Pages

Thursday, 21 November 2019

NEW Genius Platelet Rich Plasma PRP aids Corneal Repair



Initially we had Autologous Serum eye drops. These were manufactured from plasma extracted from a patients own blood. These are bottled after extraction and enhance corneal healing because of all the regenerative growth factors found in our blood plasma.

Now we have a evolution of this treatment – the Genius in-house platelet-rich plasma (PRP) extraction and centrifugal preparation system. 

The Genius system we saw at the recent 2019 Toyos Conference, is very slick, taking only 2 minutes to double spin/centrifuge the blood drawn. The whole process from drawing the blood to giving the patient 3 bottles of their own personalised eye drops takes 17 minutes. 


The Genius PRP system


A 30cc or 60cc sample of blood is usually taken from the patient’s non-dominant arm, typically from the Median Cubital Vein, the Median Cephalic Vein or the Cephalic Vein. These lie in the ante-cubital fossa which lies at the bend of the elbow at the front of the arm. Generally the Basillic Vein is avoided as it runs close to the Brachial Artery and the Ulna Nerve. The veins on the dorsal surface of the hand can be used, but require a higher level of expertise. 



PRP contains 7.8x the concentration of growth factors etc compared to whole blood or plasma and is analogous to a drip feed of amniotic membrane every day. We will be watching this space carefully as I have several patients whose eyes are too dry and sensitive to wear an amniotic membrane and bandage contact lens, even for a week or two. This could the answer for them. 

Most of the cross contamination of blood products issues do not apply as its autologous blood, the patient is only being given products made from their own blood. I expect we will see much more about this recent development in the near future.


Rolando Toyos explained at the conference that this drip feed of growth factors helped facilitate proper regrowth of corneal nerves and reduction in inflammation, often still present after corneal healing seems complete.























Friday, 15 November 2019

Don’t swerve a sight test

The AOP Don’t swerve a sight test campaign, which first launched 14 November 2017, is designed to encourage all drivers to have regular sight tests.

With an estimated 2900 road casualties caused by poor vision every year, we’re reminding motorists that a sight test, every two years, can help them stay safe and reduce the number of accidents on UK roads.



Please click the below links for more information

Tuesday, 12 November 2019

A B See

Children don't know what's not normal. It's estimated more than 1 in 10 children have an undiagnosed visual problem which is affecting their learning and development. 

A sight test can help your child achieve their best. All children under the age of 16 int he UK are eligible for NHS funded eye examinations. They have also provisioned for vouchers to put towards glasses or contact lenses for under 16's. 



It is recommended taht children have a sight test with their local optometrist around the age of three. This allows any conditions which need monitoring or treating to be picked up early. After the first test, children should be seen every one to two years, depending on the optometrist's outcome. 

1 in 5 children in the UK are short-sighted
 (They can see things up close very well, but things in the distance are blurred; like the school board or teachers)

52% of parents believe every child has a full sight test at primary school, but this is not the case. 

74% of Optometrist in the last year, have seen children with vision problems which could have been treated more high success, had they been detected earlier. 

1 in 50 children will develop a lazy eye, also known as amblyopia. This becomes more difficult to treat as the child becomes older and is irreversable once past the age of 8.

Children don't need to have symptoms to be seen by an optometrist. 


Screen Time
Sunlight or white light is made up of red, orange, yellow, gren and blue light rays. Combined together, this spectrum of coloured light creats white light. 

Depending on where they lie in the spectrum, coloured light is either long wavelegnths with less energey, or short with higher energy. 

Blue light?
Blue light is high-energy visible light with much shorter wavelenghts, which is what is cause for concern. Blue light is naturally present in sunlight, but is also found in screens on our TVs, computers and phones. 

Damage?
Currently, there is no scientific evidence that blue light causes damage to the eyes. However, there is evidence suggesting that working at short distances, for example on a mobile device or reading a book for long periods can cause increased eye strain. 

Sleep?
Screen time close to bed time can cause poorer sleep quality, which means your chid's concentration levels throughout the next day are lower. This may be caused by the link between blue light and its suppression of melatonin the hormone which makes us feel sleepy. 

Nicotinamide hopes for damage in Glaucoma


Cardiff University has been granted funding, to research which dietary supplement of Nicotinamide, a form of Vitamin B3, can be used to help reduce and possibly prevent, retinal damage in Glaucoma.



Fight for Sight has helped fund this important research which could help pave the way for new types of glaucoma treatments. Currently treatment is centred around reducing eye pressure and come at a great cost both financially and in time, to the patient and the health service. 

As increased eye pressured is the main damaging driving force in glaucoma, the research will also test how effective Nicotinamide is in treating a wide range of eye pressure profiles.
There is currently a growing body of evidence which is shining a spotlight onto Nicotinamide and its protective role in preventing damage to retinal ganglion cells. (Retinal ganglion cell monitoring is now one of the latest ways to monitor and screen for glaucoma, it is also one of the earliest signs).

Tuesday, 5 November 2019

Cacicol corneal regenerative drops


CACICOL® is the first ophthalmologic matrix therapy agent which triggers REGENERATION of damaged tissues for ENHANCED HEALING.







 The Cacicol drop belongs to the regenerating agent family (or RGTA). These agents are key in corneal matrix repair therapy (or matrix repair). Cacicol helps to trigger the regeneration of damaged tissues for enhanced healing. It makes it possible to delay or even avoid more invasive surgical procedures. ItCacicol is intended for the management of chronic corneal wound healing, such as in dry eye, with persistent epithelial defects (where the surface layer of cells the epithelium is damaged) and persistent corneal dystrophies with associated pain. Cacicol is a regulated healthcare product which requires a medical prescription, to ensure it is best course of treatment  for each patient.Each box of contains 5 detachable and ready-to-use single-dose units and are preservative-free drops which are administered once or twice a week. CACICOL® acts as a scaffold. Its matrix structure permits the fixation and the protection of the components involved in the tissue regeneration process.


Thursday, 31 October 2019

Halloween horror for one unlucky contact lens lady

A  woman was rushed to ER after store bought contact lenses were suctioned to her eyes.


To really complete an outfit, many people like to add special effect contact lenses to finish off their scary disguise.  Be it coloured eyes, cat eyes or even white eyes there are so many options available, over the counter.

Although these lenses can be bought in-store without a proper fitting, these seamlessly harmless lenses can be sight threatening. 

There are countless stories where these lenses have gone wrong, yet they still remain for sale both online and in store. A recent case in America say Gaye, a 20 year old party goer comes  close to being blind.

After wearing the lenses for a party, consulting an online video on how to insert them, Gaye struggled to remove them and fell asleep with them in situ. Later awaking to somewhat blurry vision and a strange sensation, she instilled eye drops hoping to diffuse the situation and went back to sleep. By midway through the next day, the sensation had become unbearable and Gaye feared she may be going blind. 

A trip in the ambulance to a&e, an ophthalmologist told Gaye she had scratches on the surface of her eyes, the term corneal abrasions. 

Dr Thomas Steinemann commented, “All contact lenses are medical devices and the lens has to fit the patient,” the professor of ophthalmology who treated Miss Gaye. “Even though you may not wear a correction (prescription), the lens still has to fit the outer surface of your eye, the cornea.”

Though they may look legitimate, as fashion lenses are not regulated as they are from an optometrist they could themselves have germs or be defective with chips or tears. A study in America found 48% of these lenses were contaminated.

All contact lens fitting sessions come with dos and dont’s, to help ensure the safe use of the lenses. Things like avoiding contact with water, to prevent serious infection and even wearing the lenses inside out.  


If you have any concerns with your eyes or lenses you have been using, please contact our practices for an appointment with our Optometrists. 

Saturday, 28 September 2019

Nice gives Luxturna the NHS go ahead.

The National Institute for Health and Care Excellence (NICE) has recommended the use of Luxturna (voretigene neparvovec) on the NHS, Novartis has announced.

Intravitreal injection (IVI) of a therapeutic substance is the most common procedure performed in ophthalmology. The diseases treated with this method include diabetic macular oedema (DMO), retinal vein occlusions (RVO), anti-vegf for the treatment of wet macular degeneration and gene therapy for choroideremia.


The treatment has been approved as an option for treating RPE65-mediated inherited retinal dystrophies in people with vision loss caused by inherited retinal dystrophy from confirmed biallelic RPE65 mutations, who have sufficient viable retinal cells



The drug is injected under the retina and carries a functioning RPE65 gene to act in place of the faulty one, and is recommended based on data from a Phase I clinical trial which found that the difference in mean change in binocular MLMT score between patients treated and the control group was 1.6.

It's estimated that 86 people would be eligible for treatment with voretigene neparvovec in England
The National Institute for Health and Care Excellence (NICE) has recommended Luxturna (voretigene neparvovec) for use in the NHS in England, making it the first available treatment for an inherited retinal dystrophy.

Voretigene neparvovec is the first licensed gene therapy for vision loss caused by RPE65-meidated inherited retinal dystrophy.

In the gene therapy, a healthy copy of the gene is injected directly into the eye so a working protein can be produced. Patients have to have some functioning retinal cells for it to work.
Research has shown that, in the short term that the drug improves vision and prevents the condition from getting worse. The draft recommendations are now out for consideration by the company, healthcare professionals and patient groups. If there are no appeals, NICE expects to publish its final guidance next month. The treatment would then become available from January 2020. The voretigene neparvovec evaluation at NICE has taken 20 weeks instead of the average of 38 weeks within the Highly Specialised Technologies programme.

This treatment is only for the treatment of Leber congenital amaurosis type 2 (LCA2) and severe early-onset RP caused by mutations in a specific gene called RPE65.
Researchers are hopeful this could pave the way for similar treatments for dry age-related macular degeneration (AMD) to be made available on the NHS. Evidence from clinical trials shows that, in the short term, voretigene neparvovec improves vision and prevents the condition from getting worse. There is no long-term clinical evidence, but the committee considered it is biologically plausible that the treatment effect is likely to continue for decades.

The list price of voretigene neparvovec is £613,410 per patient. This technology breached the Budget Impact Test, meaning it would have cost the NHS more than £20 million in one of the first three years after being introduced. However, the company has a commercial arrangement with NHS England making the treatment available to the NHS at a discount, the size of which is commercial in confidence.

This gene therapy is similar to that used for the treatment of Choroideremia