Latest Technology
Many systemic conditions affect your eyes, for example high blood pressure, diabetes, certain medications and smoking. The eye is also susceptible to conditions such as glaucoma and age related macula degeneration, especially as we get older. There are all many more rare conditions that we can detect, such as eye tumours, retinal detachments and degenerations. Many of these conditions are not immediately obvious on a simple photo of the back of the eye. Our latest technology aids us in the detection, monitoring and management of potential eye problems.
Glaucoma
Glaucoma is a condition that affects the optic nerve at the back of the eye. It is often but not always linked to high pressure within the eye. Unfortunately the nerve becomes damaged and this leads to a loss of peripheral vision. If left untreated this progresses until all that is left is a small tunnel of central vision. Unfortunately glaucoma becomes much more common as we get older, however if discovered in time it is usually easy to treat with eye drops that lower the eye pressure.
Although common, glaucoma is quite difficult to detect, especially in the early stages. We have a battery of tests to detect it:
Intraocular pressure ( the " puff of air" test) - this measures the pressure in your eyes. A measurement above 21mmHg is considered high. If your pressure is high we will often re-measure it the way that they measure it in the hospital to confirm the reading.
A suspicious HRT result
A good HRT result
Heidelberg Retinal Tomography - as mentioned above, glaucoma affects the optic nerve. This test uses a scanning laser to map the shape of your optic nerve. Your nerve is then compared to a database of glaucoma sufferers. If the nerve is shaped more like a glaucoma sufferer's eye than a normal eye then this is flagged up to us.
The OCT disc scan
Optical Coherence Tomography of the Optic Disc - this uses a beam of light to measure the thickness of the nerve fibres as they go into the nerve. It then compares this thickness to normal and glaucoma eyes.
Visual Field Test Result
Visual Fields - this test records your 'field of vision', or the extent of your visual area when you are looking straight ahead. It is your visual field that allows you to see an object out of the corner of your eye, even when you are not looking directly at it. If there are any abnormal 'blind spots', this test will pick them up.
We use this test primarily to help diagnose if a person has glaucoma and to monitor progression of the disease
in a diagnosed patient. We screen you first on a fast FDT screener. If we identify a problem we will recommend
that you repeat the test on our fields machine the 'Humphrey Field Analyser'. This is the same test used
in Hospitals and eye departments, and our trained technicians can ensure a very accurate record of your field of vision.
The test works by shining a tiny spot of light in various positions in your peripheral vision, whilst you are
staring straight ahead. The patient is asked to indicate when they have seen the spot of light by clicking a button.
The intensity of the light is varied, so that the analyser can work out the exact amount of light needed for you to
see it in every point in your visual field. This is called the Light Threshold. The test is quite tiring so we only
do it when necessary.
Once the test is completed the computer compares your results against 10,000 'normal' patients in the same
age group. This is to see how much variance you have from the norm.
This test may also be used to look for visual field loss caused by brain and optic nerve
lesions caused by strokes or trauma for example, or very occasionally from pituitary tumours.
Macula Disorders
The Macula is the part of the retina at the back of the eye that we see our very clear central vision with. The macula can be affected by age related macular degeneration, diabetes, macula holes and abnormalities of blood vessels in the retina. There are also inherited disorders that affect the macula.
A normal OCT macular scan
An OCT macular scan showing druyssen
Age related macular degeneration is a condition where the eye becomes unable to clear its own waste products,
instead leaving them behind as yellow deposits called Drusen. Unfortunately the presence of Drusen leads to atrophy of the retina leading
to central vision loss or distortion. For an unfortunate proportion of sufferers the atrophy stimulates the eye to produce new blood vessels
in an attempt to supply more oxygen, these blood vessels are leaky and they release fluid which gets under the retina and can lead to a detachment.
This is called Wet macular degeneration.
Often the extent of macular degeneration is not clear from a fundus photo. Hence we use Ocular Coherence Tomography
to scan the retina. The image produced shows the individual layers of the macula and can show individual
drusen or fluid under the retina. We will be able to definitively tell you if you have age related macular degeneration or not.
A rentinal-detachment shown up on an Optos peripheral retina image
A standard fundus photo only shows the central portion of the retina. However, there is a lot more retina out in the periphery. Retinal degenerations and tears often occur out in the periphery. We use Optos Peripheral Retinal Photographs to look much further out than standard photography. Using the Optos we have detected many retinal detachments before they have had a chance to take hold.
You may request a full report of your examination results for your own records, or we may need to prepare a report for
referral to an Ophthalmologist. These reports are quite extensive and require a large amount of time to prepare, as there
are always lots of pictures to be printed or transferred onto CDs.
If we decide that you need to be referred, we will always try to recommend an Ophthalmologist who specialises in your
particular problem. We have several choices in many specialist areas and the choice may be made on practical considerations
like area, availability and cost. A full report will be prepared and passed on to the specialist or it can be sent to you
to take to your GP for a referral through the NHS. In our experience the NHS does a good job but you do need to be patient if you take this route.