surgery & treatments
General Ophthalmology – I have a wide range of experience of all aspects of ophthalmology and was in practice before current increasing sub-specialisation limited the breadth of clinical experience. I offer consultations for lid, lacrimal, glaucoma, paediatric and eye movement disorders. For some cases I may refer to colleagues if highly specialised surgery is required.
I have extensive experience in Cataract Surgery and have carried out over 5000 procedures in my career. There has been marked development of new technologies in this area and I continue to operate using modern ultrasound techniques (known as "phaco" surgery). I am experienced in the use of cataract surgery to correct spectacle error including astigmatism. My practice is continually audited and I am confident that my performance in this area is among the leading surgeons in the UK.
I have a complication rate that is well below the national average despite a practice that includes many non-standard cases that may require a combined anterior and retinal surgery approach. In my practice I have had broad experience of treating patients with complications arising from cataract surgery including lens malposition, lens dislocation and lens implant exchange. The use of retinal surgery skills in this area is paramount and colleagues will often refer cases to me if this is required.
Cataract Surgery Audit Years 2008 - 2013
Posterior Capsule Rupture (NHS) = 0.5%
Private = 0.3%
National Consultant Average = 1.9%
I have almost 20 years of experience of retinal disorders requiring surgery. Conditions treated include retinal tear or detachment, macular hole, epi-retinal membrane, vitreous haemorrhage and diabetic complications. I am proud to have started a retinal surgery fellowship training programme for young consultants in Gloucestershire in 2000 and the Eye Unit in Cheltenham General has a nationwide reputation for retinal surgery training. Trainees from our programme are now in practice in many countries including Greece, Australia, Malaysia, Spain, India and Pakistan.
Since introduction in 2006 I have experience of intra vitreal injection treatments for retinal disorders including Age Related Macular Degeneration, Diabetic Maculopathy, Retinal Vein Occlusion and Uveitis. I set up a service to provide Avastin treatment for patients initially prior to the introduction of Lucentis. Newer treatments such as the steroid implant, Ozurdex, are also offered. There is now a range of drugs available for medical retina treatment in addition to laser treatment. The area is becoming more complex with each innovation and I maintain an active programme of continuous professional development to ensure I keep abreast of new advances in this field.
I have a busy medico-legal practice dealing with cases of accidental eye injury and clinical negligence. Detailed analysis of such cases with a specific requirement to formulate objective opinions on the nature and cause of eye problems is a skill that translates to my every day clinical practice. I act as Clinical Governance (Quality Control) lead in my local NHS trust and take a direct interest in adverse incidents or complaints that may arise. Learning from these events forms an important part of refining and improving services in both the NHS and private sector.