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Ozurdex injection for uveitis

One of the  many challenges in managing patients with uveitis is the side effects due to the long term use of oral steroids or immunosuppressive drugs. In purely ocular inflammatory disease without any systemic involvement, steroid delivery to the eye would be sufficient. Unfortunately eyedrops alone are unable to reach the back of the eye and treat the sight threatening conditions such as swelling of the macula in uveitis and oral steroids or intraocular steroid injections are often necessary.

A new treatment for uveitis

In the past triamcinolone acetonide was the most commonly used intravitreal corticosteroid for treatment of uveitis and macular oedema. The drug is available at low cost but it is associated with a high risk of raised intraocular pressure (IOP) and cataract .Since steroids are a mainstay of therapy for uveitis and macular edema, new intravitreal implants have been developed to provide continuous release of corticosteroids over prolonged spans of time with reduced systemic adverse effects. My experience lies in the use of Ozurdex, a new biodegradable steroid implant that has a better safety profile and less of these side effects and a longer duration of action. It has been developed for use as treatment of non infectious uveitis and  macula edema due to central retinal vein occlusion. Ozurdex is a biodegradable implant containing the corticosteroid dexamethasone. A biodegradable implant is one that doesn’t need to be removed after it releases medication. These implants are injected into the eye under local anaesthesia. It is a simple minor procedure and is painless. It is released as a tiny rod-shaped implant. Inside the eye, the implant is slowly dissolved in the vitreous gel that fills the eye, releasing dexamethasone. The effects of these medications may last up to 6 months.

Many patients who have received ozurdex for uveitis were able to reduce or stop  their oral steroids and other immunosuppressive drugs and still achieve good control of uveitis with improvement in vision.

Cataract Surgery

What is a cataract?

A cataract is clouding of the lens in your eye. This is usually due to old age but can also occur due to trauma, diabetes, or due to medications.

Cataract surgery is done when the lens in your eye has become cloudy making it difficult for you to see well enough to carry out your usual daily activities. If the cataract is not removed, your vision may stay the same, but it will probably gradually get worse. Waiting for a longer period of time may make the operation more difficult. If you are considering surgery, please let the doctor know if you are taking the following medications: Flomax (Tamsulosin), Doxazosin, Asprin, or any blood thinning drugs like Warfarin, Plavix or Ticlid (Dipyradimole). These medications may need to be stopped before surgery.

You can listen to Dr Fong talking about cataract surgery.

Phacoemulsification surgery

The purpose of the operation is to replace the cataract with a plastic lens (implant) inside your eye. This usually done under local anesthesia. With a local anaesthetic you will be awake during the operation. You will not be able to see what is happening, but you will be aware of a bright light...

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