ADHB Greenlane Eye Clinic Referral Process for Cataracts

Here is some information on the referral process for outpatient appointments at the Greenlane Eye Clinic. This eye clinic is a free service provided by our District Health Board (DHB).

Cataracts

The most common reason we refer people to the Eye Clinic is cataracts. Cataracts are clouding of the lens inside the eye, which reduces vision. The treatment is a surgical procedure, performed under local anaesthetic, to remove the clouded lens, replacing it with an implant. This is usually a highly effective procedure which fully restores vision. No surgery is without risk and this is a consideration when treatment should be undertaken.

Clinical Prioritization Scores

In order to prioritize who gets cataract surgery each year, optometrists and ophthalmologists use a clinical scoring tool. We enter your vision, as recorded at your appointment which is the size of the letters you could read on the chart with the best prescription lenses in place. Also included are details of the examination of your eyes and cataracts.

The final part is your ‘Patient Impact on Life Questionnaire’. With this questionnaire they grade the degree of difficulty your blurred vision is causing you, put another way, it describes how blurred vision may be limiting your life.

Once these details are entered the tool calculates a score. For Auckland DHB the magical number of 48 and above means the referral will be accepted and you can expect to receive an appointment within 16 weeks. Northland DHB has a threshold score of 54.

In our experience this system seems to work, and people we see who are struggling with their vision due to cataracts do in fact get an appointment and go on to have cataract surgery.

Cataracts in both eyes - will both eyes be treated?

Most often cataracts do effect both eyes, although commonly the vision will be worse in one eye. The usual process is to treat the first eye and review. For many people the effect is a significant improvement to their vision, and often the second eye is not treated. Why have a second surgery when you will not notice any difference? This situation is assessed on a case by case basis.

If you have a concerns about cataracts, book to see us.

Book an Appointment Online

or call us on 09 425 9646

Please NO EYE RUBBING

People rub there eyes for a variety of reasons. Eyes can feel dry, burning, and itchy, and it seems that giving them a good rub will make them feel better - BUT DON’T DO IT!

For lots of good reasons eye rubbing is never a good idea. In an allergy situation it just makes everything worse. A safe alternative is eye drops or cool compresses - cool flannel or gel pack applied very gently.

Your eyelids, guess what, you’ve got one pair to last a lifetime. They are delicate. Gravity and a lifetime of blinking are going to change the structure of the eye lids and how effectively your blink reflex works to keep the surface of your eye moist and comfortable. Rubbing will honestly not be good in the long term.

This is particularly important for people who are at risk of developing keratoconus. This is condition where the cornea becomes distorted.

So if you need any further encouragement here is a video of an MRI of a violent knuckle rub to an eye. Dr Damien Gatinel, an ophthalmologist who looks after people which keratoconus studies eye rubbing using MRI imaging.

Measuring the Eye - Axial Length

The thing with health science is it keeps evolving! So let me explain what axial length measurement is, why this is useful, and who should be having their eyes measured this way.

As you may know already, we are concerned about the myopia epidemic. An increasing number of people world wide are becoming short-sighted, at a younger age.

Why is myopia a concern? Short-sighted eyes are often longer than an average eyeball, and this is associated with increased risk of eye disease in life.

Fortunately we now have a number of treatment methods which clinical studies have shown to slow down the progress of myopia in children. (Including Miyosmart spectacle lenses, soft contact lenses, and ortho-K contact lenses.)

How does the Eye Axial Length Measurement fit in? If we can identify eyes which are longer than expected, armed with this information we can try to harness as many strategies as possible, and monitor these eyes closely.

Conversely it will be reassuring to know if an eye is average length.

How is Axial Length (AXL) measured? There are a number of methods, but the easiest uses an biometer. This is a painless and non invasive - no eye drops.

A measurement scan using optical low coherence reflectometry (OLCR) biometry measures the axial dimensions of the human eye. From the cornea (at the front) to the retina (at the back). These instruments are readily available in a Ophthalmologist’s (eye specialist) clinic for measurements before cataract surgery.

Who should have their eyes measured? We recommend young people who are myopic, especially those identified as at risk of rapid progression. These are children with highly myopic parents, children who present needing a high prescription at the start and children who are at primary school when they need their first pair of glasses.

How often should eyes be measured? As this is a new clinical procedure we plan to measure once and review. We may recommend a second annual measurement for eyes which appear to be of normal length, if the prescription progresses.

For eyes identified as longer AXL we will likely recommend a review sooner.

Where do I go? Book to see Dr Mark Donaldson, ophthalmologist, at Rodney Surgical Centre, Morrison Drive, Warkworth. Phone 09-425 1190. Request an appointment for Myopia Eye Measurement.

What is the charge? The appointment fee is $75.00

Related Articles: New spectacle lens for Myopia Control - Myoismart

Myopia Control

New Spectacle Lens for Myopia Control - Miyosmart

It is exciting to finally have a new option to help young children who are becoming myopic (short-sighted) - Miyosmart. This is a novel spectacle lens designed specifically to help slow the progression of myopia.

When young people present to us with blurred vision and we discover they are myopic, our hearts sink. We know, from clinical experience, that myopia is likely to get worse in the upcoming years. This results in the eye actually lengthening, which creates a lifelong risk of sight threatening eye conditions. (We have more information about the myopia epidemic, and myopia control contact lenses.)

Miyosmart is a lens specifically designed to treat myopia, with studies that show this lens slows progression by half.

How does it work? The lens has a central zone, which will give clear vision in the distance. In the treatment outer zone of the lens numerous small dimples create defocus on the peripheral retina. This peripheral focus is believed to slow the growth and elongation of the eye.

The study in Hong Kong followed 160 young people over two years. Myopia for the the 79 Miyosmart wearers progressed at half the rate of the group wearing the traditional single vision spectacle lenses.

How does this compare with other types of glasses lenses we have been using? Whenever possible we avoid single vision lenses, instead using lenses which are progressive. These have been the best option and evidence from clinical studies suggests myopia is slowed by about a third.

Other treatment options are contact lenses and Atropine eye drops. The results for Miyosmart match these. So this creates a very exciting treatment option for children not able to manage contact lenses.

Would you like to read more about Myopia check out our Myopia Resources & Links.

What we are wearing - Veronica in Anne et Valentin

Veronica has been our receptionist for the the past year, you may have already encountered her distinctive Colombian accent. Veronica’s first pair of prescription glasses were from Mexico, where she was living in her teenage years. She is vague about the frame but remembers photochromic lenses, and she thought having glasses was pretty cool. Since then she has had different glasses over the years but never worn full time. She tells me none were as memorable as the eyewear she has chosen since joining us. Check out her recent new glasses.

Frame: ANNE ET VALENTIN Recover

Lens: Hoya Sync* III lenses with Bluecoat Diamond Finish anti-reflection coating.

*Sync lenses have a boost in the lower lens, similar to a progressive design, but softer zones. Ideal for younger wearers including people who spend a lot of time on phones and screens.

This is your second Anne et Valentin frame.

Veronica: I just love their range. This frame is the complete opposite in style, fine and light after my ‘Diddley’ model which was solid acetate. But it still makes a statement.

How do you find the Sync lenses?

Veronica: They have taken some adjustment. I find the extra strength in the lower lens is good

McDonald Adams is one of 1500 carefully selected retailers world wide.

Anne et Valentin are a French brand born from the wild dream of two opticians from Toulouse, a town in the South-West of France. The couple, looking for graphic and original frames for their friends, decided to create what they couldn’t find. Today, still driven by our fierce independence and our familial state of mind, we continue to develop a vision that embodies our research, fueled by the highest standards and our love for the object itself.

At a time when most of our manufactured products come from South East Asia, this company is still 100% based in France. They describe “Made In France” as a moral commitment. “We have been working with the same factories located in the French Jura mountains since we started, 30 years ago, aside from a few titanium models that we manufacture in Japan, because the very best titanium is Made in Japan.”

Red Light Helps Aging Eyes

In recent times there has been a lot of information about the potentially harmful effect of blue light on eyes. Here’s something from the other end of the spectrum - red light which could prove helpful. A study has found that staring at a deep red light for three minutes a day improved declining eyesight. This may lead to home-based eye therapies.

At around age 40 years the retinal cells in the eye begin to age as the cell’s mitochondria start to decline. These mitochondria have high energy demands, and there are a lot of them in the eye’s photoreceptor cells in the retina. This means the retina ages faster than other organs as the photoreceptors lack the energy to perform their normal role.

“Mitochondria have specific light absorbance characteristics influencing their performance: longer wavelengths, red light, spanning 650 – 1000nm are absorbed and improve mitochondrial performance to increase energy production,” said Professor Glen Jeffery, University College of London Institute of Ophthalmology.

The retina’s photoreceptor population is formed of cones and rods. Cones mediate colour vision and rods give peripheral vision and adapt vision in low/dim light.

In this study candidates were first tested for rod and cone sensitivity. They had a small LED torch to take home, and look into its 670nm light beam for three minutes a day for two weeks, before being re-tested.

Colour contrast sensitivity improved by up to 20% in some people. Improvements for some were more significant in the blue part of the colour spectrum which is more vulnerable in ageing. Rod sensitivity also significantly improved in this group, though less than contrast.

Hopefully this might translate into a home therapy - watch this space.