What is Macular Degeneration
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which can cause blurred or loss of central vision. This typically occurs in older people due to damage to the macula of the retina. Symptoms include gradual worsening of vision, difficulty to drive, read, watch TV and can affect activities in daily life.

Types of Macular Degeneration
There are two types, ‘wet’ and ‘dry’. Dry macular degeneration causes gradual loss of central vision typically over several years. Wet macular degeneration causes rapid loss of central vision typically within weeks (or days) and if untreated can cause blindness within months. Unfortunately, dry AMD is progressive and the chance of switching to wet type increases annually.

Stages of Macular Degeneration

1. Early AMD – Most people do not experience vision loss in the early stage
2. Intermediate AMD – There may be some blurred or distorted central vision. Eye exam will identify pigment changes, debris deposits or both in the retina
3. Late AMD – Vision loss is more noticeable cause be significant damage to macula

Treatment
Unfortunately, dry AMD is not treatable but taking anti-oxidants in form of tablets may help in slowing down the progression of the disease in small proportion of patients.
On the other hand, Anti-Vascular Endothelial Growth Factor (anti-VEGF) injections can stabilise vision in wet AMD. Anti-VEGF medicines include Lucentis (Ranibizumab), Eylea (Aflibercept) and, sometimes Avastin (Bevacizumab)
The anti-VEGF medicines are injected using a fine needle directly into the eye. Injections are generally needed every four weeks for up to two years. The National Institute for Health and Care Excellence (NCIE) determine which patients are eligible for treatment.

What is Diabetic Retinopathy
Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.
Causes of visual loss in Diabetic Retinopathy
Neovascularisation – Abnormal blood vessels forming in the retina at risk of bleeding
Macular Oedema – Swelling at the back of the eye
Macular Ischaemia – Poor circulation at the back of the eye

Symptoms of Diabetic Retinopathy
There are no obvious symptoms until it is more advanced, however the early signs of the condition can be found during diabetic eye screening
Symptoms can include:

1. Gradual worsening of vision
2. Sudden vision loss
3. Floaters
4. Eye pain or redness

Treatment of Diabetic Retinopathy

• Laser treatment
• Eye injections
• Eye Surgery

Cataracts
Cataract surgery is the most common of surgeries performed in the UK. It is a procedure to remove the cloudy lens of your eye and replace it with an artificial lens. A cataract causes the lens to become cloudy, blurry or misty which eventually affects your vision.
The Operation
Cataract surgery is a relatively straightforward procedure that usually takes 20-30 minutes, often carried out as a day surgery under local anaesthetic.
During the operation the surgeon makes a tiny incision in the eye (cornea) so they can remove the opaque natural lens and replace this with an implant.
Intraocular Lens

• Standard lens (Monofocal) – This high-quality, clear lens delivers excellent vision at only one distance.
• Multifocal lens – Designed to reduce your need for eyeglasses for both distance and near vision, this lens gives you clear vision at several distances. This is a special lens and is not fully covered by insurance so there would be an extra payment for this lens.
• Toric lens – Designed to treat astigmatism and deliver excellent vision at a single distance. This special lens is also not fully covered by insurance.

What is Glaucoma
Glaucoma is the name given to a group of eye conditions which cause optic nerve damage and can affect your vision. Glaucoma damage can be caused by raised eye pressures or a weakness in the optic nerve.
Types of Glaucoma
There are four main types of glaucoma:

• Primary open angle glaucoma (POAG) also known as chronic glaucoma
• Acute angle closure glaucoma
• Secondary glaucoma
• Developmental glaucoma

Symptoms of Glaucoma
Many people don’t realise they have glaucoma because it develops slowly over many years and tends to cause loss of vision at the edge of your vision first. Both eyes are usually affected and without treatment can eventually lead to blindness.
You can experience intense eye pain, red eye, headaches, blurred vision and tenderness around the eyes
Treatment for Glaucoma
There are several different treatments for glaucoma, including eye drops, laser treatment and surgery

OCT Testing

Optical coherence tomography (OCT) is a non-invasive imaging test that uses light waves to take cross-section pictures of your retina. These measurements help with diagnosis and provide treatment guidance for glaucoma and retinal diseases, such as age-related macular degeneration and diabetic eye disease.
Fundus Photography

Fundus photographs are used to display the appearance of the inside of the patient’s eye including the retina. The photos are generally used to show damage to the retina that may be caused by glaucoma as well as diabetic retinopathy changes.

Pachymetry

The Pachymeter helps determine the thickness of the cornea. This test is helpful in the management of glaucoma as well as certain disorders that can result in a loss of vision.

Visual Field Test

Visual field is used to determine if a patient has a peripheral or central visual field defect. This information can help to determine if a patient has glaucoma, retinal problems, has had a stroke or if a patient has a brain tumor. By plotting the field of vision, the doctor is able to better diagnose and treat eye and health problems

Gonioscopy

Gonio photography is used to manage patients that are suspected of or have been diagnosed with glaucoma. It is also helpful in determining the type of glaucoma in which a patient may be suffering from.

The results of the recent left eye laser procedure appear to have been as satisfactory as with the previous eye. Much of the improvement was apparent to me shortly after leaving the hospital. My thanks to Mr Entabi for his skill and careful attention; it has been my pleasure to deal both with him and his secretary.

I hope my next consultant will be as kind as you and Mr Entabi have been, but you will be a hard act to follow. Thank you

This note is to formally thank you for the kind and very valuable assistance offered towards my surgery for cataract removal with my choice of a multifocal lens implant. I am very satisfied with the overall outcome. I also wish to extend my appreciation and thanks to yourself, all the team and staff who supported with professionalism in all the service and surgery aftercare. Thank again for your support towards this marvellous job.