Your Questions 2014


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Your questions and comments about any aspect of your eye health not covered in this website are most welcome. To submit your question or comment, please click here.





December 2014

Carmen from Attard, Malta, asks:
I am doing a Certificate in Diabetes Care (Warwick Medical School) and if you can, I need your permission to use your diagram in my brochure for retinal screening information for the Maltese clients please. Thank you.

Brian replies:
Dear Carmen, thank you for your email. Please feel free to use the diabetic retinopathy images for your retinal screening brochure, especially as it will be for the benefit of the public. All the very best, and please let me know if I can be of further assistance.



August 2014

Denise from Baldwin Park, United States of America, asks:
I am having surgery on August 26 2014. I am 32 years old and was diagnosed with a left detached retina last week. When I was seven years old, I was diagnosed with left cataract. I have an intraocular lens implant. My question is the surgeon's choice of using silicone oil to repair the detached retina. Doing my own research, I am questioning oil versus gas for the retinal detachment surgery. I really would not like an unnecessary further operation in six months. What's the best procedure for a complicated case like this?

Brian replies:
Dear Denise, thank you for your question. Having had cataract surgery at a young age makes your case more complex. As a result, retinal detachment surgery may not be entirely straightforward and so using silicone oil will be more appropriate compared to gas. Silicone oil remains in the eye until it is removed a few months later, as opposed to gas which is absorbed within to 6 to 8 weeks of surgery. Having silicone oil in the eye means that you reduce the risk of your retinal detachment occurring again. Your ophthalmologist has made the correct decision in this case. Good luck!



May 2014

Aida from Nairobi, Kenya, asks:
My husband just had cataract surgery of his left eye today Wednesday 30 April 2014 and has to do the right eye on Monday. A friend told us that it's not safe to do both eyes in such a short interval of time. Could you advise if he should go for the second eye cataract surgery or he should postpone until the left eye is fully recovered? Thank you for your assistance.

Brian replies:
Dear Aida, thank you for your question. When to have or not to have cataract surgery for both eyes is a personal matter for discussion between yourself and your ophthalmologist. You can even have both eyes operated on in the same day if you wish. Having said that, unless there was a particular urgency or specific circumstance that dictate so, there is often no need to rush to have surgery. You can usually wait until such time as you are ready for surgery, and this can be days, weeks or even months. Hope this helps.



April 2014

Joan from Staten Island, United States, asks:
Two weeks ago, I had left cataract surgery, which also has old age macular degeneration. I am treated for this every 6 weeks. Question: how do I clean the eye? Do I use baby shampoo, as is recommended prior to the operation? I have read the explanation regarding what to expect after surgery and only hope now my eye will recover. Tomorrow, I will undergo right cataract operation. Thanks to your positive information, I am facing this with more confidence.

Brian replies:
Dear Joan, thank you for your question. I have confidence that your eyes will recover well following cataract surgery provided that you look after them properly. In terms of cleaning the eyelids, you can perform lid hygiene using baby shampoo with cotton buds or with a clean flannel.


Bernadette from Vero Beach, United States, asks:
I had cataract surgery on my left eye on April 9th. Things went along fine for til the 12th when I started to have what seems like a dirty lens which is covering most of the eye and makes seeing blurry.

I went to the doctor on the 14th and she said all was fine and did not really tell me if this was going to go away. I am to have my right eye done on the 23rd and I am now afraid to have it done. If this happens to the right eye too I will not be able to drive as the vision is too distracting.

How should I try to correct this before the 23rd? Should I go back and make the doctor explain again what may or may not happen with my left eye?

Brian replies:
Dear Bernadette, thank you for your question. I am sorry to hear that your left eye has not recovered as expected following cataract surgery. I can understand that it can be quite worrying when you do not know what is going on. Without examining your eyes, I do not know for certain either. One possibility is cystoid macular edema, which is the accumulation of fluid in the macula at the back of the eye, thus causing blurred vision.

Cystoid macular edema is a relatively common complication following cataract surgery. It usually settles over a few weeks with anti-inflammatory eye drops. An OCT scan of the macula should confirm the diagnosis easily.

I think that if you are concerned about this happening to your right eye, you are within your rights to postpone your right cataract surgery until such time you feel ready again to proceed. I am certain that your ophthalmologist will understand if you do decide to take this course of action. Good luck.


Roopesh from Calicut, India, comments:
I recommend for patients who are affected by Vogt-Koyanagi-Harada (VKH) syndrome, according to my experience, Ayurvedic treatment in India specially in the state of Kerala. My wife had the disease for which she had to consume steroid (systematically) for 2 sessions. After that she started on Ayurvedic treatment and now for the past 2 years disease recurrence has stopped. So for those who have this type of disease, I would recommend to consider treatment Ayurvedically.

Brian replies:
Dear Roopesh, thank you for your comment. Vogt-Koyanagi-Harada (VKH) syndrome is a form of uveitis where there is severe inflammation in the eye which can sometimes result in exudative retinal detachments. Treatment for VKH is complex, and often requires steroid (and sometimes more) to dampen the inflammation. I do not have any experience with using Ayurvedic treatment for VKH, and there is no strong evidence to support its use currently. However, I believe that Ayurvedic medicine may have some benefit, and would appreciate further discussion on this subject.





Disclaimer: Replies to your questions are only general in nature, and in no way are to be considered as replacement for a proper ophthalmology consultation and examination. If you require a more specific evaluation, please consult your ophthalmologist for a full eye examination.

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