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eye care All eyes on

The eyes have it when it comes to the miracles of 21st-century medicine. We discover the amazing innovations in eye care that are changing people’s lives. Words: Anthea Gerrie

Blind people are being helped to see for the first time, while new devices and innovative treatments are helping those with failing vision hold on to their sight for longer. That’s many more of us than might be

imagined: “Only one in 2,000 people are totally blind, but one in 200 have impaired vision, rising to one in three by age 60,” says Dr Yonatan Wexler. This challenge inspired the vision technology specialist to create smart, speaking spectacles to help thousands with age-related macular degeneration, known as AMD. This is the major risk to sight

as we age, he explains: “The macula goes first, and those who are losing it can shake your hand but not see your face in detail.” Enter MyEye, the innovation

Dr Wexler developed in Israel with vision tech pioneer OrCam. It performs tasks the sighted take for granted, from recognising faces to reading bank statements. The secret is a tiny camera

which fits on the side of virtually any pair of glasses and has a speaker on the back. Using its image bank, it tells the wearer who has approached them, and also relays the words the camera is pointing at, helping those with poor sight do everything from navigating street signs to reading their mail. “While AMD remains the biggest threat

to vision, the most severe form is now treatable,” says Dr. Pearse Keane, consultant ophthalmologist at Moorfields Eye Hospital and a specialist in the condition. “Over a lifetime, the retina gets worn away

and deposits can form, known as dry AMD,” he explains. “This can progress to wet AMD, in which blood vessels grow under the retina to try and deal with the problem, a process which causes more harm than good.” The good news is that vision can be

preserved with injections into the white of the eye of wet AMD sufferers, but they need to be given every month or two: “All the travelling to hospital for frequent injections

can have a severe impact on lifestyle, but there have been positive trials of a drug called brolucizumab, which lasts three months, and should be available in the next year or two,” adds Dr. Keane. He says that while dry AMD may not be

preventable, knowing it exists may prompt sufferers to adopt lifestyle changes which have been shown to halt its progression into the wet version of the disease. Smoking is the greatest risk, while eating a healthy diet,

of glaucoma. “This is a disease of the optic nerve which can be irreversible if left undiagnosed but if spotted early it can be treated with eye drops,” says Dr. Forte. People of Afro-Caribbean origin and those with a family history of glaucoma are at greater risk of developing the condition. “Detecting glaucoma early is vital,” says

Professor Francesca Cordeiro from University College London, who’s helped develop a test that allows doctors to see individual nerve cell death in the back of the eye. Although detection is improving, most patients have lost a third of their vision by the time it’s diagnosed,” she adds. Most likely to be spotted

by optometrists during the recommended two-yearly eye test are cataracts, which cloud the lens inside the eye, making seeing and driving at night more difficult as we age: “Most of us will get them — like wrinkles and grey hair, cataracts are part of living longer,’ says Dr. Forte. However, this common condition is easily reversed with a fairly simple and painless operation. What does the future

hold? “This is a rich time for advances in eye surgery and treatment,” says Professor

including plenty of green vegetables and oily fish, has proven effective in preventing conversion,” he says. Clinical trials also suggest taking certain vitamins that have antioxidant properties and contain macular pigment can also help. One of the most effective tools for early

diagnosis of AMD is the groundbreaking OCT — ocular coherence tomography — machine Specsavers is bringing to the high street. “It’s an optional extra to the standard eye test but worth it because early diagnosis can be crucial,” explains optometrist Dr. Josie Forte. Years ago, the high street chain helped

spread the availability of digital photography of the back of the eye, now a standard, along with other tests, for early diagnosis

Lyndon da Cruz, professor of retinal stem cell and transplantation surgery at the UCL Institute of Ophthalmology. “Advances in micro-engineering, new materials and manufacturing processes including micro- 3D printing, are coupling with biological advances such as ocular gene therapy and advances in stem cell therapy,” he says. Ocular implants are one important way

forward; Professor da Cruz cites artificial retinal devices as “an important step in the generation of artificial vision for patients who are currently totally blind.” And another kind of implant, a magnet placed in the eye socket, has been shown in trials to help sufferers of nystagmus — flickering or ‘dancing’ eyes, a condition which impairs the field of vision of one in 400.

LENS REPLACEMENT TECHNOLOGY VISION CORRECTION LONDON The technology in the replacement lenses Vision Correction London uses in cataract surgery or lens replacement surgery have advanced. The latest is the trifocal lens, which is currently the most popular on the market. Previous multifocal lenses could provide distance and near vision, modern trifocal lenses are able to better replicate the natural lens in providing distance, near and intermediate vision.

LEADING CONSULTANT CARDIOLOGIST DR ROHAN JAGATHESAN Dr Rohan Jagathesan is a consultant cardiologist. He’s currently the divisional lead cardiologist at the Essex Cardiothoracic Centre in Basildon and the Essex Cardiac Lead for the East of England NHS Strategic Clinical Network. His private practice is based at the Rivers Hospital in Sawbridgeworth, Hertfordshire and The Brook Suite at the Essex Cardiothoracic Centre.

INCOGNITO HIDDEN BRACES 3M ORAL CARE Dr Steffen Decker, MAS Lingual Orthodontics, says: “I’m so excited to be able to introduce new digital technology for invisible braces to get the smile you’ve always dreamt of without anyone knowing about it. I’m the world’s number one Incognito Hidden Braces provider — widely considered as the most advanced digital system for precise and accurate beautiful smiles. I’m about to launch again in Wendover and West London.”

INNOVATIVE AESTHETICS RESTYLANE Whether you’re looking to contour and enhance your facial features or to address the visible signs of ageing and acne scars, by offering the broadest range of facial fillers, Restylane creates a flexible treatment approach. RES18-02-0132a Date of Prep: Mar 2018

OTOLOGIST/ENT SURGEON MR ABHI PARIKH Mr Abhi Parikh is a consultant otologist/ENT surgeon working at St Mary’s Hospital, Imperial College Healthcare NHS Trust. His area of expertise is middle ear surgery dealing with hearing loss or ear infections due to conditions such as ear drum perforation, cholesteatoma, and otosclerosis.

CONSULTANT GYNAECOLOGIST MISS AVANTI PATIL Miss Patil is a consultant gynaecologist and obstetrician at Buckinghamshire Healthcare NHS Trust, Bucks. She has special interests in urogynaecology and post-partum perineal problems. Miss Patil is the lead clinician for the gynaecology arm of the Obs/Gyane speciality and has patient-centered satisfaction goals. Miss Patil is also a specialist consultant for spinal injuries (for their gynaecology issues) at the National Spinal Injury Centre. T: 01296 337988

VITREORETINAL SURGEON MR MOSTAFA PATIL Mr Mostafa Elgohary, is an experienced vitreoretinal surgeon. He was appointed four years ago at Kingston Hospital in Surrey and set up the vitreoretinal surgery unit. His article (page six) discusses some of the potentially blinding conditions, namely retinal detachment and macular holes. The unit has been equipped with state-of-the-art machinery.

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