need to reduce blood-thinning drugs before the procedure. You will need to limit your food and drink intake from midnight onwards, prior to the day of surgery. Depending on the case, you may be able to drink some liquids (water, black coffee, tea, etc.) up to two hours before surgery. You must not drink alcohol 24 hours before or after the procedure. You must not apply creams, lotions or make-up around the eyes or to your face on the day of surgery. You will need someone to take you home after the surgery. Post-operative care: You can return home the same day of the surgery. You must wear an eye patch for four days afterwards and the ophthalmologist will prescribe drops to help the eye heal and to prevent transplant rejection and possible infection. The stitches on the cornea will be removed by the ophthalmologist during a follow-up visit. The first healing phase will take about three weeks. During this time, you must not touch your eye, you must protect it during sleep and when showering and you must wear sunglasses during the day. After having this surgery, you will usually need to wear glasses or contact lenses. Alternatives to this treatment: A corneal transplant is a major operation and is only performed when there is no other way to restore the vision. There are some cases in which a corneal transplant is not required, but your cornea may need to be repositioned to cover or minimise the lesion or opaque region that is obstructing your vision. ...

Corneal ulcer

A corneal ulcer is an open sore in the outer layer of the cornea. The cause is usually an infection by bacteria, virus, fungus or parasite. Other causes include severe dry eyes, severe allergic disease, eyelids that do not close well or foreign bodies in the eye. The treatment depends on the cause but in cases of a severe ulcer it is sometimes necessary to perform a corneal transplant. If the corneal ulcer is not treated, it can lead to loss of the eye, a considerable loss of vision or the appearance of scars on the cornea....

Dacryocystorhinostomy

Dacryocystorhinostomy is a surgical operation for treating blocked tear ducts. During surgery, a new drain line is created with tissue from the patient. When the nasolacrimal duct no longer functions properly, the flow of tears into the nose is recovered using the lacrimal sac. ...

Dark circles

What is dark circle treatment? Dark circles (technically known as idiopathic cutaneous hyperchromia of the orbital region) refer to the darkest area under the eyes. They can be hereditary, caused by hyperpigmentation, shadows, allergies, asthma or eczema or be due to medication, fatigue, sadness, hormonal changes, age or nutritional deficiency. Dark circle treatment is a highly effective and satisfactory technique to enhance this area of the face by correcting the bags under the eyes, which are sunken and defined dark circles that can give the face a dull and fatigued appearance. Due to the delicate nature of the skin in this area, it is a complex though not painful treatment, although a local or topical anaesthetic can be applied to minimise any discomfort. Why is it performed? Dark circle treatment is suitable for men and women of all ages who wish to get rid of dark circles.   What does it involve? Depending on the cause of their appearance, different techniques can be used to treat dark circles: Hereditary dark circles: you can try to eliminate them using cosmetics (which don’t contain any exfoliating acid), but if this proves unsuccessful, then injections of hyaluronic acid can be tried. Depending on the person and the amount of product injected, the result will last for a greater or lesser amount of time, and a perfecting session can be performed once a year. Dark circles due to hyperpigmentation: you can use depigmenting products to lighten the area. Dark circles due to tiredness: you can use cosmetic creams that stimulate oxygenation of the area, which prevents blood coagulation and fluid retention. You will also need to adopt some good habits: have 8 hours sleep, remove your makeup well and cut down on alcohol, tobacco and caffeine.   How to prepare for it No special prior preparation is necessary.   Post-treatment care There are no specific indications.   ...

Diplopia (double vision)

Diplopia, or double vision, is a condition of the eyes that causes you to see two of everything.

Dry eyes

What is dry eye syndrome?          Dry eye syndrome, also known as keratoconjunctivitis sicca, is a common condition that happens when the eye doesn’t make enough tears and isn’t lubricated enough, normally due to meibomian gland dysfunction (located in the eyelids and responsible for lubricating the eyes). This affects the ocular surface: the tear film, eyelids, conjunctiva, and cornea. This condition mainly affects women and the risk of getting it increases with age.   Disease prognosis Dry eye syndrome does not tend to be a serious condition; people affected tend to have some discomfort but don’t normally have vision loss. By following the specialists’ advice, it normally disappears within a few days.   What are the symptoms? The main symptoms of dry eye syndrome are tired eyes, light sensitivity, blurred vision, gritty sensation, burning, or redness. These symptoms are normally worse in environments with wind, smoke, air conditioning, dust, or low humidity. Another symptom could be an intolerance to contact lenses.   Tests for dry eye syndrome Tests for dry eye syndrome include visual acuity measurement, slit lamp examination, measurement of the rate of tear production, tear concentration, and tear film rupture time.    What causes it? It is normally caused by hormonal changes that make the eyes produce less tears, such as the menopause or ageing. Other causes include sun exposure, some antianxiety medications, contraceptives, a dry environment (for example air conditioning or wind), smoking, heat, or past surgery, among others. Other possible causes include allergies, rheumatic diseases, and the use of electronic devices. How can it be prevented?     To avoid dry eye syndrome, it is recommended that low humidity places are avoided and some predisposing drugs. It is always important to see a dry eye specialist to have a correct diagnosis and, if necessary, treatment. ...

Exophthalmos (bulging eyes)

What is exophthalmos (bulging eyes)? Exophthalmos is the term used to describe bulging eyes – eyes that protrude out of their normal position. It is also known as proptosis. Very often this can be a sign of a potentially serious underlying medical condition, such as hyperthyroidism. Generally, protruding eyes are considered bulging if the whites of the eyes are visible between the iris (the coloured part of the eye) and the upper eye lid. Sudden bulging should be treated as an emergency. Prognosis of exophthalmos: If bulging occurs suddenly, there is a small risk that the optic nerve is compressed by the pressure caused by exophthalmos, and therefore without rapid treatment your sight may be affected. However, if a symptoms of thyroid disease, exophthalmos can subside with time and treatment. Sometimes corrective surgery will be needed to stop the eyes from bulging permanently. In some cases of exophthalmos, patients are left with long-term sight problems, such as double vision, but permanent problems are rare. Symptoms of exophthalmos: Exophthalmos is the bulging outwards of the eyes. If it is a symptom of an underlying condition, you may have other symptoms of this condition. Medical tests to diagnose exophthalmos: If your eyes begin to bulge, either both or just one, see a doctor. Your doctor will want a full medical history and will conduct a physical exam. Further tests will be carried out to determine the underlying cause of the exophthalmos, including a vision test, a CT scan or MRI and blood tests. What are the causes of exophthalmos? The most common cause of exophthalmos is hyperthyroidism (an overactive thyroid gland). This gland is found in the neck and is responsible for releasing hormones that help to control the metabolism. Hence, with hyperthyroidism too much of these hormones are released. Another common cause of bulging eyes is Grave’s disease, which is an autoimmune disorder that causes hyperthyroidism. Other causes of exophthalmos include: Certain cancers (leukaemia, neuroblastoma, lymphoma) Haemangioma (an abnormal collection of blood vessels) Injury to the eyes Infections to the eye Sarcoidosis Treatments for exophthalmos: Treatment will depend on the underlying cause of your exophthalmos, but can include eye drops, antibiotics or surgery. If hyperthyroidism or Grave’s disease is diagnosed, then you will be treated for these conditions, either with medications, surgery or hormone therapy. If the underlying cause is cancer, then surgery, radiotherapy or chemotherapy will be recommended, however, you will be referred to a cancer specialist at this stage. Surgery may involve the following: Eyelid surgery – to improve the closure and appearance of the eyelids. Eye muscle surgery – aligns the eyes and reduces any double vision. Orbital decompression surgery – small sections of bone are removed from the eye socket. Which type of specialist treats exophthalmos? Depending on the underlying cause, different specialists will treat exophthalmos. However, it will likely be treated by a multi-disciplinary team including ophthalmologists, surgeons, endocrinologists and oncologists. ...

Eye cancer

Eye contact can affect the eyelids, the eye and the orbital socket. Eyelid tumours are usually benign but should be regularly monitored in cases that are not. Intraocular tumours include melanoma (the most common in adults), retinoblastoma (most severe during childhood) and choroidal haemangioma (benign but it spreads rapidly and can impair vision). Orbital tumours are less common and have specific causes. About 50% of retinoblastomas are congenital and eyelid tumours are related to sun exposure. Most ocular tumours are initially asymptomatic and may go unnoticed. Eyelid tumours are manifested by the appearance of lumps or lesions causing eye discomfort Orbital tumours are manifested by pain or ocular abnormalities, decreased vision or movements of the eyeball (proptosis or exophthalmos). ...

Eye examination

What is an eye examination?  An eye examination is a series of tests which are usually conducted by an ophthalmologist (eye doctor), or other professionals such as optometrists. There are different types of eye examination to assess different parts of people's vision, and it is recommended that all people should have periodic eye examinations to check eye health and detect any potential abnormality or disease.  What should I expect during an eye examination?  If you go in for an eye exam, you can usually expect these basic steps: Giving a medical history and describing any problems in vision, if applicable Having your visual acuity (sharpness, acuteness) measured to check if glasses or contact lenses may be needed Having your eye pressure measured Getting your eye health checked, using lights shone in particular places on the eye to examine both the front and the inside Other tests may be performed during the examination, such as the reading of an eye chart, a cover test to check the alignment of the eyes, or an examination of the retina. Your ophthalmologist will advise the tests they wish to perform, and explain the steps as they perform them. After the examination they will explain what they have found, and answer any questions you may have.  How can I prepare for an eye examination? If you wear contact lenses or glasses, make sure to take them with you when you go to the appointment, so the doctor can check if your prescription is accurate. Depending on the type of test performed, you may wish to arrange for someone to take you home afterwards, as certain tests can cause a little discomfort or blur vision. Other tests dilate the eyes, so you may want to have sunglasses at the ready, as bright lights can be uncomfortable after this type of exam.  Why is an eye examination performed? Eye examinations should be performed regularly as part of routine health checks. This means the doctor or professional can see differences in your eyesight, check for any abnormalities, and correct any vision problems. A healthy adult with no vision problems should expect to have eye tests every 5-10 years whilst in their 20s and 30s, every 2-4 years from age 40-54, every 1-3 years from age 55-64, and evey 1-2 years after the age of 65. If you already wear glasses or contact lenses, this means you should have your eyes tested more frequently. You also may need more frequent eye tests if there is a history of eye disease in your family, or if you suffer from a chronic illness or disease which puts you at greater risk of developing some kind of eye disease (such as diabetes).    ...

Eye floaters

What are floaters? Eye floaters, medically known as myodesopsia, are floaters that move across your field of vision. They may have different shapes: lines, shadows, dots, and cobwebs among others. It is one of the main reasons that people visit an ophthalmologist.   Floaters are condensations of the vitreous, which is the gel-like substance in the back of the eye that casts shadows on the retina as light passes through. In floaters, these condensations appear due to dehydration of the vitreous. Most floaters are harmless and are a normal part of the ageing process of the vitreous.  You should see a specialist if the floaters are appearing more frequently, suddenly, or you are seeing flashes of light.   What are the symptoms? Floaters appear in the visual field as stains, dots, or cobwebs. They tend to move around as you move your eyes around and they seem to disappear or be difficult to see when you try to look at them directly. They tend to be seen better when looking at a bright and well-lit surface. Causes of floaters The exact cause for eye floaters is unknown, but it is known to be related to the ageing process as well as myopia, nearsightedness. Posterior vitreous detachment (PVD) can also cause floaters, and they can also appear after cataract or capsulotomy surgery. They can also appear due to other, more serious eye conditions.   How can they be prevented? It is recommended to have your vision tested regularly, especially after the age of 40, to be able to check for floaters that may pose a risk to your vision.   What is the treatment? There currently isn’t a treatment to completely get rid of eye floaters, patients have to get used to them. There are however medications that can delay the onset of floaters as well as two other treatments: Vitreolysis: uses laser which vaporises vitreous opacities that makes them less visible or moves them away from your visual field. Vitrectomy: surgery to remove some or all of the vitreous humour from the eye and replace it with a saline solution. This procedure is performed as a last resort as it is a high risk operation.       ...

Eyelid malpositions

Eyelid malpositions can occur for various reasons and are relatively frequent. Along with being considered unsightly, they can lead to vision and eye problems that could become serious. ...

Facial paralysis

What is facial paralysis? Facial paralysis is a condition that causes partial or total motor paralysis of the facial nerve and, therefore, of the facial musculature. What are the symptoms of facial paralysis? The symptoms of facial paralysis include being unable to perform certain movements such as smiling, opening and closing the eye completely or raising the eyebrow. What causes facial paralysis? Facial paralysis can be caused by various factors, including tumours, trauma, acute and chronic ear infections and congenital disorders (Moebius syndrome). However, its causes are mostly unknown, and in this case it is known as Bell's palsy or peripheral facial paralysis. How is facial paralysis treated? Normally steroids are given to slow down the progressive deterioration of the nerve and massages are performed on the facial muscles. In the more severe cases, specific surgical treatments are also performed, using both static and dynamic techniques to restore the movement and functionality of the muscles. Treatment for Bell's palsy, or peripheral facial paralysis, should be started immediately after onset for a faster and more effective recovery. Are there any complications during recovery? Recovery from facial paralysis is sometimes incomplete because the nerve is damaged and unable to function normally. Complications may occur, such as hemifacial spasm (where some of the muscles are permanently contracted) or synkinesis (when an involuntary movement occurs during a voluntary movement). Fortunately, both complications can be improved through appropriate rehabilitative treatment such as neuromuscular facial retraining exercises or, in some cases, infiltration with botulinum toxin. ...

Fuchs' dystrophy

Fuchs’ dystrophy is characterised by a reduction in the number of endothelial cells that form the inner layer of the cornea. Their function is to maintain good transparency and process water that forms the structure of the cornea. Therefore, when they are reduced, water is not processed properly and, fluid accumulated, causing the corneal tissue to becomes thicker and loose its crystalline transparency. As a consequence, the vision is blurred and other problems can occur, such as scarring of the cornea. If this happens, a corneal transplant is necessary, whereby the affected cornea is replaced by a healthy endothelium from a donor. ...

Glaucoma

Glaucoma is an eye disease that causes progressive loss of nerve fibres in the optic nerve, whose proper functioning is essential for clear vision. Its various causes include vascular diseases and high blood pressure. As it is a degenerative disease, early diagnosis is important. In this regard, experts advise regular checks for those over 40 years of age, although the age of risk for glaucoma is generally 60+. Although the impaired vision cannot be recovered, the progression of glaucoma can be prevented by reducing intraocular pressure. This can be achieved, with the administration of drugs, laser techniques or non-invasive surgery, depending on the needs and condition of the individual patient. ...

Glaucoma surgery

Glaucoma is one of the most common eye conditions, and surgical techniques are often used to correct the issue. The operation is usually done on an outpatient basis, with a local or general anaesthetic. Surgery is one of the treatment options for glaucoma. Other options are topical eye drops or laser treatment. ...

Glaucoma surgery - MIGS

MIGS glaucoma surgery is a term for a number of interventions, techniques and devices that lessen intra-ocular pressure. MIGS stands for minimally invasive glaucoma surgery and the techniques are usually safer and with a quicker post-operative stage. ...

Hyperopia (farsightedness)

What is hyperopia? Hyperopia (also known as hypermetropia, farsightedness or long-sightedness) is a very common eye condition in which distant objects will appear clearly, but objects closer up can appear blurry. If you suffer from hyperopia, your eyes are better at focusing on distant objects than nearby ones. Hyperopia generally affects adults over the age of 40, however, it can affect people of all ages and children too. Hyperopia can be corrected with glasses or contact lenses. Symptoms of hyperopia: The symptoms that you might experience if you have hyperopia include: Nearby objects can appear blurry or fuzzy You might have to squint to see clearly Your eyes may feel tired or strained when focusing on nearby objects, such as reading or writing. You may have headaches Children who have hyperopia may not have obvious symptoms at first, but if left untreated can develop other conditions such as a squint, crossed-eyes or a lazy eye. Medical tests to diagnose hyperopia: If you think you may be suffering from hyperopia, you will need to have an eye test, which can be booked at any local opticians. An eye test will confirm whether or not you are long-sighted and what prescription you will need for glasses or contact lenses. You should have an eye test every two years to ensure your prescription is kept up-to-date. If you think your prescription has changed, book an eye test to confirm this. What are the causes of hyperopia? Hyperopia will occur when your eyes do not focus light on the retina correctly. The retina is the layer at the back of the eye. This may result from your eyeball being too short, the lens being unable to focus or having a flatter cornea. The cornea is the transparent layer at the front of the eye. Treatments for hyperopia: Children and younger adults do not always require glasses to fix their hyperopia because their eyes are able to adjust and adapt. However, adults will require glasses or contact lenses to adjust their vision. Adults who are interested in being independent from glasses can consider laser eye surgery to correct their vision. Which type of specialist treats hyperopia? Ophthalmologists will treat and diagnose hyperopia. ...

Intravitreal injection

An intravitreal injection administers medication to treat eye conditions and vision problems. The medication is injected into the back of the eye, near the retina, into the vitreous humour. Drops are applied to dilate the pupils, the eyes and eyelids are cleaned, and then a liquid anaesthetic is delivered in drops. The medicine is then injected with a small needle.The procedure takes between 15 and 30 minutes. An intravitreal injection is usually done in cases of macular degeneration, diabetic retinopathy or retinal vein occlusion. Although there are minimum risks, it is possible that the patient may feel pressure, but no pain. There may also be some light bleeding or floaters, but these will improve with time ...

Keratitis

What is it? Keratitis is a condition in which the eye's cornea becomes inflamed, mostly due to an ongoing infection. However, surgical trauma or any foreign object entering the eyes can also cause inflammation. This condition can affect anyone, but people with weakened immune function (caused by diseases such as HIV) and people who wear contact lenses have a higher risk of developing keratitis.   What are the symptoms of keratitis? The symptoms of keratitis are usually clear. These usually include: moderate to severe pain in the eye area photophobia (light sensitivity) hyperaemia (red eyes) excessive tearing vision abnormalities (blurred vision) a sensation that there is something in your eye What causes it? Any tear or superficial trauma of the cornea can lead to keratitis. Factors which increase the risk of developing keratitis include: wearing contact lenses (with poor hygiene or incorrect care of the contact lenses solution) a decrease in quality and quantity of tearing immune conditions some medications (such as corticosteroids) chemotherapy How is it treated? Treatment for keratitis will depend on the cause of the infection to the cornea. The inflammation may be of bacterial, fungal, protozoal, viral or ulcerative nature. Usually, you start by using some eye drops, medications or injection therapy. Any foreign object found in the eye will also be removed. More specifically, the main treatments according to the nature of the infection are: Bacterial keratitis: Often due to poor hygiene and improper contact lenses care, although it can arise following an abrasion to the cornea and after using make-up contaminated by bacteria. You may need to take antibacterial drugs or, in the most severe cases, oral antibiotics. Viral keratitis: There are two types of viral keratitis: dendritic or adenovirus keratitis. Dendritic keratitis can lead to a chronic inflammation of the cornea and, in the most severe cases, it can cause glaucoma or even blindness. Adenovirus keratitis is usually less severe and it can lead to the formation of corneal opacities. Both types of viral keratitis are treated with eye drops and antiviral medications. However, viral keratitis may become a recurrent condition. Fungal keratitis: A very rare and dangerous condition which requires immediate treatment, as it can cause permanent sight loss if it reaches an advanced stage. Immunosuppressed individuals have a higher risk of developing fungal keratitis. It can be treated with eye drops and oral antifungal drugs; Acanthamoeba keratitis: This type of keratitis is caused by a parasite and it is very hard to treat. In the most severe cases, a corneal transplant may be required. Which doctor should I talk to? You should see an ophthalmologist in order to treat keratitis. ...

Keratoconus

What is keratoconus?               Keratoconus is an eye disorder in which the corneal tissue thins and deforms. The cornea is unable to support the internal eye pressure and it bulges out in a cone shape, hence the name, kerato, which means cornea, and conus, which means cone shaped.  It is a degenerative condition of the cornea that appears progressively in one or both eyes.     Disease prognosis Although keratoconus is a degenerative disease, it can be corrected with glasses, with contact lenses, and different surgical procedures.    A patient with keratoconus should have regular corneal topographies to detect changes in the cornea. What are the symptoms? Keratoconus usually affects young people in the form of myopia and astigmatism as well as blurred vision. It may also cause eye irritation and increased photophobia (light sensitivity). A specialist will confirm the disease when and if they detect corneal thinning in the central or paracentral part of the cornea. Tests for keratoconus A corneal topography is done to detect mild forms of the disease, it involves capturing an image of the cornea and creating a topographic map of the eye surface. In cases where the keratoconus is more advanced, a slit lamp exam is done, a keratometer (also known as an ophthalmometer) may also be used, which is a device that is used to measure corneal curvature by focusing a circle of light on it and measuring its reflection.  What causes it? The exact cause for keratoconus developing is unknown, but it is believed that many cases are due to genetic factors. This disorder is also linked to collagen related diseases, skin conditions, systemic diseases (such as Down’s syndrome), and eye injuries caused by excessive rubbing or by long term use of hard contact lenses.      How can it be prevented? To prevent keratoconus, it is recommended that you have your eyes checked at least once a year. There are also some actions that are best avoided, such as continuously rubbing your eyes. Early detection is crucial to be able to treat the symptoms and prevent corneal degeneration. What is the treatment?        There isn’t a cure for keratoconus but there are different treatments available that can slow down its progression, which will depend on how advanced the disease is: Glasses or contact lenses Semi-rigid lenses Crosslinking (CXL): is a minimally invasive procedure in which vitamin A and ultraviolet light are used on the cornea to strengthen bonds and structures of inner collagen fibres. The procedure is performed in an hour on an outpatient basis. Ring implants or intracorneal ring segments; implants designed to make the central cornea more homogenous.    Corneal transplant; although this is only necessary in 10-20% of cases and it involves replacing damaged cornea with a healthy one from a donor. What specialist should I see?   Keratoconus should be managed by an ophthalmologist. ...

Keratoprostheses (artificial cornea)

This is a surgical treatment where an artificial cornea is inserted to replace a damaged or diseased one.It is usually undertaken if a donor cannot be found or has not been successful., ...

Lens Replacement

Intraocular lenses are transparent artificial lenses used to replace the natural lenses of the eyes when they are damaged. The eye lens is responsible for receiving light rays which carry images, so when the lens is damaged, vision is impaired. Replacing it with an intraocular lens restores normal vision. Normally, intraocular lenses are made from flexible and pliable material and are the same size as the natural lens. The intraocular lens is generally implanted in the eye during cataract surgery. ...

Low vision

Low vision is vision loss that is not improved by conventional lenses or surgery. Vision loss can cause problems for everyday tasks, and often requires psychological support to prevent the patient from falling into depression. ...

Macular degeneration (AMD)

The macula is the part of the eye responsible for providing clear vision. Macular degeneration, also known as AMD, occurs with ageing. This is a fairly common condition in people over 60 years of age and can occur in varying degrees, In some cases, it can be imperceptible but it can also be more virulent causing progressive and total loss of sight. Although there is still no definitive treatment to repair the effects of macular degeneration, it is important to make an early diagnosis to slow its progression; it has been found that consumption of antioxidant vitamins and zinc can contribute to this. ...

Macular oedema

Macular edema is an eye disease that causes accumulation of fluid in the macula, the part of the eye responsible for providing a clear and sharp vision. It is a very sensitive and important area of ​​the eye, when this fluid accumulation occurs vision is lost and distorted way objects are observed. It can also affect only certain parts of the eye or the whole macular area. It is a pathology associated with diabetic patients because it is a major visual impairment sufferers. Treatment is to seal fluid leaks in the macula, which can be done by laser surgery or therapy intraocular injections. Both techniques provide very good results. ...

Myopia

Myopia, also known as near-sightedness, is an ocular abnormality. A dysfunction in the retina causes difficulty with long range vision. Although close range vision is normal, obstacles at a distance are blurred. There are many degrees of myopia: for example, high myopia exceeds 6.5 dioptres. The most common treatments are glasses and contact lenses, but increasingly, patients are opting for laser surgery, the application of which depends on the characteristics of each eye. The procedure consists of modifying the surface of the cornea, correcting the dioptre affected. For the most severe myopia, a procedure to implant intraocular lenses, whose function is the same as the eyes’ natural lenses, is an option. ...

Neuro-ophthalmology

What is it? Neuro-ophthalmology is a field of medicine which studies and treats diseases of the nervous system that affect the visual system. This includes analysing ocular motility, the functionality of cranial nerves and of all the other nervous structures coordinating eye movement, which are integrated with other sensory systems. Neuro-ophthalmology is a clinical and scientific subspecialty vital in identifying neurological conditions or systemic diseases. What conditions does it treat? Neuro-ophthalmology can treat and diagnose several conditions, including: Eyelid twitching and some types of adult strabismus Optic nerve tumour Cranial nerves palsy, gaze palsy and oculomotor nerve palsy Pupillary abnormalities, myopathy and ocular myasthenia gravis Hereditary retinal dystrophies and inflammatory optic neuropathies, be it or dysimmune or associated with multiple sclerosis (MS) There are several conditions which can affect the visual system, thus interfacing with neuro-ophthalmology, such as: diabetes glaucoma multiple sclerosis cardiovascular disease infectious diseases What symptoms can be traced back to a neuro-ophthalmologic condition? The symptoms vary according to the condition you may be suffering from. However, the main and most common symptoms are functional visual loss, diplopia (or double vision), headache, ptosis (drooping eyelids), exophthalmos (bulging eyes) and pain. What tests can you take? Neuro-ophthalmologic conditions can be diagnosed by using tools and techniques such as a visual field test, optical coherence tomography (OCT) for looking at the cornea and retina, or an optical electrophysiology test. Usually these tests can be done at an outpatient clinic: you will only need to stay in hospital if you need a complex diagnosis or complex treatment. What doctor will you see? The neuro-ophthalmology field is mainly composed of neurologists and ophthalmologists. ...

Nystagmus

Nystagmus is the constant, uncontrolled movement of the eyes caused by spasms in the skeletal muscles of the eyeball. The involuntary rapid eye movements can be in different directions: horizontal, vertical, rotary, etc. Although the exact cause of the condition is unknown, it is associated with a defect in the functioning of brain areas responsible for movement control. It can be a symptom of other diseases, so each case should be examined by a specialist, giving special emphasis to the inner ear and nervous system. The use of contact lenses can slow the movements down thereby improving vision, but although drugs and surgery have been tried, for now there is no definitive cure. Depending on the cause, nystagmus may disappear. ...

OCT (optical coherence tomography)

OCT is a high resolution intravascular diagnostic technique. It is used to study the inside of the coronary arteries and the inside of the macula and retina. The macular OCT or optical coherence latomography is a test that allows the diagnosis and monitoring of macula and retina problems. Pathologies in which it is performed: macular degeneration (AMD) Glaucoma macular oedema Serous central choroiditis epiretinal membrane macular holes magna or pathological myopia This technique does not cause discomfort to the patient and does not require prior preparation. A microscopic study of the tissues of the eye is carried out using an infrared laser beam. ...

Ocular hypertension

Ocular hypertension is the term to describe an increase in pressure in the eye. Anyone can suffer this condition however people with eye injuries, eye diseases, on certain medications, and diabetics are more inclined to develop ocular hypertension. Symptoms are not always visible so it is very important to perform eye examinations as a means of prevention of disease. Ocular hypertension can be treated with medication to reduce eye strain and prevent damage to the optic nerve and to reduce the risk of glaucoma thus avoiding the permanent loss of vision. ...

Ocular melanoma

Ocular melanoma is a form of cancer that affects melanin, the cells that produce pigment in the body. Despite being a rare disease, it is the most common type of cancer that occurs in the eyes. It can affect all parts of the organ, especially those less detectable, so it is essential eye examinations are undertaken regularly. Treatment depends on the degree of development in melanoma when detected, but there are two main types: radiation therapy, which aims to stop the growth of melanoma or, if possible, eliminate it; and ocular melanoma surgery, in which the tumour is removed, unless it is too large (which would require complete removal of the eye and an implant). ...

Oculoplastics

What is oculoplastics? Oculoplastics, also known as oculoplastic surgery, is an umbrella term for a number of surgical procedures on the eye and the surrounding structures, including the eye socket, eyelids, tear ducts, and parts of the face. Oculoplastic surgeons are specialised ophthalmologists, who have undergone additional fellowship training. Some surgeons from certain other specialties, such as plastic surgeons, ENT surgeons and oral and maxillofacial surgeons may be trained in some procedures that fall under oculoplastics.   Why is it done? Oculoplastic procedures may be done for a number of reasons. Many, such as upper and lower eyelid blepharoplasty, eye bag removal and eyebrow lifts, are done for cosmetic reasons, while others, such as eyelid repair for entropion, ectropion and ptosis are done for functional reasons – to make life easier for the patient. Other procedures, such as eye removal and reconstruction may be essential for the patient’s wellbeing.   What does oculoplastic surgery involve? Oculoplastics can involve a number of techniques, depending on the specific operation. Oculoplastic procedures can range from the cosmetic, such as Botox injections, liposuction, and blepharoplasty to essential surgery, such as eye removal and orbital reconstruction.   Types of oculoplastic procedures Eyelid surgery Cosmetic/Aesthetic Upper eyelid blepharoplasty – removal of excessive upper eyelid skin and hooding Lower eyelid blepharoplasty – A procedure to reduce bags by removing excessive skin and subcutaneous fat. Brow lifting – raising or reshaping of the brow Eyelid Malposition Ptosis (droopy eyelid) repair Lower eyelid entropion (inturning) or ectropion (out turning) repair Eyelid lesions benign and cancerous Excision or biopsy of cysts/moles/lesions of the eyelids Eyelid tumour removal – the eyelids can be affected by skin cancers, like basal cell carcinoma or squamous cell carcinoma Tear duct surgery Procedures to reduce watering and unblock tear ducts Biopsy or removal of a lacrimal gland Removal of part of a lacrimal sac Eye removal Complete removal of the eye and possibly also the connecting tissue and muscles – usually done due to the presence of a malignant orbital tumour. Removal of the inside of the eye, leaving the scleral shell – usually done to reduce pain in a blind eye. Orbital reconstruction Artificial eyes Orbital decompression for Graves’ disease Cosmetic procedures Botox injections Facelift – part of the facelift procedure can involve the eyelids and surrounding area. Eyebrow/forehead lifts Liposuction of the face and neck ...

Open angle glaucoma

This is the most common form of glaucoma and tends to build up slowly over years. It happens when the eye is correctly positioned but does not drain properly, causing a build up of pressure. Treatments can be topical, surgical or by laser. ...

Optic neuritis

What is optic neuritis? Optic neuritis (ON) is the swelling or inflammation of the optic nerve. The optic nerve is responsible for transmitting the image from the retina to the brain. It is one of the most common disorders of the optic nerve, others include glaucoma, eye atrophy, or drusen.   Disease prognosis    Patients who get optic neuritis and do not have a linked disease, such as multiple sclerosis, have a higher chance of full recovery. However, although people with an autoimmune disease have a more negative prognosis, they may still regain vision in the affected eye. What are the symptoms?    If the neuritis affects the eye nerve fibers then it could cause short or long term vision loss.  There can also be changes in the way the eye reacts to bright lights, a chromatic vision loss, and the patient may also have pain with eye movement. Tests for optic neuritis To rule out other diseases, the patient will be given an eye colour test, a visual acuity test, visual field test, a brain MRI, and an indirect ophthalmoscopy to examine the optic disc. What causes it? The exact cause for optic neuritis remains unknown, but it is quite often linked to the following diseases:      Multiple sclerosis which is a chronic neurological disease that causes inflammation and demyeliation of the nerve fibres. Optic neuritis is often the first symptom of the disease, while it is estimated that half of all people with MS will develop optic neuritis at some point.    Cryptococcosis Respiratory infections Autoimmune diseases such as lupus Bacterial infections such as meningitis Viral infections such as chicken pox Vitamin B12 deficiency Leber’s optic neuropathy When it develops with no known cause, it is known as idiopathic neuritis. How can it be prevented?   Consult an ophthalmologist and a neurologist so that they can study each case and detect risk factors. Quite often a brain MRI will be done if it is suspected that the patient may have one of the related diseases.   What is the treatment? Treatment for optic neuritis will vary depending on the related disease; sometimes intravenous or oral tablet form corticosteroids are used to shorten the duration of symptoms and accelerate visual recovery. In some cases, vision may return within 2-3 weeks without any treatment.    What specialist should I see? The specialist that diagnoses optic neuritis is an ophthalmologist.       ...

Orbital cellulitis

Orbital cellulitis is an acute infection of the tissues surrounding the eye, particularly the eyelids, eyebrows and parts of the cheeks. This condition is often caused by a sinus infection where the virus spreads to the aforementioned areas. It most commonly occurs in childhood and it is essential it is treated properly to ensure treat without causing damage that can be maintained in adulthood....

Paediatric ophthalmology

Paediatric ophthalmology is the area of medicine that deals with the eye and its diseases in children, from birth through adolescence. Since some eye diseases begin to show symptoms at these ages, it is very important to consider childhood ophthalmology as part of their general health care. Among the most common conditions are lazy eye and strabismus. Also, if any of the family of the patient has congenital diseases associated with vision, early checks and follow-ups are a necessity. ...

Presbyopia

What is presbyopia? Commonly known as tired eyes, presbyopia is the loss of accommodation, the ability to maintain a clear image of an approaching object. In other words, presbyopia the increase in optical power, for example, we need to use 3 dioptres to focus 33 centimetres away.        It is estimated that by 2020 there will be 2.3 million people with tires eyes.   Disease prognosis      Tired eyes develop gradually and evolve over time. It can be treated with temporary or permanent techniques, so prognosis will depend on the technique used, even though it isn’t a serious condition.          What are the symptoms? Presbyopia can cause the inability to focus up close; it can also cause headaches when looking at a book or computer screens. Tests for presbyopia and accommodation The specialist will study the patient’s ability of accommodation (near focusing), measuring the amplitude and the monocular and binocular accommodative flexibility. If the ability to accommodate is unbalanced, exercises that have been proven to work will be recommended.  These exercises involve reading visual therapy at close vision with positive and negative different strength lenses. Flipper training for short distance or changing focus from long to short distance using the Hart Chart is also used, among other techniques.              What causes it? Tired eyes occur due to a loss of lens elasticity, which is the eyes natural lens for focusing on objects. Over time, the lens loses elasticity and the ability to focus. How can it be prevented? Tired eyes can’t be prevented as it is a condition associated with the ageing process. Even so, it is important to have your eyes tested regularly, especially after the age of 40, to detect any age related conditions.    What is the treatment?      There isn’t a permanent treatment for tired eyes, there are however techniques to compensate for loss of focus. The most common one is glasses, and there are different types of lenses according to the issue: Bifocal lenses: for far and near vision. Trifocal lenses: for short, medium, and long distance vision. Progressive lenses (also called multifocal lenses): the upper part of the lens is for distance, the lower part for near, and the middle part for all distances.   Occupational lenses: for short and intermediate distances; particularly suitable for people who work with computers. Even so, surgery is quite often used to get rid of tired eyes. There are different techniques: Laser surgery: the cornea is moulded to increase the depth of focus and compensate for the loss of focusing ability.  Intracorneal lens implants: are placed on the cornea and change the corneal curvature to address the inability of accommodation. Intraocular lens implant: the lens is replaced by an intraocular lens, which can be monofocal, bifocal, or trifocal, depending on the distance reach needed. What specialist should I see? Tired eyes should be treated by an ophthalmologist.    ...

Pterygium and pinguecula

Pterygium and pinguecula are two abnormal lumps in the conjunctiva of the eye that often emerge because of excessive exposure to ultraviolet rays. That’s why doctors stress the importance of protecting the eyes from the sun. Specifically, pterygium appears as fleshy tissue on the cornea. Its size may vary, and accordingly, the treatment can range from applying eye drops to surgery. Pinguecula emerges as a yellowish bump on the white of the eye. In the case where it does not grow over the cornea, it does not usually require any specific treatment unless it affects vision, in which case it would need to be removed by surgery....

Ptosis (droopy eye)

Ptosis is the drooping of the eyelid as a result of relaxation of the muscles that hold it. This is one of the most common eyelid malpositions, and can occur in patients of all ages. There are numerous causes, from injuries to neurological factors. They all cause difficulty in vision, so it is necessary to surgically intervene to repair the tendon or muscle shortening. Various surgical techniques exist and the option will depend on the eye condition of each patient. ...

Retina

The retina is to be found inside the eye, it receives light which is then interpreted as images by the brain.

Retinal vein occlusion

Retinal vein occlusion is when the veins carrying blood away from the retina become blocked.

Retinitis pigmentosa

Retinitis pigmentosa is considered a serious eye condition and is the most common hereditary degenerative retinal condition. Progression causes decreased vision due to the death of photoreceptors, the retina cells and it can end up causing blindness. Its first symptoms are lack of capacity to adapt to the dark (nocturnal blindness) and a decreased visual field, causing tunnel vision. As the disease progresses, symptoms worsen, so it is important to know how the disease developed in close relatives to understand how it will affect the patient. Although there is currently no specific treatment for this disease, consumption of vitamins, minerals and other nutrients may help slow its evolution. In addition, vision therapy is advised; exercises monitored by an ophthalmologist to improve the visual conditions of the patient. ...

Retinopathy

Retinopathy is the common name of any non-inflammatory disease of the retina, the innermost layer of the eyeball responsible for receiving and sending visual images from the eye to the brain. That is why the term encompasses a range of conditions, but the most common is diabetic retinopathy, which occurs due to elevated blood glucose levels in these patients. The symptoms are not evident during the early stages of this type of retinopathy, which can lead to vision loss, so it is important that diabetics undergo regular eye examinations. Its main treatment is photocoagulation, laser surgery to repair abnormal blood vessels that have been manifested in the retina. Another common condition is blood in the vitreous humour. When bleeding has been severe enough to warrant surgical treatment, a vitrectomy is performed. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals.  ...

Secondary glaucoma

Glaucoma is considered secondary when it has an underlying disease or condition. It can also be of the open or closed variety.

Strabismus

Strabismus is also known as cross eyes and is a deviation in the line of sight of the two eyes, meaning they do not align with each other when looking at an object. While one eye looks towards a particular object, the other goes off in another direction. This problem affects sight and aesthetics. Occurring at an early age, it is crucial that action be taken as quickly as possible to avoid other eye and visual ailments. To treat this disorder there are multiple techniques including alternating eye patches, use of special glasses, a toxin injection to temporarily paralyse muscles or surgery. This is recommended only in extreme cases and is to avoid eye strain by strengthening or weakening, as appropriate, certain eye muscles. ...

Stye

What is it? A stye is the result of an inflammation on or inside the eyelid or around the eye. It is a red, hard and painful lump originating from the eyelid’s sebaceous glands or from the eyelashes’ follicles. What are the symptoms? The symptoms of a stye include a painful lump which grows more and more red, lacrimation and, sometimes, a scratchy sensation on the inside of your eyelid. The signs of a stye on the outer eyelid are caused by bacteria attacking the follicles, thus accumulating pus. If you do not have treatment early on, the infection may evolve into a chalazion (a type of cyst). How is it diagnosed? In order to diagnose it, your doctor will simply take a look at the infection to determine what stage it has reached. What causes a stye? A stye originates from a bacterial infection, mainly from the Staphylococcus bacterium, which penetrates into the eyelashes’ follicles and causes an infection of the sebaceous glands. The bacterium is transmitted by direct contact: the simple act of touching your eyes can be enough. How can it be prevented? Avoiding infection involves proper eye and facial hygiene and refraining from touching your eyes excessively. It is also very important to pay attention to proper hand hygiene and to changehand towels as frequently as possible. If you wear make-up, remove it completely before going to bed. You shouldn’t share any eye cosmetics. Make sure you replace your eye make-up regularly. How is it treated? Most cases of styes usually resolve on their own after seven to ten days. From the moment the stye bursts open and starts releasing the pus, it will heal on its own. However, you should remember not to touch or try to burst the stye open yourself, because this could further aggravate and spread the infection. In order to help the stye heal, you could apply warm compresses on your eyelid. If the infection has been going on for a long time, you could also use a macrolide antibiotic-based ophthalmic ointment - that should stop the bacteria from spreading. For more severe cases, the doctor may decide to remove the eyelashes closest to stye, so that the pus is released more easily. ...

Thyroid eye disease

Thyroid eye disease is an autoimmune disease in which the cells that protect us from infections or other aggressive agents act defectively, attacking different organs or tissues of the body such as the thyroid and eyes. For example, with hyperthyroidism (excessive or out of control hormone production), inflammation of the eye may occur or there is an increase in pressure behind the eyes. This can lead to protruding eyes (proptosis), misalignment of the eyes (strabismus) and dysfunctions in the eyelids where, in severe cases, visual disturbances occur. Tobacco and stress are risk factors for developing hyperthyroidism. Treatment includes endocrine control, steroids or, in more severe cases, surgery. ...

Trabeculectomy

The most common glaucoma treatment, a trabeculectomy is a surgical procedure which involves draining part of the eye to relieve pressure. A trabeculectomy is the most common surgical procedure used in the treatment of glaucoma. The specialist will make a small incision to remove part of the eye's trabecular meshwork to relieve pressure in the eye. ...

Uveitis

What is uveitis?      Uveitis is the inflammation of the uvea, the middle part of the eye made up of the choroid, the ciliary body, and the iris which surround the inner part of the eyeball. As there are many blood vessels in the head, this area is very prone and sensitive to many infectious and inflammatory processes. Inflammation in this area can cause severe vision loss, so it is very important to treat it as soon as possible.          Uveitis can affect people of any age, but it is most common in people aged between the ages of 20 to 50, it can also affect children. There are different types of uveitis depending on what part of the uvea is affected: Panuveitis: is often considered the most dangerous form as it affects every part of the uvea.   Posterior uveitis (choroiditis): affects the back of the eye and may be related to a systemic infection or an autoimmune disease. Intermediate uveitis: is a rare type of uveitis that affects the vitreous in the centre of the eye. It can develop at any age but is most common in children and teenagers.   Anterior uveitis (iritis): is the most common type of uveitis and it occurs in the front of the eye. What are the symptoms? Uveitis symptoms vary according to the part of the uvea that is affected; if it is the posterior part there will normally be a loss of vision, and if it’s the anterior segment there will normally be blurry vision, eye pain, red eyes, and photophobia.     It can appear in one or both eyes and may be gradual or sudden.   What causes it? Causes for uveitis include infectious, autoimmune, osseous, and rheumatic diseases as well as eye injuries. Some examples of these are; arthritis, AIDS, syphilis, tuberculosis, and psoriasis. Other causes can also be exposure to toxins and other injuries. It can also be caused by exposure to toxins and other injuries. How can it be prevented?      There are some steps that you can take to reduce the risk of a uveitis flare-up, such as:     Follow treatment recommendations       Don’t use contact lenses Don’t smoke       Maintain good hand and eyelid hygiene. What is the treatment? Treatment depends on the area to be treated; in anterior uveitis anti-inflammatory eye drops are used, for posterior uveitis oral cortisone is normally used. Immunosuppressant drugs are used when it is linked to a chronic condition. Occasionally surgery is carried out if related complications arise, such as glaucoma or cataracts.  ...

Vision therapy

Optometric vision therapy is a technique for children based on eye exercises to optimize and improve various vision dysfunctions. It should be a personalized treatment for each child. It is prescribed for those children who have suffered any ocular pathology and any refractive error, and those with visual dysfunctions that cause poor school performance. Vision therapy works to correct deficient dysfunctions related to eye movements, focusing problems and correcting bad habits of reading and writing caused by problems with vision....

Visual impairment

Visual impairment can have many causes, either congenital, degenerative, due to disease or trauma.

Watery eyes

Watery eyes, also known as epiphora, is a condition where there is an overflow of tears onto the face. It is very common and can develop at any age, although it is more common in babies and people over the age of 60. It may affect one or both eyes and usually manages to get better without any treatment or, if need be, it can easily and effectively be treated.   What causes watery eyes? The causes of watery eyes are: Blocked tear ducts Some people are born with underdeveloped tear ducts and it is normal for newborn babies to have watering eyes, which clear up as the ducts develop. In adults and older children, the most common cause is blocked ducts or ducts that are too narrow. Narrowed ducts are a result of swelling or inflammation. If the tear ducts are blocked, the tears will build-up and not be able to drain. The build-up of tears in the tear sac increases the risk of an infection, meaning the eye will produce a sticky liquid. Overproduction of tears Eyes that become irritated may produce more tears than normal. The eyes can become irritated by a number of factors, including; some chemicals, such as fumes, infective or allergic conjunctivitis, an injury to the eyes, such as a scratch or from grit, from the eyelashes growing inward or to the lower eyelid turning outward. Other causes Watering eyes can result from an infection of the cornea (keratitis), an open sore on the front surface of the eye (corneal ulcer), styes, Bell’s palsy, dry eyes, allergies such as hay fever and the use of certain medications due to the preservatives as an ingredient. . Treatment of watery eyes In mild cases of watery eyes, the doctor may recommend ocular lubricants in the form of dry eye drops and monitor progress. Depending on the cause of watering eyes, there are different treatment options. For watery eyes caused by an irritation, if it does not clear up by itself then a course of antibiotics may be necessary. For blocked tear ducts, surgery may be required to create a new channel between the tear sacs to the inside of the nose. The surgical procedure is called dacryocystorhinostomy (DCR). Home remedies for watering eyes It is recommended to take a break from reading, computer or phone screens. Most dry eye drops are available to purchase over the counter at a pharmacy to keep the eyes lubricated. Holding a warm, damp cloth over the eyes may help to release any blockages also. Cleansing the eyelids with lid wipes or a saline solution can also help alleviate symptoms of dry eyes if linked with blepharitis. ...

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Other information about Tom Williamson

Source: All information contained on this page as well as office hours available, are provided directly by the doctor who has the ability to update them at all times in order to keep the information as accurate as possible.
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