Corrective tablet screens good news for some

Another BBC article that caught my attention this week, this time about a VDU that can correct vision problems to negate the need for glasses or contact lenses. In short, because it is very technical, the technology is powered by software and algorithms that change the light that a screen emits to distort the image a user sees to their prescription.

When the article talks about one in three people suffering from some form of myopia (short-sightedness), the fact is the vast majority of these people need corrective lenses or glasses for more than just using a tablet. For these people this piece of technology is unlikely to be of any use.

However, there is a very small group who could find this technology hugely beneficial. Even with the most sophisticated contact lenses or glasses, some people with conditions such as keratoconus still see halos and ghosting when looking at VDUs. My hope is that it is that this group that may benefit from this specialist technology. Keratoconus can affect people from a relatively young age, people for whom computers an integral part of their lives both in the work place and at home, so hopefully for this group, this technology could make a real difference.

The cornea…but not as we knew it

Patients often tell us that at each visit we unveil some new exciting gadget or piece of technology for investigating the health of their eyes. It seems like that to us too! In this ever changing tecnhological world though, where our tools to image your eyes are constantly improving, what doesn’t usually change is our understanding of the structure of the eye……until now…

dua

The transparent cornea at the front of the eye is merely 0.5mm thick , and has always been understood to have five distict layers. When you put your chin on the slit lamp during your consultation we can identify these separate layers which provides vital information as to the severity of your eye condition. However Prof Harminder Dua of Nottingham university has discovered a new layer in the cornea. At only 0.001mm thick the layer was discovered by experimentation on human eyes donated to research banks.

The implication of this discovering could be very important for corneal surgery and the understanding of eye conditions such as acute hydrops, descemeteocele and some corneal dystrophies effecting the deeper layers of the cornea.

During corneal surgery tiny air bubbles are injected into the corneal stroma. If these bubbles burst then damage is caused to the patients eye, but by injecting under the strong Duas layer we may reduce the risk of tearing and damage.

Prof Dua suggests that many of the eye conditions that we know to affect the back of the cornea could relate to the presence of this new found layer. Corneal hydrops is one such condition. It is a buildup of fluid in the cornea that is common in patients with keratoconus and might be caused by a tear in Dua’s layer.

 

First rate eye surgery education for optom team

Last week was a busy one as the optometry team were guests at the Centre for Sight in East Grinstead, for their 2013 optometry education day. The private eye clinic is run by Mr Sheraz Daya.

This pioneering eye surgeon performed the first laser vision correction procedure (LASIK) in the UK in 1995. He has since developed a number of surgical techniques and has been involved in the area of Stem Cell Transplantation and tissue engineering. He is the surgeon responsible for performing the stem cell graft that has started to improve the vision of Katie Piper, the model who was left blind in one eye after an acid attack. Mr. Daya has also invented a series of innovative ophthalmic instruments for use in Corneal Transplantation, Collagen Cross Linking (CXL), Laser refractive Surgery and more recently femtosecond laser cataract surgery. He has devised a new technique called “Trans-lens Hydrodissection” which enables easy removal of the lens during laser cataract and lens surgery We heard lectures from the resident surgeons at the clinic.

Talking on the most recent developments in corneal, laser refractive, and cataract surgery. We also heard from a guest lecturer on treatments for retinal eye disease and keratoconus. A highlight of the day was watching Mr Daya perform live cataract surgery. The last time I scrubbed in to see cataract surgery was as a pre-registration optometrist at Ninewells hospital – how things have changed! The state of the art laser which Mr Daya also uses to perform “blade free” laser corrective surgery was used to do some of the most complex parts of the procedure. The highly accurate laser made precise incisions in the lens of the eye, while Mr Daya sat back and watched. This part of the surgery now being “hands free”. The introduction of this type of laser makes recovery times for the patients as little as just a couple of hours.

Other surgical advances included implantable contact lenses in single vision, toric and multifocal forms for correction of long and short sight, astigmatism and presbyopia. Visiting the centre for ourselves and discussing the procedures with the people who perform and develop them really impressed on the us the improvements being made in the field of ocular surgery.

It was a long day and a lot of travel but we believe it is vital for our optometrists to get the very latest information on surgery so that we can advise our patients better on treatment options.

2nd Edinburgh Keratoconus Group meeting

The Keratoconus Group is resourcing and self help group for people with keratoconus. Cameron Optometry has long been a supporter and we have often travelled to Glasgow to attend and speak at meetings.

With Ian’s help an Edinburgh based group was set up and has just had it’s second meeting here at the practice. Ian spoke about the latest advances in contact lenses and answered all sorts of questions about keratoconus.

They hope to run another meeting on another topic in Spring and we’ll keep you updated here. If you are interested in keratoconus or have the condition, you should join the group online at www.keratoconus-group.org.uk

Another UK contact lens first

Cameron Optometry is one of the leading contact lens practices in the UK and as a result, we’re often among the first to get to try new lenses. Yesterday we became the first Private practice in the UK to be given access to the new ICD 16.5 lens.

This lens is really designed for people with unusual eyes and it quite cleverly vaults right over the top of all the central irregularities that normally cause difficulty in contact lens fitting and comes to rest gently on the least sensitive and most regular portion of the eye – the sclera.

I heard about these lenses at the recent AAO Meeting in Phoenix so it’s really exciting to get hold of this lens. It is mainly for specialist purposes like keratoconus, but they are suitable for people with regular shaped eyes too. This promises to be a fantastic addition to the range of lenses we can offer people especially people who have never been able to get contacts to fit previously.

Heather has already had a shot with one patient the day we got it, but Ian and Gillian are still waiting for a go!

Corneal Cross Linking shows good long term results

Results of a 2 year study into the long term effects of Corneal Cross Linking (CXL) in people with progressive keratoconus have shown encouraging results.

Corneal cross linking has been gaining a reputation as an important treatment for stabilising progressive keratoconus, but as a relatively new treatment, long term results on its effects are scare.

This study measured various aspects of vision and shape in 40 eyes over 2 years in patients under 18 with progressive keratconus. Visual acuity both with and without correction in contact lenses of glasses but a significant amount and the prescription or power of the eyes reduced a noticeable amount making correction of the vision easier.

Measures of the shape of the cornea also improved over the study with the shape becoming more regular and a reduction of aberrations which are various types of ‘optical interference’ that cause haloes, glare and shadowing in keratoconus.

Keratoconus linked to sleep aponea

A rather odd link has been found between Keratoconus and sleep aponea.

Researchers in Chicago did some clever statistics on a group of 184 people (half of whom had keratoconus) and found 18 had a known sleep apnoea history and 49 were identified as high risk of the condition.

No one is really sure what to do with the finding but if you’re tired all the time and your vision is blurry then come and see us just in case.

 

Corneal crosslinking heals corneal ulcers

A new application of corneal cross linking (CXL), a treatment previously used for treating keratoconus has been shown to be effective in treating infectious corneal ulcers.

Indian specialists initially treated 6 eyes with the procedure before the favourable results prompted them to expand the study to 31 eyes. Initial treatment was with conventional antibiotics but after 2 weeks and where the eye was not healing properly CXL was performed. All except 2 eyes showed a positive response to the crosslinking procedure.

Crosslinking is a relatively new procedure where special drops of riboflavin are instilled into the eye and then activated by controlled exposure to UV light. The riboflavin increases the cross linking between the fibres of collagen that make up the cornea strengthening it. It is a little like the process of tanning leather and happens naturally throughout life. In conditions like keratoconus the eye is more fragile and begins to become misshapen and research has shown cross linking can halt the progression of the condition by strengthening the cornea.

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