Ophthalmology

The Ophthalmology Department at Chelsea and Westminster Hospital provides eye care for a wide range of ophthalmic conditions. We have five consultants, each with different specialist interests, and we also provide a general ophthalmology service. As a teaching hospital, we give training for ophthalmologists from year 1 to year 7 (fellowship level) and we also have medical students from Imperial College whom we introduce to the specialty.

General clinics

The general clinics are run on Monday, Thursday and Friday afternoons, and Tuesday mornings. We assess and treat patients with a large number of conditions, including:

  • Blepharitis
  • Dry eyes
  • Conjunctivitis
  • Eyelid cysts, ‘lumps and bumps’
  • Corneal problems
  • Glaucoma
  • Cataract
  • Vitreous detachment
  • Optic nerve abnormalities
  • Ocular and periocular infections
  • Ocular trauma

Specialist services

Medical retina clinic

Patients seen in this clinic have diabetic eye disease, age-related macular degeneration, vein occlusions, artery occlusions and other retinal diseases. The clinic offers full retinal assessment with fluorescein angiography and 3D retinal scanning performed as necessary on the same day. We also perform retinal laser treatment during the clinic.

Macular degeneration one-stop service

The anti-VEGF treatments for wet macular degeneration (lucentis, macugen and avastin) are transforming the visual outcome of this otherwise devastating disease. Patients referred with wet AMD are seen urgently and assessed with angiography and OCT scan. Patients with treatable disease can come to theatre the same afternoon for the required treatment, which is administered by intravitreal injection. Following the initial course of 3 lucentis injections over 3 months, patients are reviewed and assessed again in the clinic and retreatment can be given the same afternoon if necessary. This minimises the number of hospital visits. Continuous outcome audit data are kept.

Diabetic retinopathy

This clinic for patients with diabetic eye disease runs on Monday and Wednesday mornings. There is a joint clinic held on the first Wednesday morning each month, where patients with problematic diabetes can be seen both by the ophthalmologists and the diabetologists at the same time. Angiography, OCT scan and retinal laser treatment are all performed same day.

Uveitis, ocular infections and ocular inflammatory disease

The uveitis service runs on Thursday mornings. Patients with ocular inflammatory disease are assessed in detail in this clinic on a one-stop basis. Patients with ocular inflammatory disease often require immunosuppressive and immunomodulatory treatment and regular monitoring. Patients requiring intravenous therapy are admitted to the Medical Day Unit.

HIV-related eye disease

A specialist clinic for patients with HIV-related eye disease runs on Tuesday afternoons.

Oculoplastic service

The main clinic for patients with oculoplastic problems runs on Wednesday afternoons where patients with problems such as lid malposition, lid tumours, thyroid eye disease, other orbital disease and craniofacial abnormalities are seen. There is frequent liaison with the plastic surgeons and the craniofacial surgeons.

Paediatric ophthalmology

The paediatric ophthalmology service specialises in the management of squint and amblyopia and assesses children with any eye conditions, but refers on to regional sub-specialists those children with glaucoma, retinal detachment or retinoblastoma.

We provide an orthoptic led service for assessment of children referred by a school nurse or health visitor, and consultant led clinics for children referred by their GP. We also screen premature babies in the neonatal unit for retinopathy of prematurity and provide assessments for paediatric inpatients who develop eye problems.

Ophthalmic surgery

Cataract surgery

We have 3 operating lists a week dedicated to cataract surgery. We perform small incision phacoemulsification cataract surgery on all patients and the preoperative assessment includes discussion with the patient about their preferred refractive outcome and biometric ocular measurements are made accordingly. We have a state-of-the-art phacoemulsification machine which minimises surgical time and shortens the post-operative recovery period. We also keep a continuous outcome audit. We perform about 800 cataract operations each year.

Intravitreal treatments

The new treatments for medical retinal diseases, including age-related macular degeneration, severe diabetic eye disease not responsive to laser treatment, recalcitrant macular oedema from vascular occlusions and inflammation are all administered directly into the vitreous cavity. We administer these treatments either during the cataract surgery lists, or in a new dedicated list on Wednesday afternoons.

Laser retinal surgery

Laser treatment of the retina is the main treatment for proliferative retinopathy and for some causes of macular oedema. Most laser treatment is performed in outpatients and we have a dedicated session for this on Monday afternoons. Occasionally patients require general anaesthesia for this and the treatment is given in theatre.

Oculoplastic surgery

Oculoplastic problems often require a surgical approach and our team operates twice a week. Complex cases with more extensive disease problems are operated on jointly with both the oculoplastic team and the craniofacial teams.

Paediatric ophthalmic surgery

Children who require surgery for strabismus or other problems, such as eyelid cysts or congenital nasolacrimal duct obstruction, are treated in our paediatric theatres at Chelsea and Westminster.

Referrals

We accept referrals via eReferrals, by letter, and emergency referrals via telephone accompanied by referral letters. All routine referrals are triaged by the consultants to ensure that the patients are booked in to the most appropriate clinic.

Our time to outpatient appointment is around 4–6 weeks and more than 95% of patients are now seen and treated within the 18 week time period.

Contact information

Ophthalmology (eyes) adults

New appointments
T: 020 3315 6666

Follow-up appointments:
T: 020 3315 3235/58345

Surgery/admissions:
T: 020 3315 5042

External resource

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