Why Choose Dr Taneja?
- Dr Taneja has extensive experience in performing intra-vitreal injections for the management of a variety of conditions including macular degeneration, retinal vein occlusions and diabetic eye disease.
- Intravitreal injections are performed in rooms and a variety of anaesthetic options are available to patients in order to minimise any discomfort experienced during the procedure.
- Macular degeneration is the commonest cause of irreversible sight loss and occurs when the central retina undergoes degenerative changes.
- Macular degeneration is divided into two forms: exudative (“wet”) and non-exudative (“dry”).
- Wet macular degeneration may lead to sudden and drastic loss of vision, whilst dry macular degeneration is generally associated with gradual decline.
- At present, active treatment is available for wet macular degeneration: the most common intervention is intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents.
- Intravitreal injection involves numbing the eye with anesthetic, thorough cleaning of the surface of the eye and surrounding skin with an antiseptic solution followed by an injection into the eye using a fine needle. Patients are advised not to drive themselves home after their procedure.
- More than 90% of patients undergoing injections maintain their vision and between 40 and 50% make significant gains in their ability to discern objects.
Retinal Vein Occlusion
- Retinal vein occlusions occur when there is blockage in the blood vessels carrying blood out of the retina. Blockage may occur either to the main vein (“central retinal vein occlusion”) or one of the smaller branches of this vein (“branch retinal vein occlusion”).
- Vision loss can be due to subsequent swelling (oedema) of the macula or due to a resulting loss of blood supply (ischemia).
- Patients with vision loss due to retinal vein occlusion may benefit from active treatment in the form of intra-vitreal injection, LASER or vitrectomy.
- For patients with macular oedema, intravitreal injection has been demonstrated to be superior to “traditional” management (LASER in branch vein occlusion and observation in central vein occlusion). Intravitreal injection increases the chance of significant improvement by a factor of 2 to 3 times over “traditional”
- Occasionally, growth of new blood vessels onto the retinal surface may occur: this may cause haemorrhage in the vitreous gel or mechanical detachment of the retina from pulling on the retinal surface – such patients may benefit from intravitreal injection and LASER or vitrectomy surgery.
- Rarely, new blood vessels may clog up the drainage mechanism of the eye. This causes an increase in pressure inside the eye and is known as neovascular glaucoma. Depending on the stage and severity of blood vessel growth, a number of treatment options are available. Intravitreal injection may be used in the short term to “buy time” by temporarily shutting down these new vessels; however, further treatment is also required. This may include LASER or surgery.
Diabetic Eye Disease
- Diabetic eye disease has been the principal cause of vision loss in those of working age. However, the rates of vision loss are decreasing as the result of improved detection and management.
- Diabetes affects the eye in many ways and can affect both the blood vessels in the retina as well as the nerve cells contained in the retina.
- Treatment is generally reserved for patients who develop swelling of the macular (diabetic macular oedema) or for those in whom new blood vessels have grown into the eye (neovascularization).
- Depending upon the nature of the changes, treatment may consist of intravitreal therapy with an anti-vascular endothelial growth factor (anti-VEGF) agent, LASER or vitrectomy surgery.
- Intravitreal injection involves numbing the eye with anesthetic, thoroughly cleaning the surface of the eye and surrounding skin with an antiseptic solution followed by an injection into the eye using a fine needle. Patients are advised not to drive themselves home after their procedure.
- LASER is generally conducted in rooms and involves focussing a green LASER light onto the retina. This results in heating of the retinal tissue. Although topical anaesthesia is used, many patients experience ache at the time of LASER application, though for the majority the discomfort is minimal. Patients who experience significant discomfort, or in whom extensive LASER is required, may benefit from undergoing the procedure in hospital with local anaesthesia and sedation.
- Vitrectomy is a micro-keyhole surgery in which the vitreous gel is removed. In the context of diabetes, scar tissue may also need to be removed from the eye at the same time. Vitrectomy is performed in accredited hospitals and requires overnight admission.