Our services
Eye department - treatments provided
Cataract (clouding of the lens of the eye)
Glaucoma (high pressure in the eye)
Macular degeneration (age wear-and-tear change of the centre of the vision)
Squint, lazy eye and eye movement problems
Imaging, diagnostic and optometry services
Cataract (clouding of the lens of the eye)
Cataract surgery is carried out at Wycombe Hospital and Stoke Mandeville Hospital (although the initial consultation may take place at one of the other hospitals listed above). Cataract operations are mostly carried out as day case operations under a local anaesthetic, but we can provide for the small proportion of people with complex cataracts or special medical needs who need a stay in hospital following cataract surgery. Cataract surgery is the commonest operation we perform (around 3500 per year), but this is not just a production-line service. We aim to treat each person as an individual and tailor our service to their particular needs.
Glaucoma (high pressure in the eye)
Glaucoma is a common condition, especially in later life. It is advisable for people over the age of 45 to have sight tests with an optician every year or two (particularly for those who have a close relative with glaucoma), as this is the usual way in which glaucoma is discovered before it starts to damage the vision. Although glaucoma can cause sight loss, it is usually discovered before this happens and treatment can normally prevent sight loss. Most people with glaucoma have to take eye drops to keep the condition stable and attend hospital for periodic outpatient checks. Our main facilities for assessing people with glaucoma are at Stoke Mandeville, Wycombe and Amersham hospitals, though we can carry out some glaucoma assessments at Buckingham and Hemel Hempstead hospitals. A small proportion of people need laser treatment or surgery for glaucoma and we have facilities for these types of treatment at Stoke Mandeville and Wycombe hospitals.
Macular degeneration (age wear-and-tear change of the centre of the vision)
Macular degeneration is a common cause of difficulties with vision in later life. Many people with macular degeneration have it in a mild form and experience few problems, but some people have more serious problems such that they cannot see to read or drive. It does not cause complete blindness, however. The “dry” form of macular degeneration is the commonest form. There is no treatment for it at present, but it usually changes very slowly. The “wet” form of macular degeneration is less common but can cause the vision to deteriorate over a period of weeks. The warning sign is that the central vision becomes distorted (straight lines such as edges of window frames start to look wavy). The wet form of macular degeneration can often be treated if the central vision is not too badly damaged. Treatment may involve a series of injections or a special type of light treatment known as photodynamic therapy. The National Institute for Health and Clinical Excellence (NICE) provides guidance on the circumstances under which treatment can be provided under the NHS. Treatment is available at Stoke Mandeville and Amersham Hospitals under the leadership of Ms Consuela Moorman and Mr Kuan Sim. Where the vision cannot be improved with treatment, we can help people to make the best use of their vision with optical aids such as magnifiers and special lighting. Our hospital optometrists provide low vision clinics at Stoke Mandeville Hospital, Wycombe Hospital and in Hemel Hempstead.
Diabetic retinopathy
People with diabetes can sometimes develop problems with their eyes and this is more likely if they have had diabetes for a long time or if their diabetes is poorly controlled or if they also smoke. Although blindness from diabetic retinopathy is quite rare these days, it is still important to treat diabetic eye problems before they cause serious problems with the vision. There is a national programme for screening all diabetics for retinopathy which offers appointments for eye photographs annually. Buckinghamshire Healthcare’ eye department works closely with the diabetic retinopathy screening programmes for Buckinghamshire and West Hertfordshire. We assess people who are referred from the screening programmes, or by opticians who have been found to have diabetic retinopathy. Some diabetics require laser treatment to prevent problems with their vision. We offer treatment for diabetic eye problems at Stoke Mandeville, Wycombe and Hemel Hempstead hospitals.
Eyelid and tear-duct problems
We provide assessments and treatment for a wide variety of eyelid and tear-duct problems such as droopy eyelids, in-turning eyelids, watering eyes, eye problems caused by overactive thyroid glands, eyelid tumours, ingrowing eyelashes, styes and other eyelid swellings. Eyelid and tear duct surgery is performed at Wycombe and Stoke Mandeville hospitals, though minor eyelid surgery is also performed at Amersham and Hemel Hempstead hospitals. Most surgery is performed on an outpatient or day case basis, though an inpatient stay can be provided at Stoke Mandeville Hospital for the small proportion of people who require major procedures under a full anaesthetic
Vitreo-retinal service
We provide assessments and treatment for surgical problems of the retina such as detached retina, macular holes and epi-retinal membranes. Our two consultant vitreo-retinal surgeons, Mr Richard Bates and Mr Kaykhosrov Manuchehri conduct outpatient clinics at Stoke Mandeville, Milton Keynes and Hemel Hempstead hospitals. Operations on the retina are carried out at Stoke Mandeville hospital.
Detached retinas usually need surgical repair, but the urgency with which this needs to be carried out depends on the type and extent of retinal detachment. We aim wherever possible to schedule retinal detachment operations on day-time operating lists at Stoke Mandeville hospital, but at times of high demand, we occasionally need to refer people who require urgent retinal detachment surgery to other specialist units such as the John Radcliffe Hospital in Oxford, or Moorfields Eye Hospital in London.
Corneal disease
The cornea is the “front window” of the eye. Minor problems of the cornea are quite common and can be dealt with in our clinics at Stoke Mandeville, Wycombe, Amersham, Hemel Hempstead and Buckingham hospitals. More serious problems of the cornea such as inflammation or clouding require specialist treatment. Mr Nigel Cox conducts corneal clinics at Wycombe and Stoke Mandeville hospitals. Surgical procedures on the cornea such as corneal grafts are carried out at Stoke Mandeville hospital.
Keratoconus is an uncommon condition where the cornea becomes distorted. It usually affects teenagers and young adults. Most people with keratoconus can regain good vision with contact lenses and our hospital optometrists have special expertise in the fitting of contact lenses for this condition.
Squint, lazy eye and eye movement problems
A squint is when the two eyes do not point in the same direction. An adult whose eyes develop a squint will usually have double vision. Young children whose eyes are out of line usually do not notice double vision because their brains “switch off” the input from one eye. If this continues for some time, the vision may fail to develop in that eye, in which case it is referred to as an amblyopic or lazy eye. It is often possible to persuade a lazy eye to see better by patching the good eye for a length of time each day, but this only works up to the age of about 7. If an eye is still lazy beyond the age of 7 or 8, it will probably remain lazy into adult life. The treatment of squint and lazy eye also sometimes involves the prescription of glasses, or surgery to straighten the eyes.
Our orthoptists assess children with suspected squint or lazy eye at Stoke Mandeville, Wycombe, Amersham, Buckingham and Hemel Hempstead hospitals and also at a number of other locations such as community hospitals and certain GP surgeries in Buckinghamshire. The ophthalmologists also assess patients at the first five locations.
Surgery for squint usually requires a full anaesthetic, though it is normally possible to go home the same day.
Eye emergency services
Whilst the eye department is not able to cater for self-referrals, there is a facility for GPs, optometrists and hospital Accident and Emergency departments to make urgent referrals to the eye department. Emergency eye clinics are held daily (morning and afternoon) Monday to Friday at Stoke Mandeville hospital. In addition, urgent referral clinics are held once weekly each at Wycombe hospital and Amersham hospital. Outside normal working hours, eye emergency referrals are seen at Stoke Mandeville hospital.
Reasons for emergency referrals include: eye injuries, sudden loss of vision, severe eye infections or inflammation, or acute vision disturbances such as the sudden appearance of flashes or floaters in the vision.
Patients requiring emergency admission to hospital or emergency surgery for eye problems are normally admitted to the eye ward at Stoke Mandeville hospital.
Imaging, diagnostic and optometry services
The eye department has a comprehensive range of imaging and diagnostic facilities to support its specialist services. This includes retinal photography, fluorescein angiography, ocular coherence tomography (OCT), heidelberg retinal tomography (HRT), visual field analysis, ocular ultrasound, corneal mapping and wavefront analysis.
The visual electrodiagnostic service provides specialised tests of function of the eye and the brain such as electroretinography (ERG), visually-evoked cortical potentials (VECP) and electro-oculography (EOG). These tests are used to provide additional information in cases of suspected disorders of the retina or the part of the brain which serves vision. The service is provided on an outpatient basis at Stoke Mandeville hospital and is run by Mr David Sculfor (head of optometry) and Mr Richard Smith (consultant ophthalmologist).
The optometry service, led by Mr David Sculfor at Stoke Mandeville hospital and Mr Irfan Ahmed at Wycombe hospital undertakes sight testing and dispensing of spectacles for patients attending the hospital eye clinics including the fitting of spectacles for young children. It also includes the fitting of complex contact lenses (eg for keratoconus) and other optical appliances such as low vision aids.
Voluntary services
People who have significant problems with their sight may need medical treatment, but often they also need support and help to adjust to their condition, particularly if a cure is not possible.
BucksVision has offices within Trust eye clinics at Amersham, Wycombe and Stoke Mandeville hospitals and employs two Eye Clinic Liaison Officers (ECLOs) to offer emotional support for patients and their carers as well as providing practical information about local and national organisations. The Eye Clinic Liaison Officers work very closely with Trust staff and with Bucks Integrated Sensory Service (BISS). BuckVision supports both adults and children and offers a drop in service and an appointment system.
At Hemel Hempstead Hospital, the Hertfordshire Society for the Blind fulfils a similar valuable role.
We do NOT provide
- Laser treatment for short or long sight. This is not normally available on the national health service although some NHS hospitals such as Moorfields Eye Hospital and St Thomas’ Hospital in London have the necessary facilities and many years of experience in this type of treatment.
- Therapy for dyslexia and related difficulties with reading and spelling, such as the use of coloured filters or overlays.
Downloads
Listening to your views
Let us know your comments, compliments and complaints so that we can listen, learn and respond
Sign up to our newsletter
