Ophthalmology

The Ophthalmology department at Queen Elizabeth Hospital Birmingham (QEHB) is one of the busiest in the West Midlands, with around 30,000 patients visiting the Outpatients department every year for a wide range of eye conditions.

The department provides both medical and surgical treatment, with four major areas of research activity:

  • Neuro-ophthalmology
  • Glaucoma
  • Retinal disease
  • Inflammatory eye disease

Ophthalmology also plays a major role in treating a range of complex rare diseases, as these can affect the eyes as well as other organs and systems.

The importance of collaboration is emphasised by the ophthalmology team’s contribution to research led by other specialties. Patients enrolled on trials of new drugs must often be tested regularly to check for side effects which might affect their vision. Some serious illnesses or injuries, which might be treated and researched mainly by other specialists, cause incidental damage to the eyes, so our ophthalmologists play an important role across a wide range of medical and surgical research.

Neuro-ophthalmology

Neuro-ophthalmology is the study of visual problems which are related to the nervous system. This includes a wide range of conditions, including:

  • optic neuritis
  • optic neuropathy
  • papilloedema
  • eye movement disorders (including myasthenia gravis)
  • idiopathic intracranial hypertension

The hospital is host to the Birmingham Neuro-ophthalmology Unit, the country’s largest neuro-ophthalmology team, led by Tim Matthews, Mike Burdon and Andrew Jacks. It is already a globally respected centre for neuro-ophthalmology training and is developing its research portfolio. The concentration of clinical expertise and the large catchment area creates the possibility for clinical research in neuro-ophthalmology not possible elsewhere.

Work is underway with Dr Alexandra Sinclair at the University of Birmingham. This research builds on the unit’s previously published research on the treatment of idiopathic intracranial hypertension, a condition in which the pressure on the brain increases without the presence of a tumour or other disease. It can cause swelling of the optic disc, leading to serious vision problems. Dr Sinclair’s current research looks at whether weight-loss surgery for obese patients can help reduce idiopathic intracranial hypertension.

Glaucoma

Glaucoma is an eye disease in which the optic nerve is damaged, usually associated with increased fluid pressure within the eye. The optic nerve is the nerve which carries all the information from the eye to the brain. In glaucoma, damage to this nerve may cause permanent worsening of vision and lead to blindness if left untreated.

The hospital’s work with glaucoma patients is carried out under the leadership of Professor Peter Shah, one of Britain’s pre-eminent glaucoma specialists.

Retinal disease

This area of clinical work and research covers the broad range of conditions and diseases which directly affect the retina. The retina is a layer of tissue at the back of the eye which receives light and converts the light through biochemical reactions into nerve impulses. These impulses are then transmitted along the optic nerve to the brain, which interprets the impulses into vision. Research in retinal disease is co-ordinated by Miss Marie Tsaloumas and Mr Alastair Denniston.

Inflammatory eye disease

Uveitis is the term used for any inflammation within the interior of the eye. Scientists still do not know the causes of the condition, but genetic mutations and infections have been implicated in its development.

It is a common cause of blindness in the UK, and is usually sub-divided into anterior, intermediate and posterior uveitis, affecting the front, middle and back of the inside of the eye respectively.

Rare diseases

The ophthalmology team is involved in work on Queen Elizabeth Hospital Birmingham’s (QEHB) nationally renowned rare disease programme. Many rare diseases require the input of different specialists, traditionally requiring multiple visits to hospital by the patient. QEHB now aims to coordinate these different specialists, organising one-stop clinics for specific diseases in order that patients can see all of the relevant specialists together. This enables the clinicians to discuss treatment plans and diagnostic testing more effectively, as well as creating opportunities for joint research into these rare diseases.

Other collaborations

The Ophthalmology department provides significant support to other researchers at the Trust, because the eyes can be affected by a number of systemic conditions which do not originate in the eye itself. This includes:

  • some types of cancer
  • brain injury or disease
  • lupus
  • multiple sclerosis
  • diabetes

Many drug trials also require close monitoring of eye health for side effects.

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