UHS Medical Times February 2017

UHS Medical Times 1

Newsletter | February 2017

Dr. Mohammed Atif Makdum

Dr. Qasem Mohamad Mubarak Alhammouri

Dr. Azza Mohamed Elgemey Ahmed Eldmohy

MBBS, Master of Surgery in Ophthalmology, Fellowship in Vitreo Retina

Jordanian Board in Ophthalmology German Fellowship in Ophthalmology (Giessen University, Germany), ICO Certificate (UK)

Bachelor of Medicine and Surgery, Postgraduate Diploma in Ophthalmology, Fellowship Ophthalmology Assembly Alramdiah (Egypt)

Senior Specialist Ophthalmologist and Vitreo Retinal Surgeon

Consultant Ophthalmologist, Anterior Segment, Medical Retina and Paediatric Ophthalmology Surgeon

Eye Specialist

DEPARTMENT OF OPHTHALMOLOGY

LOW VISION 246 MILLION PEOPLE WORLDWIDE ARE ESTIMATED TO HAVE - (W.H.O)

According to the International Classification of Diseases, there are 4 levels of visual function normal vision, moderate visual impairment, severe visual impairment and blindness. Moderate and severe visual impairment are clustered under the name “Low Vision”.

Low vision is having a visual acuity of 6/12. The normal acuity is 6/6 vision or 20/20 as per USC equivalent. It is a permanent injury that cannot be corrected with spectacles, surgery and medications. The principal cause of vison loss among people aged 50 years old and above is Age-Related Macular Degeneration. Among other reasons are Diabetic Retinopathy and Retinitis Pigmentosa. An eye injury, Cancer of the Eye, Albinism or a Brain injury can also cause low vision.

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ANATOMY OF THE HUMAN EYE An eye is a marginally unequal globe, about an inch in diameter. The front part – the one you see in the exterior includes:

Iris - the colored part Cornea - a clear dome over the iris Pupil -the black circular opening in the iris that lets light in Sclera - the white of your eye Conjunctiva - a thin layer of tissue that covers the entire front of your eye, except for the cornea

Behind the iris and pupil lies the lens. The lens helps focus light on the back of the eye. Most of the eye is ďŹ lled with a clear gel called the vitreous. Light projects through the pupil and lens to the back of the eye. The inside lining of the eye is covered by special light-sensing cells that are collectively called the retina. The retina converts light into electrical impulses. Behind the eye, the optic nerve carries these impulses to the brain. The macula is a small extra-sensitive area in the retina that gives central vision.

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Newsletter |February 2017

COMMON CAUSES OF LOW VISION 1.

Age-Related Macular Degeneration – The leading cause of blindness among 50 years old and above. An age-related illness that affects the retina. The macula on the retina which is responsible for the central sharp vision weakens leading to blurred vision. People with this disorder can have difficulty reading and for some may experience blind spot in the central area of visualization.

Types of Age-Related Macular Degeneration: Non-Exudative or Dry Form – This type of ARMD is slow in progress over decades. The presence of drusen – yellow deposits in the retina made up of lipids increases the risk of acquiring dry form ARMD. Exudative or Wet Form – The aggressive type of ARMD. It progresses more rapidly over months and can cause severe vision loss. Abnormal blood vessels leak fluid or blood into the macula.

2.

Diabetic Retinopathy – Overtime, diabetes damages the blood vessels in the retina. It causes the blood vessels nourishing the retina to develop tiny and abnormal branches that leads to vision impairment and blindness.

3.

Retinitis Pigmentosa – RP is a degenerative genetic disorder that affects the photoreceptors of the retina which leads to severe vision impairment. Photoreceptors are cells in the retina that initiate the process of seeing.

4.

Amblyopia – also called “the lazy eye”. This happens when the visual system fails to develop normally during childhood.

5.

Cataract – is clouding of the lens in the eye which leads to decrease in vision.

6.

Glaucoma – is a group of eye disorders that result in optic nerve damage. If left untreated this condition may lead to peripheral vison loss and blindness.

7.

Retinal Detachment – This occurs when the retina is detached from the underlying tissue on the eye. Flashing lights and floaters may be the first symptom of this occurrence.

8.

Retinopathy of Prematurity – ROP takes place in infants born prematurely.

The smaller the baby is born the higher is the risk for developing this kind of eye condition.

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Newsletter |February 2017

RISK FACTORS OF LOW VISION People 65 years old and above Family History of an eye disorder Medical conditions like Diabetes and Hypertension

SIGNS OF LOW VISION People with low vision usually having difficulty performing the following tasks:

Recognizing faces.

Doing things that require to see close up such as reading, cooking, and stitching, fixing things around the house, picking out and matching the color of your clothes.

Doing household chores.

Reading signage.

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Newsletter |February 2017

COMPREHENSIVE EYE AND VISION EXAMINATION According to the American Academy of Ophthalmology, one should get a baseline eye examination at age 40 because at this time, early signs of eye disease or changes in vision may occur. Some people who have risk factors like family history of eye disorder, diabetes and hypertension should see an ophthalmologist even if younger than 40. For 65 years old and older, eye checkup should be done every 1-2 years for sign of age-related eye condition.

1. VISUAL ACUITY The visual acuity test is used to determine the smallest letters one can read on a standardized chart also called the Snellen chart or a card 20 feet (6 meters) away. Special charts are used when testing at distances shorter than 20 feet (6 meters).

This test is done at a doctor’s clinic. You will be asked to remove your spectacles or contact lenses and stand or sit 20 feet (6 meters) away from the eye chart. You will keep both eyes open.

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Newsletter |February 2017

Cover one eye with the palm of your hand, a piece of paper, or a small paddle while you read out the smallest line of letters you can see on the chart. This test is done on each eye, one at a time. Numbers, lines, or pictures are used for people who cannot read, especially children. To test for near vision, you may be asked to read letters and numbers from card 14 inches away.

The results of visual acuity testing are written in fractions. 20/20 is considered normal. The top number refers to the distance one stands from the chart. While the bottom number indicates the distance at which the person read the letters and numbers normally.

2. PRELIMINARY TESTS Preliminary tests help to begin the process of finding potential problems you may be experiencing and they provide the doctor with valuable information for their diagnosis.

These tests comprises of evaluations of depth perception, color vision, eye muscle movement, peripheral or side vision and the way pupils respond to light.

3. KERATOMETRY With the use of ophthalmometer, the doctor will measure the curvature of the cornea to assess the degree and axis of an eye condition called astigmatism.

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Newsletter |February 2017

4. REFRACTION The refraction test is a diagnostic test to measure a person’s grade or prescription for spectacles or contact lenses by the use of a machine called phoroptor or refractor. The device contains lenses of different strengths that can be moved into your view. You look through the device and focus on an eye chart 20 feet (6 meters) away. The test is done one eye at a time. The doctor performing the test will ask if the chart appears more or less clear when different lenses are in place.

If your vision (without glasses or contact lenses) is normal, then the refractive error is zero (plane) and your vision should be 20/20. This means you can read 3/8-inch (1 centimeter) letters at 20 feet (6 meters).

If you need a combination of lenses to see 20/20, then you have a refractive error which means that the doctor will give you a prescription. Prescription is a series of numbers that describe the powers of the lenses needed to make you see clearly. If your final vision is less than 20/20, even with lenses, then there is probably another, non-optical problem with your eye. The vision level you achieve during the refraction test is called the best-corrected visual acuity (BCVA).

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Low vision is not corrected by any medications, spectacles and surgery. Making the most out of the remaining vision is the best way to deal with it. There are various tips and devices to help making things brighter and visible.

Low Vision Aids – Make use of devices like audio books if reading may be difficult.

Improve lighting by the use of a lamp directed onto the desk, adjusting room lighting or carrying a penlight/flashlight.

Increase contrast by using highlighter, line guides and color filters - Contrast sensitivity refers

to the ability to detect differences between light and dark areas, increasing the contrast between an object and its background will generally make the object more visible.

Make things bigger by moving closer to the subject, enlarging texts and magnify bu using low

vison magnifiers.

Organize by designating a spot in your home or workplace to help you find things.

Label things clearly.

Use electronic books, e-book readers and audio books.

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Newsletter |February 2017

OBSTETRICS AND GYNECOLOGY OPHTHALMOLOGY TEAM AT UHS TEAM AT UHS

QUALIFICATIONS

SPECIAL INTEREST

Dr. Qasem Alhammouri graduated from Faculty of Medicine,University of Jordan and later completed his fellowship in pediatric ophthalmology and strabismology from University of Giessen, Germany.

Cataract Cases of Different Types Diabetic Retinopathy Including Laser Management and Intraocular Injections Different Anterior Segment Diseases (Eye Lid Lesions, Dry Eye and Medical Management of Different Corneal Diseases.

He is member of Jordanian Medical Association, Jordan Society of Ophthalmologist and International Council of Ophthalmology (UK).

EXPERIENCE Dr. Qasem Alhammouri has acquired 20 years of experience in general and anterior segment ophthalmology with high volume clinical and surgical work. He was also associated with Prince Rashid Military Hospital in Jordan as Chief of Ophthalmology.

Dr. Qasem Mohamad Mubarak Alhammouri Jordanian Board in Ophthalmology German Fellowship in Ophthalmology(Giessen University, Germany), ICO Certificate (UK) Consultant Ophthalmologist, Anterior Segment, Medical Retina and Paediatric Ophthalmology Surgeon

Medical Management of Glaucoma Cases Management of Pediatric and Adult Squint Cases Management of Different Types of Ocular Trauma

LANGUAGE KNOWN Arabic, English and German

He has comprehensive experience in the diagnosis and management of anterior segment disease and pediatric cases beside management of diabetic retinopathy and glaucoma.

He has performed more than 5,000 cataract surgeries (Extracapsular Cataract Extraction and Phaco) and 700 squint surgeries until date. Dr. Qasem also performed 300 eye trauma surgeries (Globe Repture) and has the expertise in using different ophthalmic laser machines (Argon, Yag and Diode).

QUALIFICATIONS Dr Mohammed Atif Makdum acquired his basic medical education in MAHE University in India. He then pursued his Master’s Degree in Ophthalmic Surgery acquiring his Fellowship Certificate in Vitreo-Retina Surgery.

LANGUAGE KNOWN Arabic, English and Hindi

EXPERIENCE Dr Atif is a Senior Specialist Ophthalmologist and Vitreo-Retina Surgeon with 18 years of extensive clinical experience. Before joining University Hospital Sharjah, Dr Atif was affiliated with various medical institutions in India and a government hospital in Dubai.

Academically, he lectured medical students in India and also hosted many local and international talks pertaining to his expertise.

SPECIAL INTEREST

Dr. Mohammed Atif Makdum MBBS, Master of Surgery in Ophthalmology, Fellowship in Vitreo Retina Senior Specialist Ophthalmologist and Vitreo Retinal Surgeon

Ophthalmic Surgeries including ECCE, Manual SICS, Phacoemulsification, DCT, Pterygium Excision with Conjunctival Autograft, PRP (Single Spot Conventional/PASCAL), Macular Grid, Focal Laser, Prophylactic Laser, Intra Vitreal Injections, Scleral Buckling, Silicone Oil Removal, Pneumatic Retinopexy, PDT, Trans Scleral Cyclophotocoagulation, PARS Plana Vitrectomy

Diagnostic Procedures including FFA, OCT (Stratus/Spectral OCT), B Scan ICG, Specular Microscopy

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Newsletter |February 2017

OPHTHALMOLOGY TEAM AT UHS

Dr. Azza Mohamed Elgemey Ahmed Eldmohy Bachelor of Medicine and Surgery, Postgraduate Diploma in Ophthalmology, Fellowship Ophthalmology Assembly Alramdiah (Egypt)

QUALIFICATIONS

SPECIAL INTEREST

Dr Azza Elgemey acquired her MBBS from the University of Alexandria was subsequently granted a higher degree in Ophthalmic Surgery by Cairo University. She also completed her fellowship training in Ophthalmology at the University of Alexandria.

EXPERIENCE

LANGUAGE KNOWN

Dr Azza is a Specialist Ophthalmologist with 15+ years of experience in ophthalmic surgery, trauma care and all ophthalmic investigations and procedures. She is well trained in various ophthalmic instrumental examinations such as OCT, Fluorescein Angiography, Visual Field, Pentacam, Phoropter Refraction, B Scan and IOL Biometry. Furthermore, she is also well versed in differential diagnoses of ophthalmic diseases, in addition to minor surgeries and emergency management of trauma patients.

Arabic and English

Ophthalmic Ultrasonography B-Scan OCT Fluorescein Cross Lining of Refractive Error

As a recognised Specialist in Ophthalmology, Dr Azza practiced in Egypt, the Kingdom of Saudi Arabia and the UAE. She worked under Ministry of Health hospitals for 10 years in Saudi Arabia before joining UHS in 2012.

Dr Azza is an active member of the Egyptian Society of Ophthalmology and the International Council of Ophthalmology in Cambridge University, UK.

Eye Specialist

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Newsletter | February 2017

SCOPE OF SERVICES AT UHS MEDICAL SERVICES

SURGICAL SERVICES

CARDIOLOGY

NEUROPHYSIOLOGY

Anesthesiology

Bariatric Surgery

24-Hour BP Monitoring

Electroencephalogram (EEG)

Aviation Medicine

Ears, Nose and Throat Surgery

24-Hour Holter Monitoring

Electromyography (EMG)

Cardiology

General Surgery

2D/3D Echo

Evoked Potential Test

Critical Care

Neurological Surgery

3D Transesophageal Echo

Brain Auditory Evoked Potential

Dermatology

Obstetrics and Gynecologic Surgery

CT coronary Angiography

(BAEP)

Emergency Medicine

Ophthalmic Surgery

Somato Sensory Evoked Potential

Endocrinology

Orthopedic Surgery

Dobutamine Stress Echo for Ischemia and Viability Studies

Family Medicine

Pediatric Surgery

Gastroenterology

Plastic and Reconstructive Surgery

Internal Medicine

Urologic Surgery

Medical Oncology

Vascular Surgery

Neonatology Nephrology Neurology Pediatrics Psychiatry Pulmonology Rheumatology MEDICAL DIAGNOSTICS IMAGING (MDI) 128 Channel CT Scan with Coronary and Cardiac Facility

PATHOLOGY & LABORATORY MEDICINE

Interventional Cardiology Stress Test

(SSEP) Visual Evoked Potential ( VEP) Nerve Conduction Studies (NCS)

Treadmill Stress Test

AUDIOLOGY

OTHER SPECIALTY SERVICES

Biochemistry

Acoustic Reflex Threshold

24/7 Emergency Services

Blood Transfusion Medicine

Auditory Brainstem Response

Ambulance

Cytology

Auditory Steady State Response

Hemodialysis

Hematology

Cochlear Implant Mapping

Physiotherapy

Histology

Electrocochleography

Pharmacy

Immunology

Free Field Audiometry

Sharjah Breast Centre

Microbiology

Hearing Aid Fitting and Programming

Phlebotomy

Newborn Hearing Screening

Bone Densitometry

Otoacoustic Emission

Digital X-Ray and Fluoroscopy

Pure Tone Audiometry (PTA)

Mammography and Guided Breast Intervention

Speech Audiometry

MRI 1.5 TESLA

Tinnitus Evaluation

Ultrasound

Tympanometry

Vascular Interventional Lab

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