Daily Mail - 27.08.2019

Page 49

1 IN 50

Proportion of people

over 40 with glaucoma

A LASER could end the

inconvenience of eye drops

for glaucoma. Guy Staniforth,

62, a project engineer from

Greenwich in South-East

London, tells ADRIAN MONTI

about having the op.

A painless blast

of light to stop^

you going blind

WHAT ARE

THE RISKS?

n A VERY small risk of

prolonged blurred vision.

n FIVE per cent of patients

cannot have this op due to

other conditions such as

inflammation in the eye.

n ‘THIS is a well-conducted

large study and the results

open the door for a new era

in managing patients with

glaucoma,’ says Samer

Hamada, a consultant

ophthalmic surgeon at the

Queen Victoria Hospital NHS

Trust in West Sussex, and the

Eye Clinic London.

‘The main benefit is

preserving the healthy

surface of the eye. Long-

term use of topical drops is

known to cause damage to

the ocular surface.’

ME & MY OPERATION

LASER FOR GLAUCOMA

microscope

Under the

CAN YOU RUN UP THE STAIRS?

YES, I’m pretty sporty. I like yoga, golf,

swimming and rugby. I started playing

rugby at university and almost went

professional. I go to the gym regularly,

too. If I’m blessed to be a dad one day,

I want to avoid getting a dad bod.

GET YOUR FIVE A DAY?

I’M VERY disciplined about it. When

I’m at home I start the day with a

blueberry yoghurt bowl with extra

strawberries and bananas, along with

a green smoothie. I don’t like it, I just

view it as functional medicine.

EVER DIETED?

NOT really, because I try to eat well

regularly, which can be challenging

on the road. Recently I was filming up

a mountain in Wales. We got back

down at 10pm and the only place

open was Nando’s. I just train a bit

harder the next day. I’m 6ft 1in and

weigh 15½st.

ANY VICES?

I HAVE my dad’s sweet

tooth. Any excuse and I’ll

have a little cheesecake,

especially New York

cheesecake with

raspberry coulis. But I

don’t beat myself up

about it.

ANY FAMILY AILMENTS?

MY DAD’S side of the family has a lot

of heart problems. My older sister

Mererid encouraged me to get my

cholesterol checked and I have high

LDL (the bad form), which can be a

precursor to clogged arteries. I’m

still trying to work out what to do

about it.

WORST ILLNESS/INJURY?

I FRACTURED my skull and got ligament

damage in my left leg playing rugby.

Years ago when I did the Cresta Run in

Switzerland, I broke a finger and

busted my shoulder.

POP ANY PILLS?

I TAKE vitamin C, just because it seems

sensible to, and vitamin D, because

it’s important for people at risk of

cardiovascular disease. I also take a

vitamin B complex because it helps

promote better sleep.

DO YOU COPE WELL WITH PAIN?

YES, I always get complimented

on that.

TRIED ALTERNATIVE REMEDIES?

I’VE had acupuncture to help with

muscular pain and I swear by it.

EVER BEEN DEPRESSED?

NO, BUT I’m one of life’s worriers. As

soon as my head hits the pillow my

mind starts overthinking.

HANGOVER CURE?

I’M NOT a big drinker. When I’m out I’ll

have a few drinks, but I don’t want to

spend the next day recovering.

BIGGEST PHOBIA?

NONE, although I wouldn’t want to

jump out of a plane with a parachute,

despite the fact that I fly them — I have

a pilot’s licence.

LIKE TO LIVE FOR EVER?

SURE, I like life!

GETHIN is working with Brita on

its ‘Just Tap. Filtered’ campaign to

convince us to ditch bottled water.



TV presenter

Gethin Jones,

41, answers

our health

quiz

Interview by SARAH EWING

take part in a clinical trial for

newly diagnosed patients.

Patients in the trial would

either have daily eye drops —

the usual treatment — or laser

treatment to open up the

blocked channels.

The laser beam would be

aimed at the blocked area of the

eye the fluid should drain from.

I was happy to take part and

pleased to be told I’d be having

laser treatment, as taking daily

drops would be a nuisance.

T

haT December, I went

back to the hospital

for the procedure.

anaesthetic drops were

put into each eye. I then rested

my chin on a support so I was

looking directly into the device

which would fire the laser into

my eyes, one after the other.

I heard a clicking sound and

saw a yellow-green flash of light.

It all took about 15 minutes.

I didn’t feel a thing, but straight

afterwards my eye pressure had

fallen from 28mmhg to 14mmhg

— ‘normal’ is less than 22mmhg,

but can vary.

I went home on the train

afterwards. I had no side-effects

and was told to carry on as

normal. I’ve returned for check-

ups every six months over the

past six years. I’m always a bit

worried the treatment might

stop working.

But so far the pressure has

remained stable and I’m

told that, if it does start to

climb, I can have a second laser

treatment, which should be as

effective as the first.

I so appreciate what’s been

done for me at Moorfields. I

really hope it can help others

with glaucoma as it has me.

THE SPECIALIST

GUS GAZZArD is a

consultant ophthalmologist

and glaucoma service

director at Moorfields Eye

Hospital in London.

GLauCOMa is a build-up of

pressure in the eyeball which

impacts the optic nerve, slowly

eating away at sight.

It occurs when the spongy

tissue drainage area in the eye,

called the trabecular meshwork,

becomes less porous, preventing

fluid — the aqueous humour

that makes up the eye — from

draining properly.

It’s not known why or how it

happens, but it is thought to be

down to genes and ageing. Ten

per cent of patients lose their

vision, while 20 per cent suffer a

significant reduction to it even

with treatment.

Often, people with glaucoma

do not realise they’re losing

their sight, as it’s so gradual. It’s

common for the peripheral

vision — what you can see at the

side rather than directly ahead

— to be affected first.

I’ve seen patients who drive

start clipping wing mirrors, and

that’s the first sign. Once vision

has been lost, it cannot be

restored, so picking the condition

up early is vital — all it takes is a

normal eye test. The traditional

treatment is daily drops, some of

which encourage fluid to leave

the eye quicker, while others

‘turn off the tap’ so less fluid is

pumped into the eye in the

first place.

If drops don’t work, are too

inconvenient or cause side-

effects, such as sore eyes and

sleep disturbance, one fifth of

cases go on to have surgery. This

involves making a tiny hole in

the sclera (the

wall of the eye),

or inserting tubes

or stents, to help

the fluid drain.

another option

is known as selec-

tive laser trabec-

uloplasty (sLT).

Introduced after

the millennium, it

was used in fewer

than 5 per cent of glaucoma

operations until five years ago.

sLT fires pulses of relatively

low-energy light at the cells in

the drainage meshwork of each

eye. This encourages healing

white blood cells to rejuvenate

the meshwork, clearing debris to

make it more porous.

existing studies show it lowers

eye pressure by up to 30 per

cent, yet uptake has been slow

— I sought to change this, and

out of this grew our six-year

study at Moorfields.

It involved 718 patients from

six centres across the uK with

glaucoma, who’d never been

treated for it before. at the end

of the initial three-year study,

three-quarters of the patients

who’d had laser treatment did

not need any drops to control

their glaucoma.

The findings were published

this year. If the treatment proves

to be as successful with all

patients as it has with our study

cohort, it could save the nhs

up to £250 million a year.

The process is swift and

painless. after the patient’s eye

pressure has been checked and

they are given a mild anaesthetic,

a laser beam is fired through a

glass lens (to direct the beam to

the exact spot) into their eye.

We fire 100 shots, 360 degrees

around the drainage channel of

each eye, which takes about five

minutes per eye.

The laser treatment starts a

biological change

in the tissue which

leads to the fluid

draining out of the

eye better.

Following the

treatment, we take

another pressure

check. The patient

doesn’t need to be

taken home but we

don’t recommend

driving for eight

hours in case of blurriness.

We do another check two

months later — allowing the

optimum time for the treatment

to take effect. after that they

have bi-annual checks, as we

expect the effects to eventually

wear off.

Many hospital eye units across

the uK, including those at york,

Belfast and norwich who assisted

in the trial, are using sLT now,

based on our findings.

It’s not a complex procedure,

and can be carried out by

optometrists as well as doctors,

so it’s a real game-changer in

that sense.

THE PATIENT

eye appointments have been part of

my life since I first got spectacles for

short-sightedness when I was five.

so in October 2013, I took my annual

eye test in my stride, business as usual.

But this time, the optician referred me

for further investigation.

I knew glaucoma ran in my family —

my grandfather had it — and I thought

they might have seen some indication

that I had it, too.

It’s when pressure builds in the eye as

the fluid, which gives it shape, doesn’t

drain away properly, because channels

out of the eye are blocked. This pressure

can damage your optic nerve and lead

to blindness if it’s not treated.

about three weeks later, I went for my

appointment at Moorfields eye hospital

in London with my wife Zoe and our

children George, 21, and Molly, 19.

after more tests, the consultant told

me I did have the early stages of

glaucoma — and asked if I would like to

Daily Mail, Tuesday, August 27, 2019

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