What is your experience with glaucoma treatment?

I have a very long history of experience looking patients with glaucoma. My interest in glaucoma started off with me doing a glaucoma research fellowship in the 1990s. My research looked at the role of inflammation in glaucoma surgery, and ever since then, I’ve been involved with glaucoma in some form or fashion.

Because I have been an NHS consultant since 2008, I have seen thousands of patients in glaucoma outpatient clinics as my NHS subspecialty expertise is in the subject of glaucoma. This means that I base my outpatient service almost exclusively on assessing patients who may have risk factors for glaucoma, or who already have a diagnosis of glaucoma.

The care of my patients includes diagnosing and treating their glaucoma. I regularly perform glaucoma treatments including a weekly operating list and a monthly laser list. I undertake an annual appraisal in which my outpatient service, as well as my surgical log book, is scrutinised. In my years as an NHS consultant and the many years I spent training before becoming a consultant, I have never been subject to an adverse event (called a clinical incident) related to my performance.

I am particularly interested in glaucoma surgical treatments including a more recent innovative treatment called microinvasive glaucoma surgery. The reason why I became interested in this type of treatment is that I believe it is essential to be able to offer my glaucoma patients the full range of glaucoma surgical treatments. I have been able to provide this type of treatment to my patients since 2012 and perform about 20 to 30 of these operations per year. I also do the longer established trabeculectomy surgery, performing similar numbers per year.

My experience with cataract surgery for patients with glaucoma

While cataract surgery is an operation performed by most ophthalmologists, cataract surgery is also a treatment for some patients with certain types of glaucoma. I perform about 100 to 150 cataract operations a year. I scrutinise my complication rate as part of my annual appraisal, and it has never been worse than the national average. My case mix in the NHS does consists of patients who have potentially complex cases because of angle closure glaucoma or patients with sight in only one eye.

I enjoy looking after patients long term. When looking after glaucoma patients, it is my job to help patients choose the right management or treatment to help preserve their visual health or function in the long term. I am interested in taking my patients through that journey and looking after them in the best possible way.

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