Tuesday 17 November 2015


Optegra Eye Health Care, which operates six specialist eye hospitals across the UK, held a ceremony last week (5 November) to celebrate the opening of its new flagship hospital in London’s famous Harley Street medical district.

The state-of-the-art Optegra Eye Hospital London, on Queen Anne Street, occupies six floors of two adjacent houses and will open its doors on 14 December after two years of development.

Behind the Edwardian and Victorian facades, the buildings have been transformed into specialist ophthalmic facilities, offering a spectrum of procedures led by renowned consultant ophthalmic surgeons.

The £13m investment in the hospital design and build, as well as the latest technologies, mean that Optegra will offer a full laser suite, medical ophthalmology rooms, ophthalmic theatres and an 11-bed ward in central London. The new treatments include the latest laser eye surgery ReLEx SMILE, which is a bladeless, flapless, minimally invasive alternative.

The first surgical patients have already booked in to the new hospital for retinal transplants in January.

Explaining to OT that the new hospital would have a “boutique hotel feel,” director of the hospital, optometrist Amy Richardson, added: “We appreciate that patients can be nervous and sometimes frightened about eye surgery, so we have created a calming, relaxed space.

“Although we are bursting with medical equipment, in parts it does not feel like a hospital at all. We will do everything in our power to make the whole experience as pleasurable as possible.”

She added: “Our brief was very much to create a stunning environment once people step through our doors, capturing the high quality of our service through the optimum standards of design, materials and experience.”

At the launch celebration on the 42nd floor of The Leadenhall Building in London, the 240 guests heard that the new hospital aims to offer “the A to Z of eye health care,” from vision correction options such as laser eye surgery and lens replacement, through to medical treatments for conditions such as cataracts, age-related macular degeneration, floaters, retinal tears and glaucoma, as well as hoping to provide stem cell transplants in the future.

The new hospital will also be offering ‘innovative services’ such as a telemedicine service for optometrists wanting advice on optical coherence technology images.

There will also be a low vision aid service to help patients maximise their remaining vision, as well as a vision counselling service run in conjunction with the Royal National Institute of Blind People to help patients come to terms with their vision loss.

The new hospital has clinical and non-clinical areas, to help patients feel calm and relaxed. Each aspect of the layout has been created to flow and to put patients’ needs at the heart of the design. For example, diabetic patients will have all of the necessary diagnostics and treatments carried out on one floor.

Light is maintained throughout the open floor space through the extensive use of glass, with opaque areas to ensure patient privacy.

One of the key spaces within the hospital is the patient pods on the third floor. Patients are provided with their own dedicated spaces which they will occupy for the duration of their stay, both pre and post-operatively.

Managing director for Optegra Eye Health Care UK, Rory Passmore, highlighted at the celebration that optometrists referring patients out of their practice would see continuity of care, with a letter to them from the hospital explaining what treatment had been given and that patient referred back to the practice.

Mr Passmore said: “We believe that our new hospital in central London shows that modern, innovative eye healthcare can be delivered in stunning, first class surroundings without compromising on impeccable customer service, which is core to everything we do.”

He concluded: “This hospital opening marks a key development for the business and an investment which reflects our success both in the UK and internationally.”


US researchers have discovered a compound which clears the protein clumps associated with cataracts and stops them from forming

Researchers in the US have identified a chemical which dissolves the protein clumps of cataracts, which could potentially form the basis of an eye drop treatment.
Cataract occurs when the crystallin proteins of the lens lose their ordered structure and form clumps. In a healthy lens, crystallins maintain their ordered transparent structure, while being able to flex and stretch, due to chaperon proteins which sit in between them. But as the eye ages, or in inherited conditions, the crystallin proteins become misfolded, forming persistent amyloid clumps which make the lens cloudy. 
While cataract operations are a common day procedure in the UK, the World Health Organization lists the condition as a ‘priority eye disease’ which is responsible for an estimated 51% of blindness worldwide.
In the search for new treatments, a team of researchers from the University of California, San Francisco (UCSF), University of Michigan and Washington University, screened a stock of 2450 compounds, whittling the number down to a handful of potentials.
One of the compounds, named ‘compound 29,’ was found to prevent crystallins from forming clumps in laboratory tests, and even dissolved clumps of protein which had already formed. 
When delivered via eye drops, compound 29 was shown to reduce the cloudiness of the lenses in mice predisposed to cataracts. Similar results were seen when the compound was tested on human cataractous lens tissue, removed during surgery. 
“We are starting to understand the mechanism in detail,” said Dr Jason Gestwicki, associate professor of pharmaceutical chemistry at UCSF and senior author on the study, adding; “We know where compound 29 binds, and we are beginning to know exactly what it’s doing.”
Compound 29 is one of a class of molecules called sterols, important organic molecules which play a wide role of biological functions, such as precursors to steroid hormones. The team found that the compound fits between subunits of the protein, stabilising it.
Earlier this year, researchers in China and the US identified another sterol, lanosterol, as having potential to be the first in a new class of drug to treat cataracts after successful animal experiments in dogs and rabbits.
A postdoctoral fellow in Dr Gestwicki’s lab, and lead author of the latest study, Leah Makely, is founder and chief scientific officer of ViewPoint Therapeutics, which is actively developing compound 29 for human use. 
The findings offer raise the possibility of using sterols, such as compound 29, in neurological conditions involving protein clumps, such as Alzheimer’s or Parkinson’s disease.
Dr Gestwicki said: “By studying cataracts we’ve been able to benchmark our technologies and to show by proof-of-concept that these technologies could be used in nervous system diseases, to lead us all the way from the first idea to a drug we can test in clinical trials.”
The research is published in the journal Science.

Motorists banned in error after DVLA eyesight test fails

The DVLA has banned more than 600 motorists from driving following eyesight tests used by government-appointed opticians it now admits have been giving false results.
But the government agency is refusing to compensate drivers, many of whom were forced to sell their cars and pay for taxis and other forms of transport, as it blames the makers of the eye-testing equipment for the problem.
Over the past few months the DVLA has contacted 604 motorists after it emerged that a field vision analyser, used by DVLA-accredited optometrists since 2010 to assess competency to drive, is unreliable. Around 80% of those who agreed to be reassessed have since had their licences restored.
Derek Harlow, 78, is among the many drivers who were wrongly banned. He lost his licence in April 2013 after an eyesight test – and also lost a lifeline. The glaucoma sufferer from Witney in Oxfordshire cares for his disabled wife, and as he was the sole driver, the couple were forced to sell their car. “My wife struggles to use public transport and has become progressively housebound for much of the time since then,” he says.
But in August Harlow was staggered to receive a letter from the DVLA admitting that his eyesight test had been unreliable. When he went for reassessment he was told he was perfectly able to drive and his licence was restored.
“When the initial elation subsided, I felt aggrieved that my life has been disrupted so needlessly,” he says. “I have complained to the DVLA but have received a ‘not-our-fault’ letter obviously encouraging me to take no further action. Surely the DVLA cannot absolve itself of the responsibility having contracted specific opticians to carry out the eye tests on its behalf? I had no choice as to which optician to use.”

Harlow sold his Vauxhall Corsa for £1,800 when he lost his licence, and has since had to spend £5,200 replacing it with a five-year-old Toyota Yaris, as well as funding taxis, trains and buses for two-and-a-half years. “We’ve lost a lot of money through no fault of our own,” he says. “We also lost much of our independence. My wife and I have had more than 50 years of freedom of travel, including many trips abroad by car and campervan. That all came to a sudden stop in April 2013.”
Under DVLA rules, drivers with certain medical conditions are required to reapply for their licence every one to three years, and if their treatment or condition has changed, to undergo paid-for optical tests at optometrists appointed by the DVLA. These involve tracking random flashing lights on a screen while focusing on a target straight ahead.
But the software fault in the equipment caused the lights to shine less brightly than they should. The DVLA said: “There may be some individuals who would have been able to detect the lights at the higher brightness standard that should have been used, but were unable to detect the lights at this lower brightness. As soon as we became aware of the fault we asked opticians to immediately stop using the equipment and contacted everyone who had undergone the test on that equipment.”
The agency says that of the 604 people affected, less than half of those who replied have sought to reapply for their licences; 71 are still awaiting a reassessment; and the DVLA is trying to get in touch with the 232 who have not yet responded.
The DVLA says it acted as soon as the problem came to light and can’t be blamed for the fiasco. “As this software issue originated at the point of manufacture and not as a result of any action or inaction by the DVLA, we are not responsible for any losses that might have resulted from the defect,” a spokesperson told the Guardian. “The fault with this particular piece of equipment seems to have originated from an inherent software defect and, although the model has been in circulation for a few years, the defect has only recently been identified.”
But the government agency faces a potential multimillion-pound bill if it becomes a target for the new-style class legal actions permitted under the recently enacted Consumer Rights Act.
Nitin Khandhia, civil litigation and dispute resolution lawyer at solicitors BTMK, says: “The consequences of this situation could be very far reaching. Due to the number of people affected by this there may be potential for any claim for compensation or damages to be bought as a group action.”
The DVLA not only rejects liability, but has also made it very difficult to make a claim against the equipment manufacturer by refusing to disclose the name of the company. Harlow is also unable to seek redress from the optician who carried out the test as the practice has since shut down.

Because the DVLA pays for the eyesight tests, patients do not get to see their results. Instead, these are passed straight to the DVLA which makes the decision on whether the individual is allowed to retain their licence. If they are forced off the road they can appeal and send in medical evidence to back up their claim or apply to be re-examined, but DVLA bureaucracy can be time-consuming and the few who succeed often endure months in which they are unable to drive.
Jenny Hirst, a former optometrist and co-chair of the Independent Diabetes Trust, fears that hundreds more drivers may have lost their licences because of what she calls the “blunt instrument” used to assess them.
“One of our members passed the test eight years after having his licence revoked on the grounds of inadequate field vision,” she says. “The instruments used were never designed to test ability to drive and the results take no account of individuality. It’s not illegal, for instance, for a one-eyed person to drive because the good eye adapts to compensate – but if a one-eyed person developed diabetes and had to take this field vision test they would most likely fail.”
Last year the DVLA signed an exclusive £8m contract with high street chain Specsavers to provide its required visual field and acuity tests for four years – a move that caused huge controversy among independent opticians. “At Specsavers you have the test once and the DVLA makes its decision on that score, whereas independent opticians would allow you several retests to check the result is accurate,” Hirst says.
Although Specsavers has hundreds of branches, in some parts of the country drivers complain that while in the past they could use their local accredited optometrist, they now face lengthy journeys to the nearest Specsavers branch. Residents in Campbeltown in Argyll discovered they were expected to make an eight-hour round trip to Ayr if they wanted to keep their licences.
The DVLA says it was obliged to seek the best deal for taxpayers since it foots the bill for obligatory sight tests. “Previously we dealt with many individual opticians on an ad-hoc basis,” says a spokesperson. “Although the individual cost per optician was relatively low, the aggregated spend on the service meant that the contract had to be tendered in accordance with the Public Contracts Regulations 2006. Specsavers provided the most economically advantageous tender.”
Specsavers says that it is thanks to its exclusive contract with the DVLA that the problem with the visual field analysers came to light. “It is because we started doing all the official tests that we had access to enough data to realise there were anomalies,” a spokesperson says. “Since being awarded the contract, we have tested nearly 60,000 people on behalf of the DVLA, of which less than 300 were affected by this software issue.
“The software issue has been rectified and Specsavers has taken the decision to replace the machine entirely. Our stores are doing their very best to work with the DVLA to ensure these patients are prioritised and that their new test results are sent to the DVLA for processing as quickly as possible.”

Saturday 14 November 2015

Wiseman Fund backs Moldova trip


A group of students and their supervisors from Cardiff saw 1,708 patients in a week during a ‘Returning Vision To Moldova’ trip sponsored by The Wiseman Memorial Fund.
Student Jemima Morgan said: ‘We were a group of 11 and each day we travelled to remote villages where there is no access to eye care. We were greeted by the community – young and old – waiting patiently for us to see them. In one day we tested the eyes of 588 people, and never left each day until we had seen everybody.
‘The trip allowed us to see a wide variety of patients, which has helped us prepare for our final year of study and future careers. It was amazing to see that we could make such a huge difference to peoples’ lives.’