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As tourism and hospitality businesses reopen across Ireland, you'll want to know you're safe. That's why Fall to Ireland introduced the covid-19 Safety Charter. When a business displays the symbol, you'll know that business is agreeing to follow the recommended cleaning and safety guidelines supported by staff training. And they also agreed to undergo spot checks to. So you can enjoy yourself with confidence. Look for the symbol nationwide brought to you by Ford, to Ireland and the government of Ireland.

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That Pat Kenny show on news talk with Marter private network during current restrictions. Don't ignore your health concerns. Our expert team is ready to help. Well, now it's time for our Ask the Experts. And joining me now is ophthalmologists and medical director at the Wellington Eye Clinic at the Beacon, Arthur Cumming's Arthur.

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Good morning and welcome. Good morning, Pat. Thank you very much. Now you have a good news story to end 20/20 with new technology, contact lenses with augmented reality. Explain.

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Yes, Pat, it's an interesting company that based in the US and they've all taken proper news, have started this, and they're looking for some ophthalmic input and optometric input to help them with the lens. But they have already raised 160 million dollars. And what they have is a lens with so much technology packed into it that you would wear this lens. It's a hard lens and the lens has the ability to project the heads up display. So you could do the likes of doing a presentation and have a teleprompter, you know, out in space that no one else can see.

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But you can see it has the ability for you to go navigating a city and to recognize a building and give you information. It has the ability to do facial recognition. So you could go to a meeting where you should know everyone, but you just don't get the name on the tip of your tongue and will tell you it is so very interesting. And then the next step, once they've done that, is to have a lens that can actually be placed inside the eye.

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So when you're doing cataract surgery over lenses can look do the same things from inside the eye and look backwards at the back of your eye and keep the doctor updated with images so it would reduce visits and you'd have a very good historic and photographic evidence of what's happening inside the eye in terms of diabetes or glaucoma or macular degeneration or all these sorts of things. And it's amazing how technology is advanced and how they can put things like batteries and all the circuitry into such a small space.

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It's I find it remarkable.

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Well, it might be a year or two before we see it practically, but it's on the way now. Questions from Ana Nataline. I have a 16 year old daughter who is short sighted. We were wondering at what age can she have corrected laser eye surgery?

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That's a very good question. And is one of the myths one of the big myths is that you need to be stable before you can have laser eye surgery done. And as long as the eyes are healthy, you do not have to be stable at all. The number one thing that stabilizes the vision is, in fact, the vision correction. So we normally say from the age of 18 upwards is a very good time to contemplate it.

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My four year old son has had an intermittent divergence in his eyes for more than a year. One eye moves outward, more likely when tired, but becoming more frequent. Were waiting on a public referral. Should we seek private consultation quickly? Could it become permanent if not addressed?

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So again, this is a very good question and it's one that you should be concerned about if the driver if the divergence is inward. But if it's answered, it sounds like this is outward, then the risk of getting a lazy eye is much smaller and you don't really have some level of urgency if the eyes are turning out more than half of the waking hours. So if it's only when the child's tired, there's nothing to be concerned about for now and there's no problem waiting for the referral.

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If it's turning inwards, then there's a much bigger chance of the eye being lazy and then it makes sense to see someone as soon as possible.

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I'm currently experiencing my first bout of uveitis. I have ankylosing spondylitis. I'm being treated by an ophthalmologist. But I was wondering if your eye specialists think there's anything I can do to avoid repeat bouts from Amanda.

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Unfortunately not. Pat and Amanda. The best thing to do is to be aware of the symptoms and to be on top of things, and especially with ankylosing spondylitis. Sometimes the symptoms can be quite subtle. So you should be very aware of the first sign of it coming on and speak to your ophthalmologist about this. But they might even encourage you to have a drop, a bottle of steroids at home. And if you think something starting up, you can actually put the first few drops in before you even get to see them.

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So the sooner you treat it with steroids, the the better the success is going to be and the less you need to use steroids. But there's nothing you can do currently to prevent the recurrence of the recurrence or it wants to make any progress on laser treatment for long sightedness.

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Yes, there is there has been so long sighted that I was treated quite successfully with laser up to sort of plus five somewhere around there, not really higher than that. We have a group of patients that we always feel we let down, and this would be young people in their 20s and 30s who are very high plus numbers. So they are too high for laser. They they are too young to have a lens replacement and often they don't have enough space inside the eye to add a contact lens inside the eye.

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So this is a group that people are working on, very good solutions. And we think there's one down the tracks probably within the next year, which is adding tissue. So it would be much the same as Lasik. We make a little flap and then the laser, we do the reshaping. But in this particular case, it makes a little flap and then instead of reshaping it, actually. Add a collision contact lens under the flaps almost, it's almost like getting an organic contact lens under the flap that's permanent.

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The beauty of the procedure is that it's completely, completely reversible. So for whatever reason, you didn't like the way it looked. You lift the flap up, remove it, and you're back to where you were. So I think that's going to be very interesting.

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It's called a yeah. If it's collagen, would it leach out, you know, the way people get collagen in their cheeks or lips or whatever it might be?

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That's a very good question. So this is, in fact, corneal corneal tissue cornea that would have otherwise been used for a corneal transplant before whatever reason couldn't be used in a number of reasons why it couldn't be used for a full thickness corneal transplant. And then this company has found a way of treating this cornea, removing all the cells, sterilizing the cornea, and then reshaping it with a laser to give you the exact power you need. And then you place it under your own inside your own cornea.

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So it's basically corneal collagen, it's fibres. So it's not going to absorb, it's not going to move around or something.

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Anything like that in my right eye has a twitch, which has been there for the last six weeks, is driving me mad. I spend all day in computers, so screen time is a big factor. I appreciate that. Is there anything else I can do to stop the twitch from Mary and Keri?

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Yeah, that's a it's a problem that everyone at some point is going to encounter, and mostly it's got to do with a number of things. One is screentime. Second one would be dryness. Third one would be too much coffee, perhaps. And then the fourth one is just that's just been exhausted this time of the year and given the year that we've had. So just don't worry about it. It'll tend to clear up completely one in a thousand cases, which might become worse.

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And this is one of the first times Botox was ever used. It can actually be injected with Botox to break the cycle. But for the massive majority of people just don't think about it anymore and it'll disappear. And another thing is you see it an awful lot worse than what other people see. Other people would hardly notice it. Well, to you, it looks as though, you know, there's an earthquake around the eye.

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Now, a question here about someone who had laser surgery 12 years ago results mostly positive, but I experience a halo effect around the light of cars at nighttime that can be quite distracting and sometimes impossible to drive any solution to this, any type of eyewear, or would I need more laser surgery to correct it? I was told the halo effect would subside and eventually go away, but it didn't happen. Can you help?

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Yeah, absolutely. This person can absolutely have a an assessment to figure out where the sorts of play is coming from. The glare can be coming from the cornea. So from the previous laser surgery, if it was a small optical zone, it could also be coming from the lens. And amazingly, it could also be coming from dry eye. So one would first have to figure out where it's come from. If it's from the cornea, optical zones could be expanded with modern lasers.

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So that can be addressed very, very well with corneal surgery. This person, at 46, could also easily have an early particular kind of cataract called the posters that capture the cataract. That could particularly give you clear driving at night. And it's just the start of a very small cataract. So I would I would advise them. It seems like it's really bothering them. I would certainly advise Jeanne to have it assessed with an ophthalmologist. Yeah.

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A question for Arthur. Can older people have laser surgery to correct vision for reading how great it would be to save all that putting on and taking off of reading glasses? That's from Stephanie.

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Yes, you can. If you're distance is really good, you can do an assessment to see how you would get along with just one eye corrected for near. That's called minor vision or blended vision. And as you know and I know it works very well for maybe 85 percent of people can do it. The 15 per cent who just don't like the balance, but 85 percent of people can do it very effectively. So it's certainly worth looking at.

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Yeah, I got that done, as you know. And I can see with distance, with one eye and reading with the other eye. But I'm afraid the reading with all this screen time has just improved. So maybe there's something I can do rather than have to wear specs. I've had cancer and undergone treatment, chemotherapy and surgery, which ended over a year ago. I've noticed a change in my eye color. They were always brown. They've now turned blue at the top of the iris.

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What might have caused this?

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Yeah, I would suggest that that this person has this checked out. It's probably nothing to be concerned about. But if you are always brown and then are going blue, it just means you're losing pigment. So on the iris, it could be from the chemotherapy, it could be from rubbing that, it could be from radiotherapy and it could cause a rise in pressure in the eye. So I would really encourage this person to have an examination done and sooner rather than later, there's a very, very small chance to that that cancers can spread to the eye.

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So it's something you want to make sure about that that would be a very small chance, but it's something you want to make sure of that.

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If Vincent says I'm a diabetic, recently had laser eye treatment to cauterize blood vessels, but my vision in that eye is now somewhat blurry. Will that improve in time? So, Vincent, there's so many causes as to why it could be simpler with diabetes, one could be you just have swelling in the back of the eye. That would tend to improve. It might require treatment. Some of these little vessels might still be leaking a little. So that needs to be checked.

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And then finally is, as a diabetic, your your odds of getting a cataract also higher than normal. So the quite a few things that could be causing it. And it's simply the next time you see ophthalmologist, just bring it to the attention that you concern. Your vision is not as good as it was. And if they can just try and establish a cause, most time it's treatable. When I blow my nose, says another, some fluid comes through my right eye, is this normal?

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Should I seek treatment?

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It is normal. So you have little ducts in the inside corner of your eyes and these take tears away and these these tears drain in the back of your throat. And normally these little ducts have a sort of little valves that keep it a one way direction. If you blow your nose really hard and build up the pressure in the nose, you can have fluid going the other way. So it's it's nothing to be concerned about that. It's just to careful building.

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And I trying not to blow so hard because you don't want the needles secretions lining up in your eye.

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Now this listener says, could you ask Arthur, I'm in my 50s. I've had a high myopia vision since my 20s. I could be minus 11 or 12.

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I had posterior vitreous detachment in 2008, then in my right eye in 2009, I have a thin cornea and live with floaters.

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I'm high risk of retinal detachment and suffer regular ocular migraines. I probably over where my contact lenses because I can see much better in them.

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Is there any laser treatment that I can have or is it too much of a risk as I now have cataracts growing? Please advise.

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So it's minus 12 with a thin cornea. It's too high for laser. One possibility that would have worked very well, especially a few years ago, would have been adding a lens. So not a lens replacement, but adding a lens. It's called an ACL and implantable contact lens. If I heard you correctly, there's signs of early cataract now, and that, in a way, is a blessing in disguise, because once you have an early cataract, at some point you're going to have to treat them.

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It's not elective anymore. It's something you have to do. And when you do the lens replacement, you choose the lens that's going to give you a good vision anyway. So your cataract surgery in the future will get you rid of your glasses. A number of people asking about dry eye and this person saying particularly, is laser surgery a good option for someone who has a dry eye condition due to the wearing of contact lenses seven days a week?

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Yeah, that's a super good question. And if you look at someone who's 20 years old with our dry eye and the one uses contact lenses for the rest of their life and the other one at 20 has lasdun, there's no there's no comparison as to who does based on the road in terms of dry, that the patient does an awful lot better. But if you already have dry eyes, you shouldn't have lasdun until the drys have been remedied and your tears are back to normal because laser can exacerbate it.

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One of the biggest reasons is your glasses and contact lenses sort of work as protective elements from the from the environment. And when you suddenly get rid of them all the evaporative strain or stress is on the eye. If you improve the Tearfund so well before the time that it can withstand being exposed to the environment, then there's no issue with laser can cause dry. So it's important before you have laser done to make sure your tears are right.

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OK, well, Arthur, we have to leave it there. Arthur Cumming's, ophthalmologist, medical director at the Wellington Clinic at the Beacon. Thank you very much for all your help in 2020. And we look forward to talking to you and answering our listeners questions in 2021. Arthur, thank you very much.

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