News & Views

In this episode, we speak with Mr. Aman Chandra a consultant Ophthalmologist from Southend who tells us about the use and safety of oil and liquid devices in vitreoretinal surgery. We also talk with Mr. Mike Burdon, the president of the college who gives us an update regarding the newly published strategic plan from the college.

The RCOpth is a stakeholder of the Clinical Council for Eye Health Commissioning (CCEHC), an independent advisory body providing evidence-based national clinical leadership, advice and guidance to policy makers in health, social care and public health, and those commissioning and providing eye health services in England.

We'll be hearing from Fahd Quhill, Consultant Ophthalmologist from Sheffield on his research into laser pointer retinal injuries followed by an interview with Jeff Hogg, a registrar from Newcastle who tells us about his work analysing prescribing trends in glaucoma.

The Secretary of State for Transport’s Honorary Medical Advisory Panel on Driving and Visual Disorders has advised that it is the visual problems associated with nystagmus that are relevant when assessing fitness to drive, not nystagmus itself.

We are calling on all those involved in funding and running national clinical audits to support our campaign #makemydatacount.

The Royal College of Ophthalmologists supports the quality standard but believes the implementation will be challenging for the overwhelmed hospital eye service.

There have been several case reports on the use of nitrous oxide in the presence of intraocular gas after vitreoretinal surgery with severe loss of vision due to central retinal artery occlusion.2-6 There have also been some cases identified via national incident reporting systems. Nitrous oxide leaves the bloodstream and vitreous cavity quickly once inhalation is terminated,7 restoring the position of the lens-iris diaphragm and reperfusion of the central artery can happen. However, irreparable damage to the retina is known to occur after 100 minutes of ischaemia.7 The extent of damage to the eye may therefore be dependent on the duration of general anaesthesia / use of Entonox and the size of intraocular gas bubble at that time. There is a theoretical risk of harm (raised intraocular pressure or hypoxic iris) in anterior chamber gas bubbles during keratoplasty in the same circumstances, that is flying, high altitude or nitrous oxide use. It is currently unclear whether this represents a significant risk, as there is little published, but some corneal surgeons are warning their patients not to fly postoperatively.

Allergan Pharmaceuticals Ireland is recalling numerous batches of Ozurdex due to the possibility that a single loose silicone particle of approximately 300 microns in diameter may become detached from the needle sleeve during administration of the implant and may be delivered into the eye along with the implant.

The College has received queries from members to clarify whether there is a specific cut off for glycaemic control, either measured via HbA1C or a blood glucose level on the day, beyond which it is unsafe to proceed with cataract surgery.

There are a range of cefuroxime preparations currently in use for the prevention of endophthalmitis in intraocular surgery. The College recommends that for those using a non licensed product, users should check the SmPCs and avoid use of any product which specifically cautions against intraocular use.