Corneal collagen cross-linking treatment
CXL treatment aims to prevent the progression of keratoconus and hence the need for a corneal transplant.
The CXL procedure
Mr Ahmad carries out the CXL procedure with anaesthetic eye drops. CXL treatment involves removing the fine surface layer of the cornea known as the epithelium. Then, we apply Riboflavin drops to the cornea and expose the eye to ultraviolet light. The first 24 hours of the procedure can often result in pain and irritation from the eye affects adolescents and young adults.
Potential risks of CXL
The benefits of CXL outweigh the risks in progressive keratoconus. The rare risks include corneal infection and corneal haze.
We advise patients to take a few days off after the procedure to enable recovery. They can resume contact lens wear once the corneal epithelium heals. We give antibiotic eye drops, anti-inflammatory drops and lubricant eye drops after the procedure.
Dry Eye Disease and its treatment
Dry eye symptoms are common and can have a significant impact on everyday activities. If severe enough, the symptoms can result in physical signs of drying of the front surface of the eye and this can result in reduced vision or infections.
The two main types of dry eye disease are:
- Poor tear production or aqueous deficient dry eye disease (ADDED)
- Increased tear evaporation or evaporative dry eye disease (EDED)
Several conditions can result in poor tear production
- the use of certain medications after laser refractive surgery,
- inflammatory diseases (such as rheumatoid arthritis or Sjogren’s syndrome) and
- scarring of the tear (lacrimal) gland ducts.
A significant cause of increased tear evaporation is meibomian gland dysfunction, commonly called blepharitis. The surface of the tear film stabilises by a fine layer of oils produced by the meibomian glands of the eyelids. If these glands become blocked, the oily layer does not build on the tear film, and the tears evaporate. Other conditions resulting in evaporative dry eye disease include environmental causes such as air conditioning and poor blinking or closure of the eyelids.
We personalise the treatment of any dry eye disease to each patient’s symptoms and their everyday activities. Our treatment plans involve a stepped approach.
Treatment of ADDED
- Lubricant eye drops, gels and ointments
- Anti-inflammatory eye drops such as ciclosporin
- Temporary punctal plugs to prevent drainage of any tears produced
- Sometimes, tablets to increase tear production, such as pilocarpine
Treatment of EDED
- Lubricant eye drops, gels and ointments
- Warm compresses to help unblock the meibomian glands of the eyelids
- Short or long term courses of low dose antibiotics (doxycycline, erythromycin or azithromycin)
Allergic Eye Disease and its treatment
Allergic eye disease can be seasonal (such as hayfever) or all year round (atopic conjunctivitis). There are specific risk factors for allergic eye disease such as eczema or asthma, but these are not present in all cases. The main symptoms are redness, watering and itching of the eyes.
In rare cases, the cornea at the front of the eye can be affected, and this results in reduced vision. In children, there is a rare form of allergic eye disease known as vernal conjunctivitis.
- Cooled lubricant eye drops
- Anti-allergy eye drops and tablets
- Anti-inflammatory eye drops such as ciclosporin
The cornea is the clear front of the eye and is essential for the transmission and focusing of light on the retina so that we can see.
There are several reasons patients may need a corneal transplant:
- Corneal scarring, e.g. from corneal infections or sharp injuries
- Genetic corneal dystrophies, e.g. lattice, granular or macular corneal dystrophies
- Abnormal corneal shape, e.g. keratoconus
- Melting or perforation (the development of a hole) in the cornea, e.g. in rheumatoid arthritis or from injuries
- Corneal swelling, e.g. Fuchs endothelial corneal dystrophy
Corneal transplantation involves removing the diseased and transplanting a cornea from someone who has kindly donated their eyes for transplantation after they die.
Because the transplanted cornea is from someone else, there is a potential risk of transplant rejection. We use anti-rejection eye drops or (rarely) tablets to reduce this risk. Occasionally, taking these tablets can be lifelong.
There are several types of corneal transplantation. The conventional type of corneal transplantation that is necessary for some diseases involves transplanting all the layers of the cornea. This type is called a penetrating keratoplasty (PKP) and requires several stitches to the eye. Full visual rehabilitation after a PKP can take up to a year.
Sometimes, we use more recently developed transplantation methods if suitable. The newly developed methods correlate with a speedier visual recovery and reduced rates of transplant rejection. These include:
- Deep anterior lamellar keratoplasty (DALK) in keratoconus that involves transplanting the front layers of the cornea. This type of transplant requires several stitches to the secure the new cornea.
- DSAEK or DMEK corneal transplants that involve replacing the back layer of the cornea in Fuchs endothelial corneal dystrophy. These transplants require us to use air in the eye to hold the transplant in place for a few days to give it time to attach on its own.
OUR PATIENTS ARE OUR BIGGEST PROMOTERS
Here’s what they say
“Dr. Jane Olver was fantastic! She was so caring and sweet and it was clear that she knew what she was doing – very professional! I am absolutely over the moon with my results now!”
“Jane Olver is your woman – I wish I had found her at the start. I will be forever grateful for her care and expertise.”
“Just wanted to thank you for your exceptional assistance with my eye condition. I was so worried but you really helped me feel at ease.”
“I felt much better after speaking to you and being reassured. I am much calmer and actually got some sleep last night.”
“I was deeply impressed by the politeness and empathy shown to me. I found the surgery very peaceful and beautifully decorated and I hope to see Jane again soon.”
“I highly recommend Jane Olver. The whole experience was calm and highly professional.”
“I am writing to you to say thank you to you, Cloe and Jane for taking care of me this week. You were all really lovely and professional and I am very grateful. Big cheer for The Clinica London Team.”
“Many thanks for taking care of my ptosis surgery today. I am now back home and resting but wanted to send a quick note to thank you for taking such good care of me.”
“The treatment was a great success; within 24 hours of starting the treatment the pain and swelling subsided and as a result, I was able to enjoy a great holiday in Argentina.”
“Thank you, my eye is recovering brilliantly (you almost can’t see I had it). Jane was amazing, please pass on a huge thank you.”
“What I loved most was her willingness to take my knowledge of my disease and experience into consideration. I am very impressed and feel lucky to be in her care.”
“Dr. Crawley is always in such a good mood and always does her utmost to help. Best doctor I have ever seen!”
“Dr. Crawley has a wonderful manner, is clearly knowledgeable and is an asset to the hospital.”
“It was a pleasure to be there, the premises are excellent and the professionalism and care that was extended to me were equally excellent. I can’t fault any part of the process whatsoever and am pleased that the procedure seems to have been successful.”
“Thank you for your help during the year.”
“Just a quick note for saying thanks for looking after my Mum so wonderfully as she was very worried about the appointment and you really made such a big difference to the experience.”
“Thank you very much for seeing me yesterday, you were marvellous and a pride to the NHS.”
“I was treated with great courtesy and kindness, and everything was explained to me in layman’s terms so I could fully understand my condition. I was immensely impressed.”
“Many thanks to Mr Khan. His prompt diagnosis and explanation was very reassuring indeed.”
“Dr Khan and Ingrid both put me at ease, talked me through the procedure, the aftercare, gave general tips/advice for maintaining a healthy/clean eye and were really friendly, whilst being professional throughout.”
“Just keep up the good work Dr. Khan. My wife, who accompanied me, and I were both very impressed by the care and consideration shown by the whole team when I had surgery. The care of this team has made it a wonderful experience for me.”
“Ever since my first consultation with you, the caring dedication and understanding I have received from you has been priceless. Thank you with all my heart. Wishing you a healthy and happy future.”
“We left with a much greater understanding of the issues involved with genetic testing. It was also very helpful and reassuring to see Dr. Amar again and be introduced to Jonathan the genetic counselor.”
“On behalf of my mother as well as myself, I would like to thank you for the consultation we had with you last Friday regarding my Usher Type 2/ RP condition. The knowledge and advice you shared with us was much appreciated.”
“Your caring attitude and honest approach to help relieve my problem and find the best solution is overwhelming. And it is with this in mind we would like to express our sincere thanks for everything you have done for me.”
If you suffer from the genetic condition meibomian gland dysfunction, you will suffer from dry, itchy, red eyes most likely accompanied by a low-grade infection along your eyelid margins. Although you will never get rid of it entirely, there is a tried and trusted way of keeping this troublesome condition at bay, which is cleaning, massaging and warming your eyelids. However, we hear of various other home remedies that are said to work. Read on to find out if they’re worth a try!
Are you bothered by a recurrent lump on your eyelid? This is most likely to be a chalazion, and it’s particularly stubborn. It may vary in size and may sometimes even shrink back, but it never goes away entirely! However, you don’t have to put up with it - at Clinica London, we offer a same-day, one-stop treatment package that will zap your chalazion for good. Click here to find out more.
If you’re getting recurrent conjunctivitis, you need to find out what the source of the infection is. Conjunctivitis is caught from someone else, or it can arise as a result of a low-grade infection, but either way, you need to seek expert help to make sure that it’s cured once and for all. One of our patients had severe recurrent conjunctivitis to the extent where it clouded her cornea and caused her to have blurred vision. She could not get rid of it, and it was a very worrying time for her. It was only when she finally sought help at Clinica London that her problem was solved and she is now looking and feeling much better.
Suffering from an itchy red eye is not only irritating but can make you feel self-conscious. The most likely explanation is blepharitis, which has a variety of causes. It’s important to get the problem diagnosed as soon as possible to prevent it from getting worse, and to make sure that it doesn’t come back. Our experts at Clinica London can help.
Myopia (short-sightedness) is on the rise, especially in children and the reasons are various and not what you might expect.
How we may be able to slow myopia development and progression in children in the near future using Atropine
Myopia in children is a hot topic among eye doctors and parents because it is a growing problem globally. International studies are concluding on a new treatment that we hope to be able to offer in the near future to halt the progression of the condition in your child. The children’s ophthalmologist at Clinica London can recommend suitable glasses for a child who suffers from myopia and can advise on environmental and lifestyle changes that will help.