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Vitreoretinal service

Ophthalmology

Retinal surgery was established in the Queen Elizabeth Hospital, King’s Lynn, in September 2007. Now patients with retinal conditions requiring surgery or specialist opinion do not have to travel to Norwich or Cambridge.

A surgical procedureThis tertiary level, highly specialised retinal surgery service is fully up and running. Mr M Saeed, consultant ophthalmic and vitreoretinal surgeon, with his team of highly skilled and dedicated staff, would be more than happy to answer any queries relating to retinal surgery.

Common retinal conditions that are treatable with vitreoretinal surgery

Common retinal conditions that are treatable with vitreoretinal surgery are:

Retinal detachment

Retinal detachment usually presents with a sudden loss of vision which is often preceded by flashing lights and floaters. The visual loss usually starts with a curtain effect obscuring part of the vision. Urgent diagnosis is crucial in order to save vision.

The risk of retinal detachment increase with age and there are certain factors like previous eye surgery and cataract surgery which also increase the chances of retinal detachment. Short sighted (myopic) individuals also have a high risk of developing retinal detachment. Patients are advised to ask their GP for an urgent referral to eye casualty or else attend the QEH main casualty from where they will be referred to the eye department on an urgent basis.

After the initial examination by Mr Saeed and his team, the surgery is planned to be carried out within a few days depending on the deterioration and extent of the retinal detachment. Surgery is carried out under local anesthesia in a relaxed environment. Using microsurgical techniques the vitreous gel is removed and retinal tears are identified and treated with laser. Such as gas or silicone oil is used to keep the retina in place.

Very often patients are advised to keep their head in a certain position for a few days. The gas can take several weeks to absorb.

During this time the patient must not travel by air. Sometimes more than one operation is required to achieve a successful outcome. Some patients will also require and undergo removal of a cataract at the time of surgery.

Macular hole

Macular hole is a condition of unknown cause. It usually affects middle aged individuals and is common in females. The symptoms of a macular hole are of slow onset and involve the main centre of vision usually starting with distortion of vision. The peripheral vision however remains intact. However, you have a better chance of visual improvement if it is caught early.

Usually removal of cataracts is undertaken during this surgery if they are found to be present in the eye. The surface of the macular, which is the back part of the retina, is then stained with a special glue dye to enhance its visualization. This fine underlining of the retina is then peeled away using microscopic instruments. The eye cavity is then filled with gas and patients are then advised to keep their face down for seven to ten days, with a ten to fifteen minute break every hour being quite acceptable. This is hard work on the part of the patient but it pays off by helping achieve a better success to the surgery.

Epiretinal membrane

In this condition, a thin fibrous membrane develops over the macular region of the retina. It causes distortion of vision and blurring. Epiretinal membrane usually affects middle aged individuals. Sometimes, previous ophthalmic surgery or retinal laser treatment can cause this problem.

The surgery is very similar to a macular hole, involving vitrectomy of the fibrous membrane. Surgery takes about one hour and sometimes can to be combined with the removal of cataracts.

Vitreous haemorrhage

Vitreous haemorrhage or bleeding in the vitreous can be due to diabetic retinopathy or retinal vein occlusion. The treatment for vitreous haemorrhage is usually non urgent as most of the time is can clear over the course of a few weeks. A non clearing haemorrhage however can be treated with vitrectomy and internal surgery.

In the absence of diabetes or retinal vein occlusion and in particularly when an individual is short sighted a retinal tear must be excluded as a cause for the haemorrhage. In such cases urgent intervention and discussion is necessary. The surgery for vitreous haemorrhage for a person with diabetes often entails the removal of fibrous tissue and membranes on the retina and the application of laser to prevent further haemorrhage. Sometimes gas or clinical oil is used to redirect the retina.

Floaters

Floaters is a very common symptom that most of us have experienced at some stage. Most floaters are innocent in nature, however, certain amounts of dense floaters, particularly for those treated with flashing lights, should be investigated to rule out any underlying retinal tear or detachment. In the absence of a retinal problem floaters are usually inconsequential, if they become disturbing to vision, surgery may be considered. Floaters can also be due to chronic inflammations of the eye.

Complicated cataract surgery

Cataract surgery is by far the safest of the common operations carried out. Due to the sheer volume of this work, there are inevitably a small number of patient who develop complications due to surgery. With regards to retinal surgery, our facilities and expertise to hand we are able to treat those complications quickly and effectively without having to refer patients to remote units. Patients regain normal or near to normal vision after the surgery has been completed.

Our specialist team

The specialist team delivering this service is:

  • Mr M Saeed - Lead Clinician
  • Mr Manish Gunda - Speciality Doctor Ophthalmology
  • Mr M Kouroupis - Staff Ophthalmologist
  • Sister Jo Hardy - Specialist Nurse
  • Sally Garrard - Theatre Nurse

Useful documents links

The documents here may be of interest to you:

Go to the Ophthalmology overview page.

 


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