Diagnostics improving eye health

Advances in tech­nol­o­gy are now address­ing pre­vi­ous­ly untreat­able con­di­tions and mak­ing qual­i­ty eye­care more acces­si­ble.

Lon­don Eye Hos­pi­tal con­sul­tant oph­thal­mol­o­gist Bob­by Qureshi uses light-adjustable lens­es to give patients vir­tu­al­ly per­fect vision. “Even after an eye-oper­a­tion, we can cor­rect long sight, short sight or astig­ma­tism, or make the lens var­i­fo­cal by chang­ing it at mol­e­c­u­lar lev­el through a com­put­er,” he says.

“In cataract surgery, our machine makes a 3D pic­ture with­out touch­ing the cataract and then almost dis­solves it in 30 sec­onds with­out dis­com­fort, using an incred­i­bly pre­cise fem­tosec­ond laser.

“For glau­co­ma we utilise lens­es with com­put­erised built-in pres­sure mon­i­tors which trans­mit wire­less­ly to the patient’s USB stick. This helps ear­li­er diag­no­sis and treat­ment-mon­i­tor­ing. These tech­niques are not sci­ence fic­tion – our clin­ic uses them reg­u­lar­ly.”

Karen Spar­row, from the Asso­ci­a­tion of Optometrists, adds: “Con­sult­ing rooms are much more high-tech nowa­days. The elec­tron­ic visu­al-field analyser, for exam­ple, cre­ates a visu­al field map, use­ful for glau­co­ma diag­no­sis.

“Some opti­cians now pro­vide an iPhone app for a quick vision test. In Northamp­ton optom­e­try prac­tice Tomp­kins Knight, patients’ details are also typed into an iPad for con­ve­nience. So optometrists have pre­scrip­tion and eye-image his­to­ry on tap.”

These tech­niques are not sci­ence fic­tion – our clin­ic uses them reg­u­lar­ly

RNIB eye­care advis­er and optometrist Son­al Rughani says tech­no­log­i­cal progress is sig­nif­i­cant in pre­vi­ous­ly untreat­able age-relat­ed mac­u­lar degen­er­a­tion (AMD). Accord­ing to Mac­u­lar Dis­ease Soci­ety chief exec­u­tive Helen Jack­man: “Focus grad­u­al­ly dimin­ish­es in dry AMD, but in wet AMD vision dis­tor­tion is rapid with straight lines appear­ing wavy. If this hap­pens see a spe­cial­ist imme­di­ate­ly, because injec­tions can now stall wet AMD if caught ear­ly.”

Simon Barnard, of Lon­don optometrists Barnard & Lev­it, says: “Visu­al dys­func­tion in chil­dren is some­times asso­ci­at­ed with learn­ing dif­fi­cul­ties. Tint­ed lens­es may help, fol­low­ing assess­ment by the Intu­itive Col­orime­try instru­ment.”

Their state-of-the-art equip­ment includes com­put­erised Thomp­son eye charts and OCT (opti­cal coher­ence tomog­ra­phy) which uses light waves to detect eye dis­ease. In addi­tion, the Optomap can pro­duce wide-field dig­i­tal images of 80 per cent of the retina’s blood ves­sels, poten­tial­ly diag­nos­ing con­di­tions includ­ing reti­nal detach­ment, hyper­ten­sion and AMD.

Gavin Rebel­lo, part­ner at Essex optometrists Patrick & Men­zies, empha­sis­es that tech­no­log­i­cal inno­va­tions can detect sub­tle eye changes and often stop dete­ri­o­ra­tion. “OCT dis­plays a 3D cross-sec­tion image of the retina’s ten lay­ers, which is impor­tant because AMD starts in the deep­er lay­ers,” he says.

“Yel­low pig­ment in eyes, meso-zeax­an­thin, absorbs dam­ag­ing blue light which caus­es AMD. If enough pig­ment isn’t pro­duced, glare sen­si­tiv­i­ty results, dan­ger­ous in night dri­ving.” OCT can also detect glau­co­ma.

Anoth­er advance is the ocu­lar aber­rom­e­ter which uses com­put­er-gen­er­at­ed wave­front tech­nol­o­gy to mea­sure refrac­tive errors and make cus­tom-made pre­scrip­tions.

Health­care provider Care UK runs dia­bet­ic retinopa­thy screen­ings where sight is affect­ed through dam­age to reti­nal blood ves­sels and pro­gress­es with­out symp­toms. Annu­al screen­ing can detect changes, halv­ing fur­ther visu­al loss.

Advances in technology are now addressing previously untreatable conditions and making quality eyecare more accessible.