Ophthalmology (eyes)

Emergency eye service

Our emergency eye service at St Helier is open as usual from 8.30am-4.30pm Monday to Friday. Please note that the Eye Unit does not open on Bank Holidays. However, we are not able to accept walk-in patients at this time. All patients will need to be triaged over the phone by a consultant ophthalmologist, and where possible, patients will be given advice over the phone. Walk-ins will be turned away with advice to phone for triage, given advice, or an appointment.

Outpatient appointments

We have cancelled all non-urgent outpatient appointments until June and have moved all other appointments back a few months to create capacity. Many of the appointments have also been changed to a telephone appointment. You will be contacted in advance of your appointment to let you know if it will be a face-to-face  or telephone appointment.

New appointments

New referrals will be triaged by our consultants, who will determine whether a face-to-face or telephone appointment is required. Where appropriate, routine conditions may have the referral rejected and the patient referred back to the GP/optometrist with advice and guidance.

Surgery

All non-urgent operations, including day case cataract, retina, and glaucoma surgery has been postponed. Surgery for urgent, sight-threatening conditions is still going ahead. Patients will be contacted individually.

Intravitreal injections for age-related macular degeneration, diabetic maculopathy, and retinal vein occlusion will continue, however, the assessment for these patients may be by telephone rather than face-to-face, and the interval between injections may be extended in high risk patients.

The ophthalmology team consists of orthoptists, ophthalmologists, opticians and ophthalmic nurses.

Ophthalmologists are doctors who specialise in eyes. They examine the health of the eyes, diagnose and treat diseases of the eyes and carry out eye surgery. They may measure the eyes (refraction) and prescribe glasses.

Orthoptists are involved in the assessment of vision in children and adults and primarily specialise in the diagnosis, management and treatment of Amblyopia (lazy eye), squints, movement disorders, and binocular diplopia (double vision).

Optometrists (opticians) are qualified to prescribe glasses. They may carry out a glasses check (refraction) objectively with drops or subjectively without drops.

Ophthalmic nurses are specially trained in eye conditions. They provide pre-operative and post-operative care, triage patients in the emergency eye unit, administer children's eye drops and facilitate and support the eye care team. 

We also have a Eye Clinic liason officer. These are members of staff who can help with practical issues like how to cope with poor sight and how to arrange other issues like sight impairment registration. We have one part time ECLO at Epsom Hospital and one at St Helier hospital. 

Key staff

Mr S Harsum 

Clinical Director of Head, Neck and Ophthalmology
Subspecialties: retina (medical and surgical), eye casualty, cataract

Miss J Leitch 

Consultant Ophthalmologist 
Subspecialties: paediatric, ocular motility, cataract

Miss Farzana Rahman

Consultant Ophthalmic Surgeon and Lead for the Macular Service

Subspecialties: Medical retina, uveitis, cataract, eye casualty

Miss C Funnell

Consultant Ophthalmologist and Clinical Lead
Subspecialties: paediatrics, ocular motility, neuro-ophthalmology, cataract

Mr EJK Lee

Consultant Ophthalmologist, College Tutor and Audit Lead
Subspecialties: retina (medical and surgical), eye casualty, cataract

Mr A Narang

Consultant Ophthalmologist and Lead for Eye Casualty
Subspecialties: retina (medical), eye casualty

Mr Beng Ong

Consultant Ophthalmic Surgeon and Ophthalmology Clinical Governance and Audit Lead

Subspecialties: Cataract, retina, laser, intravitreal therapy

Miss Andrena McElvanney

Consultant Ophthalmic Surgeon
Subspecialties: ocular surface, oculoplastics, cataracts

Mr Ramu Muniraju

Consultant Ophthalmic Surgeon and Clinical Lead for Surrey National Diabetic Eye Screening Service
Subspecialties: retina (medical), retinal laser treatments, cataracts, eye casualty

Mr P Ursell 

Consultant Ophthalmologist 
Subspecialties: Ocular surface, cornea, cataract

Mr Chris Panos

Consultant Ophthalmologist
Subspecialties: glaucoma, cataract

Dr S Izadi

Consultant Ophthalmologist
Subspecialties: retina (medical and surgical)

Mrs M Okoro 

Lead Nurse for Ophthalmology

Mrs L Ring 

Nurse Consultant

Mr Arinda Channa

Head Orthoptist

Mrs Ann Ryan

Eye Clinic Liaison Officer

Cathy Long

Eye Clinic Liaison Officers

Heidi Barron

Matron

Kate Hartnett

Head of Nursing

Ramona Lichi 

Senior Sister 

We provide a wide range of information, advice and support services, including:

• Patient support at the time of diagnosis of an eye condition that has caused or may cause substantial sight loss
• Information about eye conditions
• Advice on low vision aids and other resources to assist with daily living tasks, reading and writing
• Referrals to, or contact informaiton for, other agencies.

We specialise in sight loss problems. You are welcome to come without a referral.

Poster and contact detail cards are available in the waiting areas of the eye unit and the Patient Information Centre at St Helier Hospital.

Key staff

Ann Ryan
Eye clinic liaison officer

Justine Jasper / Cathy Long

Eye Clinic Liaison Officers

 

Opening hours

In clinic: Monday – Tuesday – Thursday - Friday 8.30am – 4.30pm. Please note that the Eye Unit does not open on Bank Holidays.
24-hour answerphone service on 020 8296 2000 ext 8718 or 07920650613 (please leave your name, contact details and any message)
You can also email enquiries to annryan@suttonvicion.org.uk or annmarie.ryan1@nhs.net.

At Epsom hospital Eye Unit on Friday morning 0900-1230

Email enquiries to dutyeclo@sightforsurrey.org.uk or info@sensoryservices.org.uk

Your GP has referred you to us because they think you may need a cataract operation. Cataract surgery is the most common surgical intervention performed in the NHS.  Eye surgery at our hospital is performed using the most up to date techniques available. 

Our team is made up of highly skilled and experienced consultant ophthalmic surgeons and nurses. We train around eight doctors every year, who go on to become consultants in hospitals across the UK including Moorfields Eye Hospital. Our staff regularly present new research at international meetings and are recognised across the world as experts in their fields.

Routine cataract surgery

Routine cataract surgery is performed using a technique called small incision cataract surgery, which results in quicker healing. To help you prepare for your surgery we have produced a comprehensive information leaflet, about what to expect, which gives you lots of information about your eye surgery and how it is performed.

When you come to us for your appointment please follow the advice in the letter we sent you as it contains important information about what to do before, during and after your visit.  At your initial assessment we will carry out all the tests and measurements necessary to prepare for your surgery.

• 98% of our surgery is performed under non-invasive local anaesthetic and 2% as general anaesthetic
• All patients are day cases
• We perform over 2500 procedures every year and audit our results continuously
• Compared to the national average, our results exceed the published standards of care for complications

We also perform complex combined procedures for anterior segment trauma, vitrectomy and glaucoma if needed.

If you have any questions about your eye condition or your surgery, please write them down before your first visit and we will do our best to ensure they are all answered. 

Cataract booklet.pdf

Watch this new video produced by our Ophthalmology Team which offers step by step guide to procedure for patients.

Watch this short video produced by RNIB about cataract surgery. You can also read RNIB's cataract guide (opens in a new window). 

 

Key staff

The following consultant ophthalmologists, perform cataract surgery:

Key staff

The following consultant ophthalmologists, perform cataract surgery:

• Miss J Leitch 

• Mr P Ursell (lead for cataract surgery)

• Miss C Funnell

• Mr S Harsum

• Mr E Lee

• Mr C Panos

• Miss Andrena McElvanney

• Mr Ramu Muniraju

• Mr Robert Petrarca

• Miss S Izadi.

Location

Clinics

• Eye Unit, Woodcote Wing, Epsom Hospital
• Eye Unit, B block, St Helier Hospital.

Surgery

• St Helier Hospital, B4 Ward
• Epsom Hospital, Day Case Unit.

 

Glaucoma of some type is found in about two per cent of the population over the age of 40. It is estimated that more than 500,000 people suffer from glaucoma in England and Wales alone, with more than 70 million people affected across the world (International Glaucoma Association (opens in a new window) 2008).

The great majority of people have a chronic, slow to progress condition known as Primary Open Angle Glaucoma (POAG). It has been shown that half of all cases remain undiagnosed, with people of African-Caribbean descent at greater risk.

It is therefore extremely important to attend an optician for an eye test - not just for glasses but to review the health of the eye. The optician will examine your eyes as well as testing your visual field and the pressure inside your eye (intraocular pressure). If the optician finds a problem with any of these elements they will either refer you directly to the hospital eye service or to your GP for referral.

The visit to the hospital eye service will allow a healthcare professional with specialist qualifications and experience in glaucoma to carry out an in-depth assessment of your eyes. This will include checking your intraocular pressure and examining the back of your eye particularly the optic nerve head (optic disc).

You will need to have your pupils enlarged to make this examination as accurate as possible. Enlarged pupils can affect your vision so please do not drive to your appointment. You may also need to have your visual field tested with a slightly more sophisticated machine than available in the majority of high street opticians.

Please do not worry if you have been referred into the hospital eye service as the aim of all treatments for glaucoma is to lower the intraocular pressure and slow the progression of the disease. The first line of treatment is usually eye drops and your healthcare professional will choose the most appropriate one for you. You may have to try a few different eye drops to find the one most suited to you personally.

There are many sources of information about glaucoma but we would recommend that you visit the International Glaucoma website (opens in a new window) as this has a wide range of information for you to access.

Key staff

Mr Chris Panos  BSc DM FEBO MRCOphth

Consultant and lead clinician

Mrs Lynn Ring

Nurse Consultant

The eye is like a camera with the retina acting as the film at the back of the eye, which processes pictures and sends them to the brain. The macula is the central and most sensitive part of the retina (the film).

Macular degeneration is a serious condition that can lead to blindness. There are two types of macular degeneration, dry and wet.

Dry macular degeneration / dry age-related macular degeneration (AMD)

Dry macular degeneration is a slowly progressive disease of the retina which causes loss of central vision. This is usually age-related but can have a genetic and environmental component.

Dry macular degeneration may cause slow and progressive damage to the film (retina) and cause central visual distortion or even blank patches in the centre of vision. Dry macular degeneration usually does not affect peripheral (outer) vision.

There is no cure for dry macular degeneration but some aids like stronger glasses, magnifying glasses, telescopic lenses and illuminated magnifiers may help with vision and reading etc. These are sometimes called low visual aids. Usually large print books or electronic devices (like e-readers or computers) may help in reading by enlarging the font.

You may be given an Amsler chart (see our dry AMD leaflet) to look out for visual distortion and to detect development of wet macular degeneration, which is much more serious and causes more rapid visual loss.

We recommend a balanced diet to everyone, especially green vegetables and fish to patients with dry macular degeneration.

We also advise cessation of smoking, which may benefit macular degeneration.

Wet macular degeneration can be an aggressive condition leading to severe and acute visual loss in a matter of weeks.

We try to prevent or limit visual loss by treating wet macular degeneration.

The diagnosis involves retinal exams which include a dilated retinal examination, digital retinal imaging (photographs), retinal scans and a dye test called fluorescein angiography.

After testing, a small number of patients will be found suitable for treatment. This is because 90% of patients have dry macular degeneration and approximately 10% of patients have wet AMD (only wet AMD is treatable).

Patients with wet AMD are offered intravitreal injection treatment (Lucentis or Eylea treatment), if they fall within the parameters NICE guidance. Few patients may need special Laser treatment called Photodynamic therapy (PDT) and are referred to PDT treatment centres.

We perform retinal scans with our Zeiss Cirrus retinal scanner and Topcon Triton plus imaging systems. We can perform laser treatment for selected patients and also offer intra-vitreal Lucentis / Eylea injection treatment. We do not offer Avastin in this trust.

We also provide support for patients with untreatable macular degeneration and low vision aids like the provision of special magnifying glasses and other visual aids.

 

Contact details

Tel: 020 8296 3820
Email: est-tr.AMD@nhs.net

Further information

Macular Society website www.macularsociety.org

 

Referrals

GPs can refer patients via paper-based referrals, via eReferral and by using the wet AMD rapid referral route. Suspected wet AMD should be referred using the following forms:

• Rapid wet macular degeneration referral form[pdf] 162KB
• Rapid wet macular degeneration referral form[docx] 52KB

Key staff

• Ramu Muniraju, Consultant Ophthalmic Surgeon
• Mr A Narang, Consultant Ophthalmologist
• Giuseppe Aramo, Clinical Nurse Specialist
• Charlotte Brent, Clinical Nurse Specialist.

Our consultants have specific expertise in dealing with ocular surface diseases, including:

• a wide range of ocular infections
• corneal ulcers
• contact lens related problems and associated infections
• dry eyes
• watery eyes
• allergic eye disease
• herpetic eye disease
• ocular surface inflammation
• eyelid problems. 

Miss McElvanney, the lead consultant, has links with the Medical Contact Lens and Ocular Surface Association (MCLOSA), and the European Contact Lens Society of Ophthalmologists (ECLSO).

We perform anterior segment diagnostic surgery, eyelid surgery and botox for therapeutic indications.

We have a dedicated medical contact lens service for the fitting of therapeutic and specialty contact lenses.

Key staff
Miss Andrena McElvanney, Consultant Ophthalmic Surgeon

Mr P Ursell, Consultant Ophthalmologist 

Contact details

Tel: 020 8296 3800.