Sometimes medications need to be injected into your eye to treat specific diseases such as age-related macular degeneration, branch retinal vein occlusion, central retinal vein occlusion or diabetic retinopathy. This is known as an intravitreal (into the eye) injection. This does not hurt, because numbing eye drops are given first. The best medication for your eye depends on the disease process. Intravitreal medications include:
The injection will be performed in the clinic room under sterile conditions. Afterwards you can perform normal daily activities and do not usually require eye drops or an eye patch. If you have concerns such as severe pain or worsening of vision, please contact the clinic or Associate Professor Fung immediately. Often injections need to be repeated after 1-2 months. This will depend on your eye condition and Associate Professor Fung will discuss this with you further.
Laser surgery can be performed for several eye conditions, including retinal tears, branch retinal vein occlusion, central retinal vein occlusion, diabetic retinopathy and central serous chorioretinopathy. It can usually be performed in the clinic. The laser is applied either at a slit lamp with a special contact lens or through a headlamp (indirect ophthalmoscope). Afterwards you can perform normal daily activities and do not usually require eye drops or an eye patch.
Vitrectomy surgery in a hospital is performed for many common surgical retinal diseases, including macular holes, epiretinal membranes, vitreomacular traction, retinal detachment and vitreous haemorrhage. This key-hole surgery is performed through the white part of the eye (sclera), usually under local anaesthesia. During the surgery you will be able to hear your operative team but you won’t see anything or feel any pain. If you do have any discomfort or concerns, please notify the team. Otherwise, please lie as still as possible and relax. Most vitrectomy operations will take between 30minutes and 2 hours, depending on the complexity.
After the surgery you will have a patch placed on your eye – leave this on until the next morning. Depending on the surgery, you may be asked to position your head (“posture”) in a certain way. If this is for long periods of time you may wish to hire a posture pillow such as summit support. You will be given eye drops to use for a month- the order of the drops is not important, however, you should wait a few minutes between instilling each drop.
Avoid excessive exertion, swimming, getting your eye wet, rubbing your eye or driving until instructed by Associate Professor Fung. If a gas bubble is placed into your eye at the time of surgery will not be allowed to fly on an aeroplane or go to high altitudes until this has dissolved.
You will be able to perform most normal daily activities. Although your vision may initially be blurred in the operated eye, it is safe to read and watch television. If you have concerns such as severe pain or worsening of vision, please contact the clinic or Associate Professor Fung immediately.
Associate Professor Fung has access to all the latest diagnostic and management equipment for your eye, including:
Age-related macular degeneration is a condition characterized by excessive aging changes at the macula, the centre of the retina. There are two forms:
AMD can cause blurred vision, a central black spot in the vision, distortion and/or difficulty with depth perception. The symptoms of dry AMD tend to occur slowly (over months to years), whilst wet AMD symptoms occur more quickly (days to weeks).
No-one really knows why AMD occurs. We know that it is dependent on aging, since most people with AMD are over 50 years of age. Both genetic (family history) and environmental (e.g. cigarette smoking) factors are likely to play a role.
AMD can be diagnosed by clinical examination and optical coherence tomography (OCT) scans. If wet (neovascular) AMD is suspected, a fluorescein angiogram is often performed.
Speak to Associate Professor Adrian Fung at your visit for more advice.
A BRVO occurs when one of the branch veins (blood vessels) in the retina is blocked up.
Some small BRVOs do not cause symptoms. Those associated with macular oedema may cause blurred vision, a central black spot in the vision, distortion and/or difficulty with depth perception. Still others that are associated with vitreous haemorrhage may cause floaters in the vision.
Most cases of BRVO are caused by a combination of aging and cardiovascular risk factors: high blood pressure, diabetes, high cholesterol and smoking. Occasionally BRVOs may be caused by inflammation in the eye or abnormal blood clotting.
BRVO can be diagnosed by clinical examination. Often optical coherence tomography (OCT) scans and a fluorescein angiogram are also performed.
Firstly, the underlying cause such as high blood pressure will need to be addressed. Associate Professor Fung may need to liase with your general practitioner. Your eye might need treatment, depending on the severity of the BRVO. Those associated with macular oedema may need treatment with intravitreal injections such as Ranibizumab (Lucentis®) or Aflibercept (Eylea®). Occasionally laser surgery is prescribed for macular oedema or to prevent/treat bleeding in the eye.
A CRVO occurs when the main (central) vein (blood vessel draining blood out from the eye) is blocked up.
CRVOs may cause blurred vision, a central black spot in the vision, distortion and/or difficulty with depth perception. Occasionally they can be associated with high intraocular pressures and pain.
Most cases of CRVO are caused by a combination of aging and cardiovascular risk factors: high blood pressure, diabetes, high cholesterol and smoking. Occasionally CRVOs may be caused by inflammation in the eye or abnormal blood clotting.
CRVO can be diagnosed by clinical examination. An optical coherence tomography (OCT) scan or fluorescein angiogram may need to be performed.
Firstly, the underlying cause such as high blood pressure will need to be addressed. Associate Professor Fung may need to liase with your general practitioner. Your eye might need treatment, depending on the severity of the CRVO. Those associated with macular oedema may need treatment with intravitreal injections such as Ranibizumab (Lucentis®) or Aflibercept (Eylea®). Occasionally laser surgery is prescribed to prevent abnormal blood vessels growing that can elevate the pressure in the eye.
Diabetic retinopathy is a vessel disease caused by diabetes (high sugars in the bloodstream).
Diabetic retinopathy can affect the vision in two main ways: swelling of the macula (macular oedema), or bleeding into the vitreous jelly of the eye (vitreous haemorrhage). Macular oedema may cause blurred vision, a central black spot in the vision, distortion and/or difficulty with depth perception. Vitreous haemorrhage may cause a cloud of spots floating in your vision “floaters” or loss of vision.
The high sugar levels in the bloodstream adversely affect the blood vessel walls, causing leaking and macular oedema. Vitreous haemorrhage occurs because abnormal blood vessels grow in the eye.
Diabetic retinopathy can be diagnosed by clinical examination. An optical coherence tomography (OCT) scan or fluorescein angiogram may need to be performed.
Firstly, the underlying cause such as diabetes and high blood pressure will need to be addressed. Associate Professor Fung may need to liase with your general practitioner. Your eye might need treatment, depending on the severity of the diabetic retinopathy. Those associated with macular oedema may need treatment with intravitreal injections such as Ranibizumab (Lucentis®) or Aflibercept (Eylea®). Sometimes laser surgery is prescribed for abnormal blood vessels and vitreous haemorrhage. More severe cases of vitreous haemorrhage or tractional retinal detachment require vitrectomy surgery.
