Our Ask The Expert Today Was Arthur Cummings OphthalmologistHighlights from The Pat Kenny Show
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- 15 Feb 2021
Our expert today to sit in on our 'Ask The Expert' slot was Arthur Cummings Ophthalmologist & Medical Director at Wellington Eye Clinic.
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The part 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. Arthur Cummings is the medical director and consultant ophthalmologist, the Wellington Eye Clinic. Hello, Arthur, how are you?
Good morning, Jonathan. Great, thanks. Hope you're well, too.
Good to talk to you again. Lots and lots of questions coming in. But before we get to it, how has covid-19 been in your world?
Have you still been able to see patients and do the treatments that you want to?
Yes, we have. We've made a lot of changes in the clinic to make sure people have seen, you know, spaced intervals. There's social distancing between patients. So over all the time, both into the well into my clinic and in the week in the hospital, there, in fact, been one single case of transmission of cowbird within those facilities. So they always have taken care of it with all the things that he suggests, you know, mask's hand washing, distancing.
Okay, so you're still going strong. Lots of questions. As I said, I got straight into them. This is a particularly current one from a Newstalk Dextra woke up this morning with swelling Endre Wanni. It's not round. So I don't think it's a cyst. And the idea what it could be. Oh Jonatha.
And it could be a little blood planned. It could be an allergy. So one way to try it out is just to a warm compress that would tend to release a Blokland and if that doesn't work, well do a coal company something called out of the freezer on a close eye. They pretend to help with things like allergies. And if it doesn't improve and starts getting bigger, then it makes sense to see a GP or optometrist who could refer you to an ophthalmologist.
Okay. Any tips on treatment for ongoing issues with bluffer itis? I might be pronouncing that incorrectly. I've tried cleansers and steroids.
Know your pronunciation is perfect. Subliterate. This is the most common eye infection you get. It's very ubiquitous and it's caused by bugs that are on our hands. And we transfer them to our to our faces when we touch our eyes. And these bugs do a good job on our skin of keeping other bugs at bay. But when they get into into the eye, they cause teeth, things. They can colonise the little follicles and they can also help block the little gland to produce oil.
So it's very worthwhile having it properly investigated and diagnose it, you know, which type it is. And in the treatment would normally be going to wash your hands. Don't touch your eyes. Often if you've done all those things correctly and you still continue with persistent infections, you're often carrying the bug in your nose and so you can treat your nose. And then today there are also a number of new drops in the market and sprays that are very, very good at you can unclosed eyelids, just put it straight on and that would keep the area sterile.
So if it persists and doesn't clear up, definitely worthwhile seeing something about it.
Next, Textor says, in 1977, I had an eye injury. I'm 60 now. The damage was a morning glory detached retina. I Googled that. It is the thing.
I got light only in my eye for more than 40 years. Any hope of getting my sight back.
So obviously, here's someone who has quite an old injury and wondering if there's anything can be done now.
So, yeah, here's the thing. Even if something could be done now, it wouldn't make sense if the other is good. None of the technology today that can restore this sort of sight. It's going to work unless it's your only eye. So there are people working on on solutions for people in this sort of situation. If that was the only I there are a couple of projects like second site with retinal implants, but while the other is functioning well, no, there's nothing.
Okay, my dad had a stroke ten years ago, said this news dog texta, leaving him with the loss of peripheral vision on one side due to brain damage in that region. At the time, he tried corrective lenses. That didn't help him, though. Is there anything new available nowadays? He's been through a lot health wise lately. If there's something to give him a boost, it would mean a loss. That's from Paul in Newcastle.
Yeah, it's a real problem. So there surely are new Lanzas, the new intraocular lenses, the prisoners one could use. But it's all going to depend on exactly what the visual field looks like. So the key thing is to have the visual field assessed by an ophthalmologist. There'd be no which areas of the retina are working. And then you can try and figure out if there's a way around it. It's all dependent on the visual field. OK, I need readers for a print text, I got them a few years ago now pretty quickly, I find I need readers for phone and computer screen to seemed like a pretty quick transition.
Is this normal? Well, I'm guessing the texta probably has been looking at screens a lot more in the last 12 months. Or could it have exacerbated an existing problem?
Yeah, it could have exacerbated it for sure. But the interesting thing is it's completely normal. You know, for some people, presbyopia creeps up on you and it's a thing that develops slowly. But for many, it happens so quickly, you just can't believe it. So, no, it's completely normal. I wouldn't be concerned about that.
Allans and Golway, I have a lazy eye which often drifts, causing some double vision. I often have to move my head and turn my eye to reset it, but at night I can get quite bad. I do not drive yet and this issue has held me back from even trying. Is there anything I can do that sounds like a severe pain on the back side if you have to move your head to reset your eye?
Absolutely. And there is. And you should do something about it. This can really set you back in ways you don't need to. What you need to do is see either an orthopedist said someone who specializes in alignment's or an ophthalmologist who specializes in sequence. And most of the time today they can help you often with surgery to align the muscles. They can help you with exercises to improve fusion, which is with the two eyes work together. And if you're not suitable for surgery, they can also spectacles.
They can put prisoners in spectacles to help. But the key thing is to find out what the underlying cause is different. To have it checked on.
Something can be done on a limerick listener who got in contact. What does a news talk? I have an underlying eye condition uveitis. Can the call for a jab possibly cause immune problems are returned of inflammation? I'm in my mid 50s. I'm going to pre-empt that by saying probably not. And if you're concerned, talk to your GP. Am I wrong, Arthur?
Now, I think you're right, but it's a very topical question given that, you know, the vaccines are being used now and uveitis is mostly an autoimmune problem. But we've seen nothing like that. We've read nothing like that. So I don't think that I think your answer is right, Jonathan.
I'm 53. I have a major problem with my eyes. Since Lockdown's work on screens all day, like a layer over my eyes all the time, often feels like I've something in my eye. Is this common, I wonder. That's from onea. She describing not dry eye there.
You and Pat are getting so good at this you don't need me anymore. I know you're spending so much time on the screen.
There are a couple of things that are happening. The first one is you're not looking away enough anymore. But this continual staring at the screen, what happened is you blink less well and every time you blink, it doesn't matter how your eyelids move. Exactly. You produce a water drop, but you only produce an oil drop that protects the delayer from evaporating when your eyelids closed properly. So you've got to be properly. So this sounds very much like that.
You're just not thinking properly. There are a number of exercises you can do. One's called the 2023 rule, which is every twenty minutes you look at something twenty feet away for twenty seconds that at least gives the the focusing muscles break. And then the other thing you should do for about a month is while you're on your screen, every time you press the enter key, squeeze your eyelids very tightly and what you're doing is you are conditioning yourself to associate pressing enter with a very strong blink.
Someone walking in the room would see you doing that. They'd wonder what's wrong with you, but only doing your conditioning. And a month later you forget about doing this activity. But now, for the rest of your life, every time you press enter, you'd have a normal blink. No one would see the difference, but the blink would be normal and diligent.
Well, is that at a minimum, it's a talking point. When you do go back to the office and meet other humans again, it probably won't be as pronounced as that. Carter's advice. Carmen. Good morning, Connor. He says, I've recently shown signs of developing glaucoma. I'm 51, overweight and fairly active. Can I mitigate against his degenerative effects? Is that a bit young to be developing glaucoma?
No, no. From the age of 40, it makes sense to to look for it. The best thing to do, Connor, is to keep your intraocular pressure low. It was a very well conducted study years ago, a massive study for people whose pressure was slightly elevated with no signs of glaucoma. And they showed that by using a drug and today it drops a once a day, you could reduce your risk of developing glaucoma by 50 per cent and certainly prevent serious look coming down the road.
So that would be my main thing. Make sure that you have seen an ophthalmologist who's assessed your risk for glaucoma down the road and then decides on whether you should be using a drug now. And as I say, they're pretty safe in one day and I'm not a big inconvenience, Billy says.
In early December, in my stronger right eye, I started to see flashes of light, something like a torch light lasting on and off for a day by chance. I was having my eyes tested for glass as I mentioned it to them. They checked out the eyes and said it was OK. Since then, my eyesight has definitely deteriorated and more annoying. Ah, the floaters in my eye. Is there anything can be done for these flautas? Do I need to have my eyes rechecks or.
He's noticed something himself. The optician did. See anything? Does he need to do something about that? So floaters are very, very common and most people have them, especially when you look at a blue sky or a grey sky or even a white wall, you tend to see these little things drifting around. And that's what Bill is referring to, what potentially is suddenly made things worse, especially if there were light flashes. Is that the jelly inside the eye?
It's called the vitreous has detached and the jelly detaching is completely, completely normal. So when people get where they touch in terms of IQ, they get very nervous because they think of retinal detachment surgery. Detachment is normal, happens to everyone. And one in 10000 cases of a detachment may lead to a retinal detachment. So it's nothing to be concerned about. But what happens when the jelly comes loose? There's almost like an interface now sitting directly in front of your fine vision area, the macula.
And it's like you're looking through this additional layer of of something and it tends to get better over time because it moves further forward inside the eye with time. And that makes it less impactful on the back of the eye and your vision. If it doesn't, there are a couple of treatments that can be done. One is you can laser the jelly with a laser called the egg laser to break it up into smaller pieces. There are only a couple of people in the country doing that.
And then you can also do a procedure where you can, in fact, remove the jelly. But these are things that are normally reserved for cases that really bothering people, impacting their quality of life and where they've waited long enough for nature to take care of it. And it just hasn't happened. But there are things that can be done. The key thing for Billy is if you suddenly start seeing a lot of light flashes again is to at an ophthalmologist, look at your peripheral retina to make sure your risk of a retinal detachment is low.
Arthur, we could go for another 20 minutes with all the questions that have come in, which means we are going to have to invite you back again at some stage in the future. But for now, Arthur Comics', medical director and consultant ophthalmologist at the Wellington Eye Clinic, thank you very much for joining us on the program.