Clinic News

Fiona represented Ireland at 3 World Cups and captained the Ireland team that won the 2013 Women’s Six Nations Championship

In 2013 she was named Sportswoman of the Year

In this article she discusses “Eat like an athlete” and mentions her surgery here at the Wellington Eye Clinic

“THIS IS A TRULY WONDERFUL TIME TO BE AN EYE SURGEON.

“The outcomes we can achieve today for people we could only have dreamed about 15 or even 10 years ago”.

Dr Arthur Cummings, speaking at the launch of his book, ‘Customized Laser Vision Correction’ at the Wellington Eye Clinic *(co-edited with Professor Mazen Sinjab).

The book was written for eye surgeons, and details the different laser eye surgery treatment options and techniques.

Our congratulations to Dr Cummings on another milestone and another career highlight!

For this study, we recruit candidates with presbyopia (age-related near vision loss). The study evaluates the use of corneal tissue to correct near vision to eliminate the need for reading glasses or contact lenses. If you are interested to register as a candidate for this study, please complete the application form below.

Presbyopia is also known as age-related near vision loss resulting in reading issues.

People with presbyopia:

• experience a gradual loss of the ability to focus on close objects or small print;

• typically develop problems reading up close as of the age 45;

• find themselves struggling while reading smartphones messages, menu cards, price tags, …;

• start to hold reading material at arm’s length;

• who don’t already wear glasses or contact lenses, may choose to wear reading glasses all the time or only when necessary to magnify up-close objects. The glasses or contact lens prescription begin with plus numbers (like +2.50).

Please note, presbyopia is not the same as hyperopia. Hyperopia is not age-related.

On 09/08/2018 the ethics committee of Beacon Hospital has given a positive advice for the conduct of this study. This approval is valid for Ireland. The study is sponsored by Allotex.

For more information or to register click here

We are often asked why does the Surgeon give eye drops during the Consultation?

Arthur Cummings Consultant Eye Surgeon at the Wellington Eye Clinic explains.

It can be a bit inconvenient not being able to drive after your Consultation for laser eye surgery. So why exactly does the Consultant Surgeon give you drops during you first visit to the Wellington Eye Clinic?

There are two reasons why you get eye drops during the Consultation.

The first reason is to make sure that your eye drops are healthy.
If you do not dilate the pupils and make them wide you cannot see inside the eye.

The second reason is that a standard eye test is subjective. So when your eyes are being examined you are asked if you prefer one lens to another, or asked if red is better than green.

This is because your lens has the ability to move inside your eye. So we never know which exactly which is the right correction for you.

In addition to widening the pupil, the drop also paralyses the lens.
So by repeating the tests when the lens is paralysed you are confirming that the original readings are the correct measurements

An intraocular lens is an artificial lens that is used to replace the natural lens in your eye.

You would use an intraocular lens if you were removing the natural lens in your eye such as in the case of a cataract, or a clear lens exchange.
In these cases laser eye surgery will not correct the vision.

In the case of a cataract (cloudy lens) and a clear lens exchange (clear lens) the natural lens in the eye needs to be replaced.
These lenses are the intraocular lenses, sometimes referred to as an” IOL” for short.

These lenses are normally manufactured from an acrylic material these days. They are designed for permanent placement in the eye and they are designed a very, very long time, much longer than the average lifespan.

The lenses are made so accurately that it is possible to select a lens power that will not only get rid of a cataract, improve your vision but also get you very near to your visual target.

In other words if you are looking to get rid of glasses for distance the target will be zero.

If you are looking to eliminate your reading glasses the target would be minus two.

So vision can be targeted as a result of the fact that these lenses are so well made.

Mr Arthur Cummings, Medical Director, Consultant Eye Surgeon and Chair of the Department of Ophthalmology, Beacon Hospital, Dublin Ireland

Consultant Eye Surgeon and Medical Director, Wellington Eye Clinic; Consultant Ophthalmologist and Head of the Department of Ophthalmology at The Beacon Hospital, Dublin, Ireland

Arthur is behind some of the smartest and most advanced interventions and instruments in refractive surgery, and his opinion – borne of years of experience at the leading edge of the field – carries considerable weight. He currently sits on the medical Advisory Boards of more than 10 companies in the ophthalmic space, including lasers, IOLs, diagnostics and dry eye diagnosis and management. His research interests include refractive surgery, cataract surgery and corneal surgery for keratoconus. Arthur’s an entrepreneur too; he was part of the team behind Clearsight Innovations’ ocular biometer, which recently made its way to a successful exit. If you had any doubts about his influence, let this fact put them to rest: he’s currently the President of the European Division of AECOS.

What have been your career highlights?

“There have been many highlights along the way and this is what makes ophthalmology such an interesting and exciting career. The gratitude that patients show on a daily basis creates job-satisfaction for ophthalmologists. That’s our baseline. Over and above that we enjoy technological advances at a pace that no other medical specialty does. In fact, there is so much technology in our field that it can sometimes become overwhelming and you have to keep your wits about you when making purchasing decisions. We have amazing meetings where colleagues, industry and the funders participate in the same meeting e.g. AECOS and this is a platform that I have not seen in any other medical specialty. It generates excitement and it creates an innovative environment. Becoming European President of AECOS was certainly a highlight for me. My son Brendan deciding to specialize in ophthalmology was also a career highlight for me.”

*What are your goals for the future?
*
“I want to expand the Wellington Eye Clinic into a more comprehensive eye clinic with world-class services across the board. Today we specialize in cataract and refractive surgery and have recently introduced an excellent glaucoma service. We have a way to go yet to get all the sub-specialties covered so this will keep me busy enough for the next decade. I want to continue to work with scientists and physicists and people smarter than me to bring new innovations to ophthalmology that increase efficacy and safety of our procedures.”

What has been your most successful collaboration?

“ClearSight Innovations was the first major private and personal collaboration that went all the way to an exit, and for this reason has to be the most successful. It involved working with friends like Michael Mrochen (qv) and that made it even more rewarding.”

What are your plans for the next 10 years?

“I want to expand the Wellington Eye Clinic and I want to continue to be involved in the innovation space both in a personal capacity working on our own projects and as an adviser on various medical advisory boards for industry partners. Being a part of a bigger picture that goes on to enjoy success and improve patient outcomes and safety is immensely satisfying.”

What drives you day-to-day?

“Patient satisfaction. It’s the first line on the Wellington Eye Clinic’s Mission statement: Patient satisfaction is our first priority. This approach ensures not only that you pursue excellent outcomes for patients but also that you treat patients respectfully and kindly so that they are just as satisfied with the experience at the clinic as they are with the actual outcomes of the surgery. I am supported by an excellent team at the clinic and I like to see them excel and grow and make the most of their opportunities too.”

Who have been your mentors?

“There have been many that have played different roles throughout my career. My first experience in private practice was in Pretoria, South Africa, where I worked with two super-star ophthalmologists Eugene Meyer and Piet van Rensburg. They introduced me to the nuances of private practice. The head of the department in Pretoria where I specialized, Professor Hennie Meyer, was an inspiration – as was his successor, Professor Polla Roux, who showed his students respect for patients. Working alongside Michael Mrochen for the past 15 years or more and the prospect of continuing to collaborate with him excites me. Michael’s mantra of not making any assumptions is easier said than done but it continues to lead to innovation when you do practice it. Guy Kezirian has been a mentor since I first met him more than 15 years ago and he has taken that to a new level with his Physician CEO course presented at Kellogg School of Management at Northwestern University in Chicago that I recently had the pleasure of completing. There are numerous colleagues that have influenced me very positively and this list contains many of them.

Many great inspirations for me personally may never appear on a list like this just because they may not be well known, but they continue to play a very important role in my life. I am inspired by people that are fighters and who succeed against the odds. In private practice, we have many people just like this that mentor me on a continual basis without ever realizing it. Ophthalmology is deeply infiltrated by really good people that are generous, intelligent and kind and it’s a great pleasure to be part of this wider family. Finally, there are the engineers, scientists and industry experts that teach me every time we meet about the things that we doctors just don’t know enough about and they too continue to educate me.”

In absolute terms, the profession that would have had laser surgery most would be Accountants.

In fact often patients who are desk-bound want to get out at the weekend and maximise their time off doing exciting things.

In the United States, many in the military that have had laser eye surgery particularly in the navy and air forces.

In relative terms however the group which has had the surgery most would be Ophthalmologists.

Eye surgeons are four times more likely to have had the surgery (pro rata) than Accountants.

This is because we see the results and know the safety profile.

You will find very few laser eye surgeons who have not had a family member treated.

One of the main advantages of LASIK is the reduced recovery time.

This is why it has come so popular.

It is possible to have the surgery done now, and within 2 hours 50% of patients have 20:20 vision.

Although it can regress overnight, by the next morning 80% of patients are 20:20 or better. It can vary from person to person, but within a couple of days the vast majority are seeing 20:20 or better.

The down time is one day and it is then possible to return to work.

In term of the vision the down time is also one day. In terms of pain, the discomfort is in terms of hours rather than anything more.

For contact sports it depends, but usually two weeks or at the most six weeks for boxing for example depending on the sport.

Of all the procedures that we do it is the procedure with the quickest recovery time.

To have laser eye surgery you need to be at least 18 years of age.

If you are a mature 18 year old then there is no problem.

Some surgeons prefer that you are 21 years of age. However there is enough evidence to suggest that if your correction is good, then the progression of myopia is stopped.

For this reason, for a patient who meets all of the criteria during an evaluation we are happy to perform the surgery from the age of 18.

At Wellington Eye Clinic we are with you every step of the way.

From your initial consultation to your post-op checks.

Our app will guide you and your family through the entire process.

The timeline will ensure that you are kept informed about the next steps in your treatment.

Informative videos will offer you everything you need to know along the way.

Reminders are sent through push notifications, so you’ll never miss a thing.

Download the app today. It’s a useful addition to your treatment.

WHAT IS MEANT BY REFRACTIVE LENS EXCHANGE / CLEAR LENS EXCHANGE?

Refractive Lens Exchange (RLE) sometimes known as Clear Lens Exchange (CLE) is where you want to improve your vision, but, you are not suitable for laser eye surgery (or any other technologies) but you do not yet have a cataract.

A cataract is where you have a cloudy lens inside your eye.

If you have a cataract operation the cloudy lens inside your eye is removed and replaced with an artificial intraocular lens (IOL) inside the eye.

For a RLE, the procedure is the same except that you are removing the clear lens inside your eye and replacing it with a new lens.

This lens will do the job of the old lens, plus the job of the glasses that you used to have.

With the RLE the new lens gives you your new vision by changing the power of your new lens.

It has some advantages. One of which is that you will never develop a cataract.

It is what we use most times when you are not suitable for laser eye surgery.

WHAT IS ASTIGMATISM?

We are often asked if it is possible to treat astigmatism with laser eye correction. The answer is definitely yes we can. But what exactly is this eye condition and how does it impact on vision?

For someone with astigmatism their cornea or the front clear part of the eye is not perfectly round.

So for a person who does not have astigmatism the surface of the cornea is a bit like a soccer ball in that the surface has the same curvature all around.

But for a person with astigmatism the cornea is shaped more like a rugby ball. In one direction it has a nice smooth curve, but in the other direction it has a much steeper curve.

This leads to your vision being blurred both up close and in the distance.

It can also lead to eyes becoming tired very easily.

Imagine looking at the letter “E” on a chart.

If you have no Astigmatism then the vertical part of the “E” and the horizontal part land up in the same place.

If you have astigmatism the different curve in your cornea can cause the horizontal, or vertical lines – or both – to be bent or distorted.

The brain needs to work harder to compensate.

In addition the vision is not always the same.

For people without astigmatism, when they wear glasses, no matter at what angle they are looking through their glasses because their corneas are regular they get the same benefit.

With astigmatism if you look slightly off centre then you are not getting the perfect prescription.

So astigmatism is a condition in which your vision is reduced.

Dr Arthur Cummings, Medical Director and Head of the Eye Department Beacon Hospital, Dublin Ireland explains what LASEK laser eye surgery is, how it differs from LASIK and what needs to happen immediately after the LASEK surgery

While under the laser, you are asked to look at a green, flashing light. Some people are concerned that they will not be able to fix on this light well enough and that it will impact their outcome. Watch this video to see why you need not worry about this any longer. The eye-trackers are so good that they will follow every movement you make, no matter how unsteady you may be.

It’s funny even though I had chatted so much to the Wellington Eye Clinic staff before going in for my consultation I was still a little nervous, I was afraid that years of surfing and swimming in the sea coupled with a stint last year of wearing very cheap contact lenses (please people NEVER NEVER do that to your eyes, I was very lucky not to suffer serious damage) that my eyes would be fit for laser eye surgery. This is something that I think it is important to be aware of, but if you let the clinic know in advance that you suffer from dry eyes or anything like that they can let you know what to do in advance to have healthier eyes by the time you come in. Since I had been following this advice then nerves were mostly drowned out with excitement. This was actually happening!

Before my consultation I did a course of omega 3 oil supplements and warm compresses on my eyes any evening I could remember. There’s a link to these videos here and here, I used a rice eye bag that I had from yoga and just popped it in the microwave when I had a chance.

On the morning of the consultation, I knew I would be in for up to two hours as various different nurses, optometrists and also Dr Cummings all ran various tests on my eyes. This was to assess my sight, the health of my eyes but also things that would affect what type of surgery I could have. The thickness of my cornea, if I had a stigmatism etc.

Everything went very smoothly and the only bit of discomfort was the dilation drops which sting a little as they go in, but it passes quickly. My eyesight was a little blurry for a few hours after so my mom came with me to drive me home.

I think many people put off the initial consultation for laser because they’re afraid of pain, worried about the cost, but for me I was afraid my eyes would be rejected and then the dream would be shattered. For anyone sharing my fear I say get tested as soon as you can, the science of the procedure advances so fast it is amazing the cases that can easily be looked after.

I was delighted to find out that I was eligible for LASIK, which is a super fast healing treatment. All of my consultation and procedure were filmed so its possible to see my absolute joy at hearing the procedure could go ahead. I’ll have a link to this in the coming months. I was booked in for the next morning and off I went home to have a good rest.

Seeing is Believing – My Laser Eye Surgery with the Wellington Eye Clinic

I was one of those lucky little ducks who for all my young life (till age 16) had perfect eyesight. Want to know what that bird is out to sea? Ask Finn. Need to know what number bus is at the end of the road in the dark? I got you!

And just towards the end of secondary school (I’m looking at you leaving cert) everything started to get a little fuzzy. Damn genetics. Like my mother, grandmother and basically everyone else in my family, I needed glasses.

Now don’t shoot me here. I’m not saying there’s anything wrong with glasses. Some people wear them and they look just effortlessly cool, more intelligent, maybe even a little French. I just look uncomfortable. Read on to find out about my laser eye surgery journey here.

Wearing glasses has never suited me. When I’m rushing around, when I’m nervous/giving a presentation they just fog up and I feel like an absolute ejit. When I work at sea on research vessels they are a complete hindrance.

Work

First of all you have to prove you’re bringing two pairs, in case one pair falls overboard. Then you have to do an eye test before you leave. When it gets to actual work you have to stuff your glasses under your science goggles and then eventually get a headache from the pressure on the sides of your head. Outside there is constantly sea spray getting on the glasses or on a nice day you’re switching between regular glasses and prescription shades all the while trying not to lose either or get them crushed in any of the machinery. Come back in from the cold at night and they fog up.

Now that I do a lot of catering work, the main battle is glasses steaming up opening ovens and looking over pots, taking glasses off to read recipes and then forgetting where the glasses are.

Play

And thats just professionally. I love to be outdoors, ever since I was little I’ve rambled and scrambled around the country side with my parents, hiking, swimming and later in my teens surfing. Needing glasses has impaired me in the water massively. I can’t see the bigger waves out the back on their way to me, I can’t see important features on land that tell me how I’m moving with the current and I can’t see other people so well (are they friendly, are they in my way/am I in theirs etc).

So why don’t you just wear contacts you ask? With science (and science at sea) I can’t wear them working with chemicals and working split shifts and sleeping 4 hours twice a day would mean two sets of contacts a day (expensive). Contacts aren’t great cooking as I can feel the heat dries my eyes. But the biggest most annoying no no is I can’t wear them in the sea surfing or swimming. Wearing contacts causes tiny cuts (more details on this) on the surface of the eye and while this can be ok for someone who works at a computer or mostly indoors this is not good when you’re in the ocean. Not only is the salt in the environment massively drying (I’ve had contacts shrink on to my eye making it difficult to get them out in the very salty seas of the Canary Islands), but there is a big chance for bacteria from the water to get into you eyes. With that in mind I just don’t wear contacts anymore for the health of my eyes.

So I’m wandering around half blind.
Sorry if I never wave at you on the street.
I promise I always wear my glasses when I’m driving.
So it was a few years back that the idea of laser eye surgery first came into periphery.

Inspiration

A fitness Youtuber that I’ve been following for years – Nikki Blackketter – did a video on why she wanted laser eye surgery and why it would be so beneficial for her career in the fitness industry. I could relate to everything. Seeing how happy it made her, as well as how quick her recovery was and generally how it was just way less scary than I had imagined it would be.

Then suddenly a friend I baked with got it and I saw what a massive difference it made for her in the kitchen. I couldn’t believe it, she was even in work the next day. Then a good friend I surf with got it and I constantly plagued her in the water asking about how her “new eyeballs” were. As her only other friend with glasses she was delighted about it, since no one else had been asking about her miracle of sight.

Then things started to fall together. I began researching laser eye clinics and seeing that there were clinics all over Ireland. I was wary of all these “two for one” type offers. After all, it’s my sight. I wanted to be sure I was in the safest hands possible.

Then in wonderful randomness of the world, when I was getting a lift home from a business course the wonderful lady who was driving me (Caca Willis is her business, look her up her cakes are some of the most beautiful creations I have ever seen) saw me fumbling with my glasses to see something out the window.

The chats began, had I ever considered laser eye surgery? I told her my story. It turns out Michelle had already had the surgery herself. What did she think of it? She said it was the best investment she had made in her life. In. Her. Life. She has a successful business, a beautiful car (this is all I’ve seen so far). But this investment she’d made in herself and her own health was priceless.

The Wellington Eye Clinic

She told me all about her surgery and I told her my trepidations about getting the surgery. The answer she said was the Wellington Eye Clinic in Dublin. One of the longest running clinics in Ireland, with top spec equipment and amazing surgeons. But what I think made her remember it all so fondly was the staff, she raved about the clinic and the surgeons and how safe she felt and how amazing the aftercare was.

It took me two months to work up the courage (I was still a little scared!) but I got in touch and right away I saw exactly what she meant, every member of staff I was in touch with was so friendly and helpful. We chatted about which type of surgery would be best suited, talked me through how it would work and sent me on loads of information about what to expect and how to have my eyes in tip top shape for the surgery. We chatted about my surfing, cooking and life working at sea and how much of a phenomenal difference it was going to make to my quality of life.

We partnered up as the clinic had decided it was time to make a new video for their patients to see before they came in for surgery. I was delighted to do this since it was exactly that video of Nikki who had put me at ease and made me realise I could do it! With that in mind I filmed a little of my last trip to sea wearing glasses and plan to film my pre and post op. So you can be with me for the whole experience and for anyone thinking of laser eye surgery they will know exactly what to expect. This will include the initial consultation to assess my vision, pre-op, the surgery itself and then post op and then some surfing and adventuring testing out the new vision!

For more information on the Wellington Eye Clinic check them out online at www.wellingtoneyeclinic.ie  and also check out their youtube videos. The videos have been a massive help for me as I have quite dry eyes these last few years from surfing and spending a lot of time working on a computer so these videos gave me great info on what I could do for myself at home even before my consultation!

Pictured at the launch of the #BeaconEyeClinicRapidAccess at the Beacon Consultants Clinic this morning were the Minister for Health, Simon Harris and Dr Arthur Cummings, who in addition to being Medical Director at the Wellington Eye Clinic, also has the same role at the new service.

The Beacon Eye Clinic Rapid Access is designed to complement existing urgent services for patients with eye problems. The Clinic offers a priority appointment with a Consultant Specialist Ophthalmologist for patients within 1-2 days, and targets a waiting time of less than 30 minutes for patients when they arrive at the Clinic.

It is difficult to reconcile given recent events yet Syria is one of the early cradles of civilization.

Since 2011 the country has been devastated by a bitter civil war.

The death toll of the conflict stands at nearly 500,000 since the outbreak. More than 1 in 10 of the population have been killed or injured. Atrocities have included the use of chemical weapons.

The Syrian Eye Surgeons are an extraordinary and inspiring group of Doctors.

In spite of the hardships that they face, they do their best to update themselves in order to offer the best treatments possible to their patients.

Dr Arthur Cummings was invited to present a paper to their congress this week concerning the treatment of keratoconus using laser surgery. The presentation was conducted via Skype to a conference room in downtown Damascus from the operating theatres at the Beacon Hospital

The organiser of the Meeting, Dr Anas Anbari told us that this meeting is regarded as one of the most important annual continuing medical education events in Syria.

Find Dr. Cummings’ editorial spotlight below.

Dr Arthur Cummings, Consultant Ophthalmic Surgeon, launched his book “Corneal Collagen Cross-Linking” at a function at the Beacon Hospital.

The book is a text which describes the range of treatments available for the management of an eye condition called Keratoconus.

Keratoconus is an eye condition in which a patient’s cornea (the clear front part of the eye) becomes progressively thinner. This can lead to blurred and / or distorted vision.

…

“If you have Lasik done, where a flap is created, then you can go back to things like golf, tennis, and running – those sorts of things within a day or two. If you want to do swimming you’d wait for a couple of weeks. Probably the best thing to do for contact sports – like karate or boxing or rugby, is perhaps to wait for 6 weeks. If you do Lasek or PRK which is on the surface, then there is nothing that you can’t do within a week. The moment the surface has healed you can go back to doing anything. You can go back to doing what you want to do.”

Dry Eye is a common condition.

There can be many causes for the condition.

Some of these include working for long hours on computers, the wearing of contact lenses, side-effects of some common medications, getting older and simply being female – all of these factors and more contribute to this sometimes very annoying condition.

Dry eyes can impact your vision very significantly as the light rays entering the eye actually bend on the surface of the tear layer and not the cornea as one might imagine. If the tears are unstable, then the vision is less crisp.

There are a number of possible approaches in the treatment of the condition.

The clinical staff at the Wellington Eye Clinic recently collaborated to compile a short document which explains what causes the condition, and also outlines the treatment options currently available here.

PLEASE CLICK ON THIS LINK TO DOWNLOAD YOUR COPY
Dry Eye Information PDF

Hear Dr. Cummings explain what a cataract is and how it forms:

“A cataract is when your natural lens starts clouding. Your natural lens is inside your eye, your natural lens is clear, is relaxed when you’re looking far, and it changes shape when you’re looking up close, and as we get older we lose this ability to change shape and that’s when people get reading glasses, but the lens continues to grow. That’s one of the reasons that this happens, but as the lens continues to grow, more and more fibres pack into the lens, so the lens becomes more dense and it becomes less clear. The best analogy is, mainly because the lens is the most protein-rich part of your body (there are more proteins in your lens than in muscle). The best way to think about this is thinking of an egg; if you’re frying an egg and you break the egg up in the pan, you can clearly see the yolk, and around the yolk you can very clearly see the bottom of the pan, and as the egg starts frying, the clear material starts becoming cloudy, it goes white eventually, and if you fry it for too long it goes black. Exactly the same with your lens. As the lens starts becoming more cloudy and the proteins are coagulating, they become less clear, and then you have a cataract. It comes from the Latin word that means “waterfall”. The first person who described this and called it a cataract, said it’s like standing in a waterfall and looking out through the waterfall. That’s how my vision feels – it’s blurred.”

QUESTIONS TO ASK YOUR SURGEON IF YOU ARE CONSIDERING LASER EYE SURGERY?

Making a choice about which Surgeon to carry out your laser eye procedure can be a little overwhelming.

Attached is an excellent summary from the American Academy of Ophthalmology of the questions you might consider asking.

http://buff.ly/2l08OaP

For more details on how to help eliminate your need for glasses or contact lenses at the Wellington Eye Clinic you can visit our Laser Vision Correction page at http://wellingtoneyeclinic.ie/vision-correction-procedures/laser-eye-surgery.php

Or email [email protected]

You will always meet a Surgeon on your first visit at the Wellington Eye Clinic.

(copy and paste the links into your browser)

Listen to Dr. Cummings talk about what you should look for in a laser eye surgery clinic:

“A good laser eye surgery clinic? You’ll never get the sense that you’re being pressurized into making a decision. I think a second thing about a good laser eye surgery clinic is that they do much more than just laser eye surgery. I’m sure you’ve heard the term, if you have a hammer, everything looks like a nail. So if you’re doing laser eye surgery or refractive surgery and the only tool you have is a laser, then anyone who comes in your door, you want to laser, even though they might not be a perfect candidate. The moment the clinic offers everything there is to offer and has a full toolbox then you can start saying when one surgery might be a better option than another for a particular prescription. That’s the first thing, the second thing is, a clinic where the surgeons have done a certain number of cases, so they’re not learning on you, they’re experienced. A third thing would be, where it’s a primary focus of the clinic. If you’re doing laser refractive surgery, you need to remember this is people who healthy, on the go, economically active and there’s no place for error. You don’t want your surgery being done by someone who’s doing this as a hobby and does two or three now and then. You want this done by someone who is doing this seriously, who wants it to be done perfectly every single time. Those are the key things for me that I’d be looking out for (in a good laser eye surgery clinic).”

Keratoconus (or KC) is a progressive disease affecting the outer-most layer of the eye (the cornea), causing permanent blurred vision and sensitivity to light at night (presence of glare or haloes). Corneal Cross-Linking (CXL) is an established surgical procedure. It was first introduced to Ireland by the Wellington Eye Clinic in January 2007 and is mainly used to treat keratoconus. The standard treatment takes one hour, although recent trials at the Wellington Eye Clinic have reduced treatment time to 40 minutes. The aim of CXL is to stop the progression of keratoconus by stiffening the corneal tissue through the use of UV-A light and riboflavin (vitamin B2). By halting the progression, a patient’s vision can be prevented from deteriorating and on occasion contact lenses can be worn in order to obtain normal vision.

The annual Corneal Cross-Linking (CXL) experts meeting, the most recent being held in Zurich Switzerland in December 2016, is no doubt my favourite conference of the year. With an average of 200 attendees, the two day congress is filled with the latest clinical and research findings on how to treat keratoconus, ectasia or corneal infection with CXL in the most efficient and painless method possible.

Epi-on or Epi-off? How much riboflavin to apply? What is the role of oxygen during the procedure? CXL with refractive surgery? Is it safe to treat children? These questions we discussed are only the tip of the iceberg of topics covered.

I have been studying CXL since 2010, and will hopefully finish my PhD in the coming months. So when I spend two days talking to the world’s leading researchers and surgeons in the field of CXL, it makes me appreciate how much the Wellington Eye Clinic contributes to research. And to be frank, we also want to improve the treatment and patient’s visual outcomes as much as everyone else in the field. Mr. Arthur Cummings, together with Dr Mazen Sinjab, recently published a book on CXL and I had the pleasure of contributing to. The book is now available and adds significant knowledge to the CXL space. (Corneal Collagen Cross Linking – Springer)

Rebecca McQuaid MSc

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