The NHS Improvement national patient safety team have informed the College of the continued trend of incidents involving issues with detachment of cannulas during ophthalmic surgery (cannula-associated ocular injury, COI). The cannula is usually attached to either a saline or a viscoelastic syringe. The combination of a small lumen and plunger pressure can result in significant hydraulic force. If the cannula does detach, it can cause extensive damage to the globe with resultant visual impairment.
This research, conducted through the British Ophthalmological Surveillance Unit (BOSU), found patients suffering permanent and severe visual loss due to health service initiated delays1. The research involving all UK consultant ophthalmologists, showed that up to 22 patients per month may be losing vision by such delays. These patients are from a vulnerable social group with chronic conditions requiring long-term routine follow-up such as glaucoma, age related macular degeneration and diabetic retinopathy.
The College recognises that botulinum toxin and surgical treatment for strabismus* are important procedures that are performed in children and adults to promote, improve or re-establish binocular function, manage diplopia and restore ocular alignment and balance. Surgical intervention (including botulinum toxin injections) performed to achieve these aims is thus not a cosmetic procedure and does not fall under the GMC guidance for cosmetic surgery. Commissioning pathways for the management of squints reflect this. Surgical intervention (including botulinum toxin injections) performed to achieve these aims is thus not a cosmetic procedure and does not fall under the GMC guidance for cosmetic surgery. Commissioning pathways for the management of squints reflect this.
These guidelines (July 2015) reflect changes in treatments, since the 2010 Interim RVO Guidelines. The guidelines provide evidence-based, clinical advice for the management of different aspects of RVO. The scope is limited to current diagnostic tools, management and service set-up and delivery to facilitate delivery of optimal care.
It is hoped that the Guidelines for Thyroid Eye Disease (2015) will facilitate early diagnosis and better treatment of patients with this disease. It is estimated that there are about 2,500 new cases of Thyroid Eye Disease (TED) every year in the UK. The figures have declined over the past 10-20 years for reasons that are unclear.