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Treatment for cataract What are cataracts? Contact us to book an appointment Cataract surgery is one of the most common and safest procedures performed in the UK, with millions of successful surgeries worldwide each year. It’s a quick, effective way to restore clear vision and significantly improve your quality of life. Most patients still rely on glasses for near vision following cataract surgery. Premium lenses, including multifocal and extendend depth of focus (EDOF) lenses, can be used to remove or significantly reduce glasses dependence. Unfortunately most of these lenses are not available on the NHS. Mr Baneke offers a comprehensive array of treatments for patients with cataracts. These are described in more detail below. Cataract surgery Read More Multifocal lenses Read More Laser after cataract surgery Read More Cataract Surgery Scroll Down Clear Vision Ahead: Understanding Cataract Surgery If your vision has become cloudy or blurry, you might be dealing with a cataract. The good news? Cataract surgery is a highly effective procedure that can restore your sight, helping you see the world clearly again. How is Cataract Surgery Performed? Cataract surgery is usually a straightforward procedure that involves removing a cloudy lens and replacing it with a clear artificial lens. The most common technique used today is called “phacoemulsification". First your eye is made numb using drops or an anaesthetic injection. During the surgery, tiny incisions are made in the eye, and a small probe is used to break up the cloudy lens into smaller pieces. These pieces are then gently removed, and the eye is irrigated with water to keep it clean and comfortable. For most patients the operation takes 15 to 30 minutes. Once the cloudy lens is removed, it is replaced with a clear plastic lens that is carefully chosen to focus light correctly onto your retina, restoring clear vision. For most people, the new lens is selected to give good distance vision, which means you might still need glasses for close-up tasks like reading or using a computer. However, there are more advanced lenses available, such as toric lenses for correcting astigmatism, multifocal lenses, and extended depth of focus (EDOF) lenses, which can reduce or eliminate the need for glasses altogether. Unfortunately, most of these premium lenses are not available on the NHS. Cataract surgery results in excellent outcomes for the vast majority of patients. However, as with any operation, there are risks involved. A small minority of patients end up with worse vision after surgery, or need a second operation to improve the vision. Posterior capsular opacification can cause blurring following surgery: this can be fixed with a simple laser procedure (see below for further details). Some patients need a stronger glasses correction than expected. The risk of vision loss from a complication such as a severe infection or bleed is around 1 in 1000 cases. Read More about Lenses What to Expect After Cataract Surgery Cataract surgery is one of the most common and successful surgical procedures performed in the UK today, with the vast majority of patients experiencing significantly improved vision afterwards. Approximately 1 in 10 patients develop posterior capsule opacification (PCO) following cataract surgery, which can be treated with a simple laser procedure in clinic. Rare complications include a deterioration in your vision or a need for further surgery. Recovery is usually quick, and most people are able to return to their normal activities within a few days. In more complex cataract surgery it can take a few weeks for the vision to improve. Patients should avoid excessive bending and heavy lifting for the first month. Patient information videos Posterior Capsule Opacification During cataract surgery, your eye's natural lens is replaced with a clear artificial lens. The lens is held in place by a natural bag, which is left intact during the procedure. Sometimes the back of this bag can become cloudy over time. This common complication of cataract surgery is called posterior capsule opacification (PCO). Around 1 in 10 people experience it after cataract surgery and symptoms include blurred vision, streaks, and halos around lights. These symptoms can gradually worsen if left untreated. The good news is laser treatment is simple, straightforward and very effective. Read More about Laser after Cataract Surgery Patient Information Videos Multifocal Lenses Scroll Down Choosing the Right Lens for Your Vision: A Guide to Premium Lens Options If you're considering cataract surgery and want to reduce or even eliminate your need for glasses, premium lenses like Multifocal, Extended Depth of Focus (EDOF), and Toric lenses could be the perfect choice. These lenses offer fantastic results, but they may not be suitable for everyone. Let's explore what each option has to offer, so you can make the best decision for your vision. The Standard Option: Monofocal Lenses In standard cataract surgery, a monofocal lens is used. This type of lens focuses light at a single distance, most commonly for distance vision. With this choice, you'll likely need glasses for near tasks like reading or intermediate tasks like using a computer. Monofocal lenses are reliable and work well for many patients, but if you're looking to be less dependent on glasses, you might want to consider a premium lens. Multifocal Lenses Multifocal lenses are designed to focus light from a range of distances, potentially freeing you from the need for glasses altogether. These lenses are a great option if you prefer not to wear glasses, have a strong glasses prescription, and don’t have other eye conditions like glaucoma. However, there are some trade-offs: multifocal lenses can cause increased glare, halos, reduced night vision, and lower contrast sensitivity. They might not be the best choice if you do a lot of night driving or have high visual demands. Additionally, these lenses aren't always suitable for patients with astigmatism. It's also common to need a Yag laser capsulotomy after surgery with multifocal lenses, which is a simple procedure but might not be included in the initial surgery cost. Extended Depth of Focus (EDOF) Lenses EDOF lenses provide an extended depth of focus, offering clearer vision at multiple distances and reducing your reliance on glasses. These lenses are an excellent choice if you want to be independent of glasses for most tasks but don't mind using reading glasses occasionally for small print. EDOF lenses tend to cause fewer issues with glare, halos, and reduced night vision compared to multifocal lenses, though these effects can still occur to a lesser degree. Like multifocal lenses, EDOF lenses are not recommended for patients with advanced glaucoma, and you may need a Yag laser capsulotomy after surgery. Toric Lenses If you have astigmatism, Toric lenses could be a great option. They correct the uneven curvature of your cornea, which is shaped more like a rugby ball than a football. Toric lenses can significantly reduce your dependence on distance glasses if you have two or more dioptres of corneal astigmatism (your ophthalmologist can determine this for you). While these lenses increase your chances of achieving glasses independence for distance vision, it's important to note that in a small number of cases, the lens can rotate after surgery, requiring a follow-up procedure to reposition it correctly. Monovision Monovision is another strategy to reduce your dependence on glasses using standard monofocal lenses. This approach involves setting one eye for distance vision and the other for near or intermediate vision. While this can reduce your need for glasses, it does come with some downsides, such as a reduction in depth perception. Some people may find it difficult to adjust to the difference in prescription between their eyes. If you’re considering monovision, it's a good idea to test it out with contact lenses first, with one eye corrected for distance and the other for near vision. Even with monovision, you’ll likely still need glasses for tasks like reading small print. Restoring Your Vision After Cataract Surgery: Yag Laser Posterior Capsulotomy If you've had cataract surgery and your vision has started to blur again, you might be experiencing a common issue that can develop after the procedure, called "posterior capsular opacification". The good news is that a quick and painless laser treatment called Yag laser posterior capsulotomy can restore your clear vision in just a few minutes. Yag Laser: Why Do I Need This Treatment? During cataract surgery, your eye's natural lens is replaced with a clear artificial lens. The lens is held in place by a natural bag, which is left intact during the procedure. However, sometimes the back of this bag can become cloudy over time, leading to blurred vision, streaks, or halos around lights. These symptoms can gradually worsen if left untreated. What Does the Yag Laser Do? In the past, treating this cloudy bag required another trip to the operating theatre. Thankfully, modern technology allows us to quickly and safely remove the cloudy part with a Yag laser right in the clinic. The procedure is straightforward and usually painless. Here’s what to expect: Anaesthetic Drops: Before the treatment begins, numbing drops are applied to your eye to keep you comfortable. Laser Treatment: A special lens may be placed against your eye, and the Yag laser is used to create a small opening in the cloudy bag. This allows light to pass through clearly again, restoring your vision. Quick and Easy: The entire process takes just a few minutes, and most patients find it completely painless. After the treatment, you might be given a short course of steroid drops to help your eye heal. Your vision should improve rapidly, and you can return to your normal activities right away. Are There Any Risks? Yag laser posterior capsulotomy is a very safe procedure, but as with any surgery, there are some risks to be aware of. You might notice new floaters or spots in your vision afterwards. In rare cases, the lens could be damaged, leading to "pitting," or you might experience a more serious complication like retinal detachment or fluid buildup in the retina (cystoid macular oedema), which could affect your vision. There’s also a chance your eye pressure could rise temporarily. While these risks are rare, it’s important to discuss any concerns with your eye specialist, who will ensure you’re fully informed and prepared for the procedure.

Glaucoma Treatment What is glaucoma? Contact us If you've been diagnosed with glaucoma it's important to know that the most effective treatments focus on reducing eye pressure, which is key to slowing the progression of the condition. There are several ways to lower eye pressure including medications, laser treatments and surgical options. With the right treatment plan we can help protect your vision and manage your glaucoma effectively. Scroll to learn more Eye drops and tablets for Glaucoma Eye drops Tablets Surgical Treatments for Glaucoma Trabeculectomy Tube Surgery Preserflo MIGS Laser Treatments for Glaucoma Selective Laser Trabeculoplasty (SLT) Cyclodiode Yag peripheral iridotomy (PI) EYE DROPS AND TABLETS Scroll Down Understanding Your Glaucoma Medications: Eye drops On this page... Latanoprost (Xalatan™), Travoprost (Travatan™), Bimatoprost (Lumigan™) Timolol (Timoptol™, Tiopex™), Betaxolol (Betoptic™) Pilocarpine Dorzolamide (Trusopt™), Brinzolamide (Azopt™) Brimonidine (Alphagan™), Apraclonidine (Iopidine™) Latanoprostene bunod (Vyzultar™), Netarsudil (Rhokiinsa™), Latanoprost and Netarsudil (Roclanda™) When it comes to managing glaucoma, reducing eye pressure is key to slowing the progression of the condition. There are several treatment options available, including eye drops, tablets, and even some newer treatments. Here's a guide to help you understand the different medications used in glaucoma treatment and what to expect from each. An expert guide: How to Apply Eye Drops Step 1: Shake the bottle well. Step 2: Tilt your head back, pull down your lower eyelid with one hand, and hold the bottle with your other hand resting on your forehead or nose. Step 3: Place a drop into your eye. Step 4: If you're not sure the drop went in, it's okay to try again. Step 5: After applying the drop, close your eyes and press gently between your lower eyelid and nose for 1-2 minutes. This helps prevent the medication from draining into your nose and throat, which can reduce side effects. Step 6: Wait 5 minutes between applying different drops. Some people struggle to administer their own eye drops. Dispensers like the one below can sometimes help. Opticare Eye-Drop Dispenser Eye Drops: Your First Line of Defence Most patients with glaucoma will be treated with eye drops. With many different types available, it can be a bit confusing to know which one is right for you. Each type of drop works to lower eye pressure, but the effectiveness and side effects can vary from person to person. Some drops are also available in preservative-free formulations, which may be helpful if you have dry eyes or wear contact lenses. Prostaglandin Analogues Prostaglandin analogues such as Latanoprost (Xalatan™), Travoprost (Travatan™), and Bimatoprost (Lumigan™), are highly effective at reducing eye pressure, often by around 30%. These drops are frequently the first line of treatment. They work by increasing fluid outflow from the eye. Common side effects include mild stinging, eye redness, and increased eyelash growth. In some cases, they can cause changes in eye colour and fat loss around the eyes. Bimatoprost may be slightly more effective at reducing your eye pressure but comes with a higher chance of side effects. Beta-blockers Beta-blockers like Timolol (Timoptol™/Tiopex™) and Betaxolol (Betoptic™) reduce fluid production in the eye and can also increase fluid outflow. They are slightly less effective than prostaglandin analogues but have fewer aesthetic side effects. Cholinergic agonists Cholinergic agonists, like Pilocarpine , help by constricting the pupil and increasing fluid outflow. They’re usually used in emergencies and can cause headaches and reduced night vision. Carbonic anhydrase inhibitors Carbonic anhydrase inhibitors include drops like Dorzolamide (Trusopt™) and Brinzolamide (Azopt™) . These medications reduce fluid production in the eye and can lower pressure by around 20%. Side effects may include stinging, redness, and a metallic taste. In rare cases, they can affect your blood cells. Alpha-agonists Alpha-agonists, such as Brimonidine (Alphagan™) and Apraclonidine (Iopidine™) , lower fluid production and increase fluid outflow. They can cause redness, itching, and dry mouth. Some patients may develop conjunctivitis (a bright red, itchy, watery eye), which means the drops need to be stopped. It's also important to avoid using these if you're on certain antidepressants like amitriptyline. New options Newer options include nitric oxide donating prostaglandins such as Latanoprostene bunod (Vyzultar™) , which are similar to prostaglandin analogues but also increase fluid outflow through the eye's internal drainage system. Rho-kinase/ norepinephrine transport inhibitors, like Netarsudil (Rhokiinsa™) or the combination of Latanoprost and Netarsudil (Roclanda™) , are new drugs that work by several mechanisms to reduce eye pressure. Roclanda became available in the UK in 2024. These newer drugs may cause side effects like eye redness and increased watering. Prostaglandin analogues Beta blockers Pilocarpine Carbonic anhydrase alpha agonists New meds Anchor 1 Understanding your Glaucoma Medications: Tablets If you’re considering any tablet-based treatments, it’s crucial to have a detailed discussion with your eye specialist to ensure it’s the best option for your specific situation and health conditions. Acetazolamide Tablets (Diamox™) Acetazolamide (Diamox™) is a carbonic anhydrase inhibitor, similar to certain eye drops used in glaucoma treatment. It's very effective at reducing eye pressure, but because of its potential side effects, it’s typically used only for short periods, such as when your eye pressure is particularly high or while you're waiting for surgery. Acetazolamide is available in both regular and slow-release (SR) formulations, and there's little difference in their effectiveness, so either can be used depending on your needs. Side Effects of Acetazolamide While Acetazolamide is effective, it can cause some side effects. Commonly, you might experience dizziness, tiredness, tingling in the fingers, and increased urination. In rare cases, it may lead to changes in your blood cells or worsen kidney stones. It’s particularly important to avoid or use a lower dose of Acetazolamide if you have sickle cell anaemia, kidney stones, or severe kidney or liver disease. The medication can also reduce potassium levels, so you might be advised to consume high-potassium foods or drinks, such as a banana, a serving of spinach, or a glass of tomato juice, with each tablet. In some cases, your doctor may prescribe Sando-K potassium supplement tablets to take alongside Acetazolamide. Nicotinamide There is ongoing research investigating whether oral nicotinamide tablets - at a dose of 1.5g daily for 6 weeks followed by 1.5g twice daily - may slow glaucoma progression. Nicotinamide does not reduce eye pressure but may slow glaucoma progression via a different mechanism: improving mitochondrial function. Rarely, nicotinamide may reduce liver function, so patients are advised to check their liver function blood tests 2-3 months after starting treatment and yearly while treatment continues. As trials on nicotinamide are ongoing, it is not currently recommended as a treatment by most glaucoma specialists. Side Effects of Nicotinamide Nicotinamide may not be suitable for everyone. It is contraindicated if you have impaired liver function, are pregnant, have a history of cancer, or are taking certain medications such as doxycycline, isoniazid, pyrazinamide, or carbamazepine. If you fall into any of these categories, it’s important to discuss this with your doctor before considering nicotinamide as part of your treatment plan. SURGICAL TREATMENT Scroll Down Surgical Treatment for Glaucoma: What You Need to Know If you’ve been diagnosed with glaucoma, and other treatments haven't sufficiently controlled your eye pressure, your doctor may recommend surgery. One of the most common surgical procedures for glaucoma is a trabeculectomy. This surgery aims to lower the pressure inside your eye to prevent further damage to your optic nerve and preserve your vision. It’s important to know that while trabeculectomy can help stop or slow down vision loss, it won’t improve your vision from its current level, and your vision might temporarily worsen before it stabilises. Trabeculectomy surgery is a highly effective option for reducing eye pressure and slowing the progression of glaucoma for most patients. While it won’t improve your current vision, it can help prevent further vision loss and reduce your need for eye drops. As with any surgery, there are risks involved, but with careful monitoring and follow-up, most patients achieve good outcomes. Trabeculectomy Surgery Trabeculectomy surgery works by creating a new pathway for fluid to drain out of the front part of your eye (the anterior chamber). During the procedure, your surgeon creates a small “trap door” in the wall of your eye (the sclera). This allows fluid to flow into a tiny reservoir called a “bleb,” which is located under the conjunctiva—the thin, clear tissue that covers the white of your eye. After the operation, you might notice a small blister-like bump on the top of your eye when you look in the mirror. The trap door is carefully closed with stitches that can be adjusted after surgery to control the flow of fluid and the pressure inside your eye. The conjunctiva is also stitched, and these stitches are usually removed about a month after the operation. To help prevent the trap door from scarring and closing, an anti-scarring agent called mitomycin C is applied during the surgery. How Successful is Trabeculectomy? Trabeculectomy is successful in about 7 to 8 out of 10 patients. However, about 1 in 20 patients may need to return to the operating theatre for an adjustment in the months following the initial surgery. Vision can reduce immediately after surgery before stabilising. The risk of a sight-threatening complication is around 1 in 200 patients. Serious complications include infection, bleeding, or very low eye pressure. A serious infection called blebitis can occur at any time after surgery, so it’s crucial to seek immediate medical attention if your eye becomes increasingly red, sticky, or painful. After trabeculectomy surgery, approximately 1 in 3 patients develop a cataract within two years, and your glasses prescription could change. You should wait three months after surgery before getting a new prescription from your optician and avoid using contact lenses during this time. Additionally, 1 in 20 patients may develop a droopy eyelid as a result of the surgery. In very rare cases, the eye can become persistently uncomfortable, which may require further surgery to correct. What to Expect on the Day of Surgery On the day of your trabeculectomy, plan to spend several hours in the hospital. After checking in, you’ll be taken to the operating theatre, where a sterile blue drape will be placed over your face, and your eye will be cleaned with iodine. An oxygen tube will provide oxygen under the drape. You’ll receive a local anaesthetic, which involves an injection around the eye. If you’re having a local anaesthetic, you can eat and drink as normal on the day of surgery. Some patients find it helpful to take a mild sedative, such as diazepam, to relax during the procedure. If you do opt for sedation, it’s important to have a friend or relative accompany you home. The operation itself takes about an hour, and you should not feel any pain. However, if you start to feel uncomfortable, let your surgeon know so that more anaesthetic can be administered. After Surgery: Recovery and Care Most patients go home the same day after surgery. It’s a good idea to have someone accompany you home, especially if you’ve had general anaesthetic, sedation, or have poor vision in your other eye. You’ll need to clean your eye when you remove the dressing the next morning—simply wash your hands and use cooled boiled water on a clean cotton pad to do this. For the first month after surgery, avoid swimming, bending, and heavy lifting. You can wash your hair a few days after surgery, but take care to avoid getting water in your eye. If you have help at home, consider washing your hair backwards over a sink. You’ll be given an eye shield to wear at night for the first 2 to 4 weeks. Most patients need 2 to 3 weeks off work, and it’s important to avoid contact sports. In the future, always wear protective goggles when playing ball sports. Your eye may be red, uncomfortable, and slightly swollen after surgery, and your eyelid might droop. In most cases, these symptoms will improve over time. However, if you experience increasing redness, pain that doesn’t improve with paracetamol, significant blurred vision, or a sudden very watery eye, seek urgent care at an eye casualty. Surgical Treatment for Glaucoma: Understanding Tube Surgery If you're dealing with glaucoma and other treatments haven't effectively managed your eye pressure, tube surgery might be recommended. This procedure is designed to lower the pressure inside your eye, helping to slow down or stop the progression of vision loss. While tube surgery won’t improve your current vision, it can be an important step in preserving the vision you still have. Here’s what you need to know about this surgical option. Tube surgery is a highly effective option for reducing eye pressure and slowing the progression of glaucoma. It is especially suitable for patients who have complex glaucoma or who have had previous surgery. While it won’t improve your current vision, it can help prevent further vision loss and may reduce your need for eye drops. As with any surgery, there are risks involved, but with careful monitoring and follow-up, most patients achieve good outcomes. For more information, please click here to access a presentation, including a video of a Paul™ tube surgery being performed (please note that this is a video of surgery on a real patient, which some individuals might find challenging to watch). Tube Surgery Tube surgery involves inserting a small tube, usually about half a millimetre in diameter, into the front chamber of your eye. This tube is attached to a soft plastic or silicone plate, which is positioned about 1 centimetre behind the cornea (the clear front part of the eye). The plate sits between or under the muscles that move your eye, and the tube drains fluid from the eye into a small reservoir known as a “bleb.” The bleb, which lies over the tube plate, helps to reduce scarring. This makes tube surgery particularly useful for eyes that are more prone to scarring, such as those that have already undergone multiple operations. The tube is covered with a patch made from donor tissue, typically from the pericardium (the sac surrounding the heart). Because donor tissue is used, you won’t be able to donate blood following tube surgery. There is a very small theoretical risk of infections that cannot be screened for, although this risk is extremely low. After the operation, you may notice a small raised area under your eyelid and a whitish patch next to the cornea when looking in the mirror. These changes usually become less noticeable over time. Types of Tubes There are different types of tubes used in this surgery, including Paul™, Baerveldt™, and Ahmed™ tubes. They all work in a similar way, but there are some differences in how they manage fluid flow. For example, the Ahmed™ tube has a built-in valve that controls the flow of fluid, so stitches aren’t needed to regulate pressure. However, some studies suggest that the Baerveldt™ tube might be slightly more effective at reducing eye pressure than the Ahmed™ tube. In Paul™ and Baerveldt™ tubes, stitches are often used to control fluid flow initially and are usually removed about 2-3 months after surgery. Success Rates and Risks Tube surgery is successful in about 7 out of 10 patients. However, about 1 in 20 patients may need to return to the operating theatre for an adjustment within a few months of the initial operation. The risk of a complication that could permanently damage your vision is about 1 in 200. Potential serious complications include tube exposure, infection, bleeding, corneal failure (which may require a corneal transplant), and problems with either high or low eye pressure. A serious infection called blebitis can occur at any time after surgery, so it’s crucial to seek immediate medical attention if your eye becomes red, sticky, or painful. You might develop a cataract after tube surgery, and your glasses prescription could change. It’s best to wait about three months after the operation before getting a new prescription from your optician. You should also avoid using contact lenses during this time. Approximately 1 in 20 patients may experience a droopy eyelid after surgery, and because the tube plate is placed near or under the eye muscles, some patients may experience double vision. In most cases, this double vision resolves within 3-6 months. What to Expect on the Day of Surgery On the day of your operation, you can expect to spend several hours in the hospital. After arriving on the ward, your details will be checked, and you’ll be taken to the operating theatre. A sterile blue drape will be placed over your face, and your eye will be cleaned with iodine. You’ll receive a local anaesthetic, which involves an injection around the eye. If you’re having local anaesthetic, you can eat and drink as normal on the day of surgery. A mild sedative, such as diazepam, may also be given, as the operation can take some time. Some surgeons prefer to perform tube surgery under general anaesthetic or with stronger sedatives administered through a vein. If this is the case, your anaesthetist may ask you not to eat on the day of the operation and to only drink clear fluids until two hours before the surgery. The operation itself typically takes about one to one and a half hours. You shouldn’t feel any pain during the procedure, but if you start to feel uncomfortable, let your surgeon know so they can administer more anaesthetic. After Surgery: Recovery and Care Most patients go home the same day after surgery. It’s important to have someone accompany you home. The morning after surgery, you may need to clean your eye. Wash your hands and use cooled boiled water on a clean cotton pad to do this. For the first month, avoid swimming, bending, and heavy lifting. You can wash your hair a few days after surgery, but take care to avoid getting water in your eye. If you have help at home, you can wash your hair backwards over a sink. You’ll need to wear an eye shield at night for the first 2 to 4 weeks after surgery. Most patients need 2-3 weeks off work. It’s important to avoid contact sports and to wear protective goggles when playing any ball sports in the future. Your eye will be more vulnerable after the operation. Initially, it may be red, uncomfortable, and slightly swollen, and your eyelid might droop. In most patients, the appearance of the eye returns to normal in the months following surgery. However, if you notice increasing redness, pain that doesn’t improve with paracetamol, or significant blurred vision, seek urgent care at an eye casualty. Understanding Preserflo™ Surgery for Glaucoma If you’re living with glaucoma, you know how important it is to manage the pressure inside your eye to protect your vision. Preserflo™ surgery is one option that may help reduce this pressure, slowing down or even stopping further damage to your visual field. While Preserflo™ won’t improve your current vision, it can be a crucial step in preserving what you have. Here’s everything you need to know about this procedure. Preserflo™ surgery is a promising option for reducing eye pressure and slowing the progression of glaucoma. While it won’t improve your current vision, it can help preserve what you have and may reduce your need for regular eye drops. Although there’s less evidence supporting Preserflo™ compared to trabeculectomy, many surgeons now prefer it due to its similar success rate, fewer variables, shorter procedure time, and potentially lower risk of serious complications. For more information, you can explore the following resources: EyeWiki: Preserflo™ Ab-Externo MicroShunt Video: Preserflo™ Surgery in a Real Patient (Please note this is a surgical video which some individuals may find challenging to watch) Preserflo™ Surgery Preserflo™ surgery involves inserting a small tube, known as the Preserflo™, into the front chamber of your eye. This tube drains fluid into a reservoir, called a “bleb,” which forms under the conjunctiva—the delicate skin covering the white part of your eye. After the operation, you might notice a shallow blister at the top of your eye when you look in the mirror. The bleb created during Preserflo™ surgery is usually positioned further back and is shallower than the one formed during trabeculectomy surgery. This positioning often makes it less visible, making Preserflo™ a good option for patients who wear contact lenses. Unlike traditional tube surgeries, the Preserflo™ tube is smaller (about 1/3 of a millimetre in diameter) and does not require a plate or stitches to control fluid flow. This can make the procedure quicker and potentially more comfortable during recovery. Success Rates and Risks Preserflo™ surgery is relatively new, and while there’s less long-term evidence compared to other procedures like trabeculectomy, early results are promising. Success rates from studies suggest that Preserflo™ is effective in 5 to 8 out of 10 patients. A minority of patients experience low eye pressure after surgery, which might require injections of a gel into the front chamber of the eye, or a follow-up procedure to place a stitch in the Preserflo™ to increase the pressure. Serious complications are rare but can include infection, bleeding, corneal failure (which might require a corneal transplant), and high or low eye pressure. The risk of a complication that could permanently damage your vision is around 1 in 250. A serious infection called blebitis can occur at any time after surgery, so it’s important to seek immediate medical attention if your eye becomes increasingly red, sticky, or painful. You may develop a cataract after surgery, and your glasses prescription could change. It’s best to wait three months before getting a new prescription from your optician. If you’re a contact lens wearer, discuss this with your surgeon as some patients may be advised not to wear them post-surgery. About 1 in 20 patients develop a droopy eyelid, and in rare cases, the eye can become persistently uncomfortable, which may require further surgery to correct. What to Expect During and After Surgery On the day of your surgery, you’ll spend several hours in the hospital. After arriving on the ward, your details will be checked, and you’ll be taken to the operating theatre. A sterile blue drape will be placed over your face, and your eye will be cleaned with iodine. You’ll receive a local anaesthetic, which involves an injection around the eye. If you’re having local anaesthetic, you can eat and drink as normal on the day of surgery. Some patients also opt for a mild sedative, such as diazepam, to help them relax during the procedure. If you choose sedation, a friend or relative should accompany you home. The operation itself takes about 45 minutes. You shouldn’t feel any pain, but if you do start to feel uncomfortable, let your surgeon know so they can top up your anaesthetic. After surgery, most patients go home the same day. It’s important to have someone accompany you, especially if you’ve had general anaesthetic, sedation, or have poor vision in your other eye. The morning after surgery, you may need to clean your eye—simply wash your hands and use cooled boiled water on a clean cotton pad. For the first month, avoid swimming, bending, and heavy lifting. You can wash your hair a few days after surgery, but take care to avoid getting water in your eye. If you have help at home, you can wash your hair backwards over a sink. You’ll need to wear an eye shield at night for the first 2 to 4 weeks after surgery. Most patients need 2 to 3 weeks off work. It’s also important to avoid contact sports and wear protective goggles when playing any ball sports in the future. Exploring Minimally Invasive Glaucoma Surgery (MIGS) If you’re managing glaucoma, there are several surgical options available to help lower the pressure in your eye and protect your vision. Minimally Invasive Glaucoma Surgery (MIGS) is a newer category of procedures that have gained popularity in recent years due to their lower complication rates and the fact that they can often be performed quickly, often alongside cataract surgery. However, it’s important to know that while MIGS can be effective, the evidence supporting these procedures isn’t as strong as that for more established surgeries like trabeculectomy or tube surgery. MIGS offers a less invasive approach to managing glaucoma, with the potential for lower complication rates and quicker recovery times. However, the evidence supporting these procedures is still evolving, and they may not be suitable for everyone. Discussing your options with your eye specialist will help you determine if MIGS is the right choice for you. For more detailed information, you can explore the following resources (please note they are designed for use by health professionals): Hydrus™ Overview Miniject™ Information Cochrane Reviews on MIGS Minimally Invasive Glaucoma Surgery (MIGS) MIGS, or Minimally Invasive Glaucoma Surgery, refers to a range of procedures that aim to lower eye pressure using various methods, typically without creating a reservoir (or “bleb”) under the conjunctiva, as is done in more traditional glaucoma surgeries. The procedures can be grouped into three main categories: Trabecular Bypass Devices: These devices, such as iStent™ and Hydrus™, bypass the eye’s natural drainage system (the trabecular meshwork) to improve fluid flow into the second part of the drain, known as Schlemm’s canal. Trabecular Meshwork Excision Devices: Devices like the Kahook™ Dual Blade, Trabectome and Omni , remove or cut the trabecular meshwork to enhance fluid drainage into Schlemm’s canal. Suprachoroidal Drainage Devices: These devices, including Miniject™ , drain fluid from the front chamber of the eye into the deeper tissues of the eye (the suprachoroidal space). Another device, Cypass™ , was previously used for this purpose but has been withdrawn from the market due to safety concerns. What Do We Know About the Effectiveness of MIGS? The effectiveness of MIGS varies depending on the specific device used, and the overall evidence supporting these procedures is still developing. Most specialists recommend that these procedures should not be used for patients with advanced glaucoma. The aim of MIGS is usually to reduce the number of eye drops needed to control early or mild disease. Almost all evidence on these devices relates to patients with Primary Open Angle Glaucoma (POAG), not other types of glaucoma. Here’s a summary of what we know: Hydrus™: There is limited evidence suggesting that combining cataract surgery with a Hydrus™ implant may reduce the need for intraocular pressure-lowering medication and further reduce eye pressure compared to cataract surgery alone, especially in patients with mild to moderate open-angle glaucoma. Hydrus™ may be more effective than iStent™ in these cases. iStent™: The evidence for iStent™ is less robust than for Hydrus, with lower-quality studies suggesting it may help some patients achieve better control of their eye pressure and reduce their reliance on eye drops. However, there is variability in the reported complications, and more high-quality research is needed. Trabectome and Omni: Some single arm studies have shown promising results, but currently there is no strong evidence supporting the effectiveness of Trabectome or Omni in treating open-angle glaucoma. Cypass™: While early trials showed that Cypass™ could help patients achieve medication-free control of glaucoma, long-term concerns about damage to the cornea led to its withdrawal from the market. Miniject™: The Miniject™ device is designed to work similarly to Cypass™ but without the associated risks of corneal damage. Early trials are promising, and suggest Miniject™ may reduce eye pressure by 35-40% and eliminate the need for eye drops in about half of patients. However, these trials were funded by the manufacturer and did not have a control group. Further independent research is needed to confirm these results and to ascertain the risks involved in surgery. What to Expect During and After MIGS These operations are usually performed alongside cataract surgery. The surgery typically takes less time than more invasive glaucoma surgeries, and most patients can go home the same day. After surgery, you’ll need to follow specific care instructions to help your eye heal properly. This includes using prescribed eye drops, avoiding heavy lifting, and wearing an eye shield at night for a few weeks. You’ll have follow-up appointments to monitor your recovery and make any necessary adjustments. Fewer follow up appointments are usually needed compared with traditional glaucoma surgery. As with any surgery, there are risks involved, which can include worse or even loss of vision, so it’s important to report any unusual symptoms to your doctor right away. LASER TREATMENT Scroll Down SLT Yag PI Laser Treatments for Glaucoma: Your Guide If you’re living with glaucoma, you know how crucial it is to manage the pressure in your eye to prevent further damage to your vision. Laser treatments offer effective ways to reduce eye pressure, often as a complement or alternative to eye drops and surgery. Here’s a guide to understanding the different laser options available for treating glaucoma. Laser treatments for glaucoma, including SLT, Yag PI, and Cyclodiode, offer valuable options for reducing eye pressure and protecting your vision. While each procedure has its benefits and risks, they are generally safe and can be highly effective in managing glaucoma. Your eye specialist will help you determine the best treatment option based on your individual needs and the stage of your glaucoma. For more information on Yag PI, please see the animated video explaining the procedure: Yag PI Laser Treatment Video . Selective Laser Trabeculoplasty (SLT) Selective Laser Trabeculoplasty (SLT) is a relatively straightforward laser treatment that can help reduce eye pressure. It’s often used as an alternative to, or in addition to, eye drops. SLT works for around 7 out of 10 patients and can keep eye pressure lower for up to 5 years. It tends to work best in patients with high pressures who have not already been treated with multiple eye drops. For this reason, it is often recommended as an initial treatment. If needed, it can be repeated. SLT uses short pulses of low-energy light to target melanin-containing cells in the trabecular meshwork, which is the part of your eye responsible for fluid drainage. This laser treatment activates cells called macrophages, which help remodel the trabecular meshwork and improve fluid outflow. On the day of your SLT treatment, your eyes will be numbed with anaesthetic drops, which may cause temporary blurring and a mild headache. The laser procedure is quick, taking about 5-10 minutes per eye, and is performed on a machine similar to the one used in routine eye exams. After the procedure, you might need to wait for an hour to have your eye pressure re-checked, and you’ll be given drops to use for up to a week. The laser may take up to 6 weeks to fully take effect, so you’ll have a follow-up appointment around that time to check your eye pressure. Although SLT is generally safe, it’s still surgery, so there’s a small risk of complications such as temporary blurred vision, mild headaches, or a slight rise in eye pressure. In rare cases, inflammation or persistent blurred vision may occur, but these are usually manageable. Yag Laser Peripheral Iridotomy (PI) Yag Laser Peripheral Iridotomy (PI) is a laser treatment primarily used for patients with angle-closure glaucoma or those at risk of developing it due to a narrow drainage angle in the eye. This procedure involves creating a tiny hole in the iris (the coloured part of the eye) to open up the drainage angle and reduce the risk of pupil block, which can lead to increased eye pressure. Yag PI helps lower the risk of developing or worsening angle-closure glaucoma, though it doesn’t eliminate the risk entirely. In some cases, cataract surgery may be a better option, particularly for patients over 50, as it provides more space for fluid to drain and can be more effective than Yag PI. However, younger patients might want to avoid cataract surgery due to the loss of near-focus ability and higher complication risks compared to Yag PI. The procedure itself is quick and usually requires one or two visits to the laser room. You’ll receive anaesthetic drops and a contact lens will be placed on your eye to help focus the laser. Some patients might feel slight pressure or mild pain during the procedure, and temporary blurring is common afterwards, usually clearing by the next day. Yag PI is a very safe procedure, but like any surgery, there are potential risks. These include a temporary rise in eye pressure, slight blurring or ghosting of images, and very rarely, inflammation, bleeding, or damage to the retina. Your doctor will discuss whether Yag PI is right for you based on your specific risk factors. Cyclodiode Laser Treatment Cyclodiode is a laser treatment used primarily for reducing eye pressure in advanced or end-stage glaucoma, particularly when other treatments haven’t been successful. It’s performed in an operating theatre, and a strong local anaesthetic injection is given around the eye before the laser is applied over the sclera (the white part of the eye). Cyclodiode works by damaging the ciliary body, the part of the eye that produces aqueous fluid. By reducing fluid production, this treatment lowers eye pressure. Traditionally, Cyclodiode was reserved for end-stage glaucoma because of the potential for severe damage to the ciliary body and the eye itself. However, newer techniques, using lower doses or micropulse diode, have made it possible to use Cyclodiode earlier in the disease process with a lower risk of complications. While Cyclodiode can be an effective treatment, it’s still primarily used for patients with significant vision loss or those whose glaucoma hasn’t responded to other surgeries. Cyclodiode

Patient information These pages are designed to provide evidence-based, straightforward guidance to help you understand your condition and the best treatment options available. Understanding Glaucoma What is Glaucoma? Understanding Intraocular Pressure Glaucoma risk factors "why me?" The different types of Glaucoma Living with Glaucoma Glaucoma Treatment Guide Eye drops and tablets A guide to surgical treatments Laser treatments Cataracts What are cataracts? A guide to cataract surgery A guide to lenses Laser after cataract surgery Other topics Dry eyes and blepharitis Services in Essex

Mr Alex Baneke MA (Oxon) MBBS FRCOphth Consultant eye surgeon specialising in the treatment of glaucoma and cataract NHS & Private Care Southend University Hospital, Southend Private Hospital & Orsett Hospital CONTACT FOR A CONSULTATION Welcome. Sharing expertise, guarding your vision. Welcome to the website of Mr Alex Baneke, an Ophthalmic Surgeon and Doctor based in Essex specialising in the treatment of glaucoma and cataracts. Whether you're seeking expert guidance on managing your condition, understanding medication, or exploring the latest treatment options, this site is your comprehensive resource. Discover a wealth of information tailored to help you navigate the journey towards better eye health with confidence and clarity. EXPLORE: PATIENT INFORMATION Expert care Mr Baneke trained at the world-leading Moorfields Eye Hospital. He now runs fellowships to train other eye surgeons in the management of glaucoma and cataract surgery. His research into glaucoma and other conditions has been published internationally. Specialist in complex surgery Mr Baneke is a specialist in managing complex glaucoma and is often referred patients in whom previous surgery has failed. He uses tried and tested surgical techniques with the strongest evidence base behind them. Read More about Mr Baneke

A Guide for Patients Understanding Glaucoma: An Introduction Glaucoma is a condition that damages the optic nerves, leading to a gradual reduction in your field of vision. Since this damage usually happens slowly, most people with glaucoma don’t realise there’s a problem until they’ve already lost a significant amount of vision. The good news is that with proper treatment, most patients with glaucoma do not go blind. Glaucoma is a manageable condition with early detection and appropriate treatment. By lowering eye pressure through eye drops, laser treatment, or surgery, it’s possible to slow the progression of the disease and protect your vision. Always discuss with your eye specialist which treatment options are best suited for your specific needs. What Causes Glaucoma? The main risk factors for glaucoma are increased eye pressure and age. The goal of treatment is to reduce eye pressure, which can significantly slow down the progression of the disease. Read More about Risk Factors and Prevention Advanced Treatment Options For more advanced glaucoma, surgical options may be necessary. These include: Trabeculectomy: A traditional surgical procedure that helps to lower eye pressure by creating a new drainage pathway for the eye fluid. Preserflo™ : A newer surgical option that also helps to reduce eye pressure with fewer potential complications than traditional surgery. Tube Surgery: This involves placing a small tube in the eye to help drain fluid and lower eye pressure. Additionally, there are various devices available under the category of "Minimally Invasive Glaucoma Surgery" (MIGS) , such as the Miniject™. These devices generally cause fewer complications than more traditional surgeries, but it’s important to note that many of them still lack strong evidence to fully support their long-term effectiveness. Read More How is Glaucoma Treated? Treatment for glaucoma typically begins with eye drops or laser therapy. Eye Drops: The most commonly prescribed eye drop in the UK is latanoprost. This medication reduces eye pressure by around 30% in most patients by increasing the flow of fluid out of the anterior chamber of the eye. Latanoprost is generally well tolerated, but it can cause some side effects such as slight redness, stinging, and increased eyelash growth. Laser Treatment: For initial laser treatment, Selective Laser Trabeculoplasty (SLT) is a safe and effective option for people with open-angle glaucoma. SLT works in about 70-80% of patients and can help control eye pressure for up to 5 years, potentially avoiding the need for eye drops. Read More TYPES OF GLAUCOMA AVAILABLE TREATMENTS CONTACT TO BOOK

A Guide for Patients Understanding Cataracts Cataracts are a common eye condition that can make your vision cloudy and blurry, much like looking through a foggy window. As we age, the proteins in our eye’s natural lens can start to change, leading to the formation of cataracts. If you’ve noticed your vision becoming less clear, particularly in low light or when driving at night, it might be due to cataracts. The good news is that cataract surgery is a highly successful procedure that can restore clear vision. What Exactly is a Cataract? A cataract happens when the normally clear lens inside your eye becomes cloudy. The word "cataract" actually comes from the Latin word for waterfall, "cataracta," because the cloudiness can resemble the appearance of water cascading down. Cataracts typically develop slowly over time, so you might not notice them at first. As they progress, you may find it harder to see clearly, especially in low light or when facing bright lights, such as headlights at night. Colours might appear duller, and you might struggle to distinguish contrasts as well as you used to. Most cataracts are simply a part of getting older, and they’re not usually linked to other diseases. However, certain factors can cause cataracts to develop earlier in life, such as diabetes, eye injuries, or the use of steroid eye drops. NHS CATARACT INFORMATION How is Cataract Surgery Performed? Cataract surgery is a procedure that involves removing the cloudy lens and replacing it with a clear artificial lens. The most common technique used today is called “phacoemulsification.” During the surgery, tiny incisions are made in the eye, and a small probe is used to break up the cloudy lens into smaller pieces. Once the cloudy lens is removed, it’s replaced with a clear plastic lens that is carefully chosen to focus light correctly onto your retina, restoring clear vision. More about cataract surgery More about different lenses

Contact Us Contact us to arrange a private consultation: 07398 997 592 / 01702 667 819 info@glaucomatreatment-ab.co.uk NHS referrals via your GP or optician Southend University Hospital 01702 435 555 Consulting rooms: Southend Private Hospital 15-17 Fairfax Drive Westcliff-on-Sea, Essex SS0 9AG 01702 667 819 Orsett Hospital, Rowley Road, Orsett, Grays RM16 3EU 01268 524 900

Living with Glaucoma For most people, glaucoma is a slowly progressing condition, and with the right treatment, many won’t notice a significant change in their vision. While glaucoma can cause some challenges, the good news is that most patients will not go blind. However, it’s important to be aware of how glaucoma can affect your daily life, especially as it progresses. In this guide, we’ll explain what it’s like to live with glaucoma, the impact on driving, and the support services available to help you. Visual Field Loss Glaucoma primarily affects your peripheral vision, but in the early stages, many people won’t notice any changes. This is because the visual field loss often happens gradually, and one eye can compensate for the other. Additionally, the brain has an amazing ability to “fill in” gaps in your vision, meaning you might not realise you have any problems until the disease has advanced. Driving and Glaucoma Driving with glaucoma depends on how your visual field is affected. If you have glaucoma in one eye but normal vision in the other, you don’t need to inform the DVLA for car or motorbike licences. However, if both eyes are affected, or if one eye has glaucoma and the other is affected by a different condition, you must inform the DVLA and take a special visual field test for driving called the Esterman test. This test is done with both eyes open, and most people find it easier than the routine visual field tests performed in clinics. Fortunately, about 9 out of 10 people pass the Esterman test. If you don’t inform the DVLA and are involved in an accident, you could be fined or prosecuted. For those with a bus, coach, or lorry licence, you must inform the DVLA even if only one eye is affected by glaucoma. Medical professionals are required by law to inform the DVLA if a patient with glaucoma refuses to do so themselves. Support Services and Charities If you’re living with glaucoma, there are many support services and charities that can help. Glaucoma UK and the Royal National Institute for the Blind (RNIB) provide advice, information, and courses on living with sight loss. They offer guidance on financial help, technology, employment rights, and caring for someone with sight loss. They also have helplines and websites for more information. Eye Clinic Liaison Officers (ECLOs) are available at most hospitals to provide direct support for patients experiencing vision loss. Ask your eye doctor for a referral to your local ECLO for help with accessing services and advice. Low Visual Aid Clinics offer tools and devices to help you manage day-to-day activities. If you are registered as sight-impaired or severely sight-impaired, you will also receive a needs assessment to help identify useful adaptations for your home. For more details on local services, the RNIB’s Sightline Directory offers links to resources for blind and partially sighted individuals. Living with Glaucoma: Daily Activities Research has shown that people with glaucoma in both eyes may find certain daily activities more challenging than those without the condition. For example, patients with visual field loss in both eyes may experience more difficulty with tasks like walking or reading. They may also walk more slowly and have an increased risk of tripping or falling, particularly if the lower part of their visual field is affected, which can make it harder to see steps or obstacles. Patients with glaucoma in only one eye tend to manage well with most day-to-day activities, as their vision in the unaffected eye compensates. However, as glaucoma progresses and affects both eyes, you may notice more difficulty navigating spaces or reading, and certain medications, like beta-blockers, may lower blood pressure and increase the risk of falls. Help available for those with Sight Impairment If you are registered as sight impaired (SI) you may be entitled to these benefits and concessions: Free postage Free NHS eye examination Disabled person’s railcard Reduced/free bus fares Free directory enquiries Cinema pass for a carer Protection under Equality Act Assessment by Social Services Those registered as severely sight impaired (SSI) are additionally entitled to: Blind person’s tax allowance TV licence fee reduction Blue badge (car parking) You may also be eligible for additional benefits, including Personal Independence Payment (PIP), Attendance Allowance, Carer’s Allowance, and Universal Credit. Living with glaucoma doesn’t mean you have to stop doing the things you enjoy, but it’s important to be aware of how the condition might affect your vision, particularly as it progresses. Regular check-ups, following your treatment plan, and taking advantage of the support services available can help you manage your condition and maintain a good quality of life. For further information, don’t hesitate to reach out to charities like Glaucoma UK or the RNIB , or speak to your local Eye Clinic Liaison Officer for personalised advice and support.

A Guide for Patients Eye care services in Essex There is an excellent range of eye-care services accessible to people residing in and around Essex, ranging from NHS or private hospital care, to high street opticians. This page summarises some of the services available. Eye Clinic Liaison Officers (ECLOs) ECLOs have lots of knowledge on eye conditions and on helpful local and national services. They provide emotional and practical support to anyone affected by sight loss, free of charge. They can advise on living with sight loss, management and treatment of eye conditions, visual aids, equipment and technology, availability of benefits and concessions, education and employment, certification and registration and other support and services that might be appropriate. By offering dedicated individual care, ECLOs can talk to you about your worries and give you advice on how to lessen the impact your eye condition may have on your life. ECLOs act as an important bridge between health and social services and are central to the support and wellbeing of patients in eye clinics. They also help prevent avoidable sight loss, by talking through treatment and helping people to understand their medication if necessary. The Southend ECLO is Tracey Meddle, who is employed by Southend-in-Sight, a local sight loss charity. Email: tracey@southendinsight.co.uk Tel: 01702 342131 The Orsett/Basildon ECLO is Sarah Jane Piper, who is employed by the charity BASIS. Email: Sarah-jane.piper@nhs.net Tel: 01268 522817 The Chelmsford ECLO is Holly Muncey, who is employed by the RNIB. Email: mse.eclomidsouthessex@nhs.net Tel: 07901 513416 Local charities BASIS is a sight loss charity providing help for patients with visual impairment in South Essex. Tel: 01268 522817 Email: admin@basissouthessex.org.uk Southend in Sight is a sight loss charity for Southend, providing help for patients with visual impairment. Tel: 01702 342131 Email: info@southendinsight.org.uk High street opticians offering glaucoma services Goldsmith Webb offers Goldmann Applanation Tonometry (GAT) which is a procedure that measures intraocular pressure (IOP), Humphrey Visual Field (HVF) analysis and Optical Coherence Tomography (OCT) which is a non-invasive imaging technique used to create cross-sectional images of the eye. Several Goldsmith Webb stores have optometrists with higher qualifications in glaucoma and offer emergency appointments. Goldsmith Webb has stores in multiple locations, including: Bodys The Opticians 25 Queens Road, Southend-on-Sea Essex, SS1 1LT Tel: 01702 354553 Goldsmith Webb 8 Grover Walk Corringham SS17 7LY Tel: 01375 677577 Goldsmith Webb 37-43 Broadway West, Leigh-on-Sea Essex, SS9 2BX Tel: 01702 710031 Humfrey Eye Care offers HVF, OCT services and emergency appointments. Humfrey Eye Care is run by Stuart Humfrey. He is an experienced optometrist with a higher qualification in glaucoma. 223 London Road Hadleigh Essex SS7 2RD Tel: 01702 599068 Euin Steele offers GAT, HVF and OCT services. Euin Steele has optometrists with higher qualifications in glaucoma and offers emergency appointments. 58 Orsett Road Grays Essex RM17 5EH Tel: 01375 37300 Karen Castle offers GAT, HVF and OCT services. 78 Hart Road, Thundersley, Essex, SS7 3PF Tel: 01268 793538 Forbes Opticians offers GAT, HVF and OCT services. Forbes Opticians has optometrists with higher qualifications in glaucoma and offers emergency appointments. 198 London Rd Hadleigh, Benfleet Essex SS7 2PD Tel: 01702 555345 James Bryan Opticians offers GAT, HVF and OCT services. James Bryan Opticians has optometrists with higher qualifications in glaucoma and offers emergency appointments. 33 The Meadows Shopping Centre Chelmsford Essex CM2 6FD Tel: 01245 357766 Emergency eye care If you have an emergency condition you can contact your GP, a local optometrist offering emergency appointments on the high street (self refer via www.primaryeyecare.co.uk , or contact one of the optometry practices on this page) or attend your local hospital Accident and Emergency Department. If you want private care, you are welcome to contact Mr Baneke’s private secretary to check whether he has any last-minute availability. The Mid and South Essex hospitals with an eye casualty department (referral is via GP, main A&E or a local optometrist) are: Southend University Hospital, Prittlewell Chase, Southend-on-Sea, SSO 0RY Broomfield Hospital, Court Road, Broomfield, Chelmsford, CM1 7ET Queens Hospital, Rom Valley Way, Romford, RM7 0AG For London patients: Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD (virtual assessment and phone triage service available via https://www.moorfields.nhs.uk/ae ) Essex Local Optical Committee Essex LOC is funded by Ophthalmic Contractors in the Essex area and acts on behalf of the Contractors, Performers, and others registered with the GOC in dealing with the NHS.

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A Guide for Patients Understanding Glaucoma Risk Factors: "Why me?" If you’ve been diagnosed with glaucoma, you might be wondering, "Why me?". It's a common question. While certain causes like steroid use, trauma, or previous eye surgery are known, the reasons behind the most common type, primary open angle glaucoma, are not fully understood. However, we do know that glaucoma is a multifactorial disease, meaning there are various risk factors that can predispose someone to developing it. This page will help you understand these risk factors and how they may apply to you. The Bigger Picture Glaucoma is the leading cause of irreversible blindness worldwide. Read More Implications for Your Family Should they be tested? Read More Risk Factors What makes some people more likely to suffer from Glaucoma? Read More Diet and Lifestyle What you can do to improve your eye health. Read More Understanding the risk factors for glaucoma can help you take proactive steps in managing your eye health. Whether it’s monitoring your blood pressure, making healthy lifestyle choices, or ensuring regular eye tests, being aware of these risks is the first step in protecting your vision. If you have a family history of glaucoma or other risk factors, talk to your eye specialist about how you can best manage your eye health. The Bigger Picture Glaucoma is the leading cause of irreversible blindness worldwide. In the UK, about 2% of people over 40 have glaucoma, but it’s estimated that more than 50% of cases go undiagnosed. This means that for every person who knows they have glaucoma, there is likely another who has it but doesn’t know. In England alone, around 480,000 people have primary open angle glaucoma. The condition is more common in older adults, with 1 in 50 people over 40 and 1 in 10 people over 75 affected. What Are the Risk Factors for Glaucoma? Risk factors for glaucoma have been identified through years of observing people with the disease. These factors can be classified into two categories: modifiable and non-modifiable. Modifiable Risk Factors: These are risk factors you can change or control, such as managing high blood pressure. Non-Modifiable Risk Factors: These include things you cannot change, like your age or family history. Elevated Eye Pressure Most types of glaucoma are associated with high eye pressure. However, some people develop optic nerve damage from glaucoma even with normal eye pressure, a condition known as normal tension glaucoma. Currently, all glaucoma treatments focus on lowering eye pressure because it’s the only risk factor we fully understand and can manage effectively. High Blood Pressure The relationship between blood pressure and glaucoma is complex. Some studies suggest that high blood pressure can slightly increase eye pressure, while others indicate that low blood pressure, especially at night, might contribute to glaucoma. A sensible approach is to maintain blood pressure within a normal range and avoid extremes. If you’re on blood pressure-lowering medication, it’s important to inform your eye doctor, as adjustments to your medication might be necessary. Diet and Lifestyle While diet isn’t thought to have a significant impact on glaucoma, there’s some evidence that vitamin B3 (nicotinamide) might slow disease progression. It is found in red meat, poultry, fish, brown rice, nuts, seeds, legumes and bananas. However, there isn’t enough evidence yet for doctors to recommend it universally. Eating a healthy, varied diet and getting regular exercise are always good for overall health. Some studies suggest exercise and meditation are helpful for patients with glaucoma. Patients with pigment dispersion syndrome should avoid high-impact sports, as these can increase the risk of pressure spikes in the eyes; this does not apply to patients with other types of glaucoma. Other Risk Factors Age Glaucoma can affect people of all ages, but it’s most common in those in their 70s and 80s. As we age, the optic nerve gradually loses nerve cells, and glaucoma accelerates this process. The longer we live, the greater the risk of developing glaucoma. Ethnic Origin People of African or Caribbean descent are at higher risk of developing glaucoma, often at a younger age and with more severe disease. This risk increases significantly after age 40. Family History of Glaucoma Glaucoma, particularly primary open angle glaucoma and primary angle closure glaucoma, often runs in families. If you have a close relative with glaucoma, your risk of developing the disease is four to nine times higher than average. If you have been diagnosed with glaucoma your direct relatives should have regular eye tests, and are entitled to free NHS eye checks if they are aged 40 or older. Myopia (Short-Sightedness) Moderate to high short-sightedness increases the risk of developing certain types of glaucoma, especially pigmentary glaucoma and primary open angle glaucoma. Hypermetropia (Long-Sightedness) Long-sightedness can lead to primary angle closure glaucoma, as these eyes are often smaller, which can crowd the drainage system and lead to increased pressure. Implications for Your Family Glaucoma is often a painless condition that damages the outer edges of vision first, gradually working its way inwards. Because it progresses silently, many people don’t realise they have it until it’s advanced. Early detection through regular sight tests with an optician is crucial. While everyone should have an eye test every two years, those with a close relative (parent, sibling, or child) with glaucoma should be tested more frequently. In the UK, people over 40 with a first-degree relative who has glaucoma are eligible for free sight tests every two years. Bigger picture Risk factors Diet and lifestyle for family MORE ABOUT UNDERSTANDING GLAUCOMA AVAILABLE TREATMENTS CONTACT TO BOOK

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