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.
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.
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.
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...Read More
aims to educate the public about the prevention of AMD through diet.Read More
What is retinopathy of prematurity? Retinopathy of prematurity (ROP) occurs in infants who are born prematurely, where blood vessels in the retina do not form normally. The retina is a thin sheet ...
Since 2006, eye doctors have been recommending a high dose of antioxidants and zinc for AMD patients to reduce their risk of getting advanced AMD (bleeding at the macula). The doses of Vitamin C, E, b...
Epiretinal membrane is also known as macula pucker or cellophane maculopathy. Recovery after vitrectomy surgery to remove this fine scar tissue covering the macula can take up to 3 months. Surgery is ...