Ophthalmology

Proudly focusing on the provision of excellence in the management of Cataract, Glaucoma and Medical Retina.

Ophthalmology and vision sciences have seen rapid technological advances in recent years making treatments less invasive and much more accurate. The specialist Ophthalmology team at the Bon Secours Hospital Dublin are dedicated to the provision of the very best and up to date patient care including eye and cataract surgery in Dublin.

In the Bon Secours Hospital Dublin, we recognise the dignity and uniqueness of each person, improving patients' visions by focusing on the latest therapies and technologies in eye care.

 

Ophthalmology and vision sciences have seen rapid technological advances in recent years making treatments less invasive and much more accurate. Our specialist Ophthalmology team at the Bon Secours Hospital Dublin is dedicated to the provision of the very best and up to date patient care.  We are proud to offer a comprehensive range of services that meets your every need. We’ll guide you through your treatment right the way from diagnosis, intervention and review.

There are ten ophthalmologists currently working in the Bon Secours Hospital, providing comprehensive Ophthalmology services. In addition to General Ophthalmology, many other services are offered to patients including:

  • Cataract - Eye lid and anterior segment surgery
  • Glaucoma - medical and surgical treatment
  • Medical retinal service - age related macular degeneration (AMD), diabetic retinopathy, and retinal vascular disease.
  • Assessment and management of uveitis (ocular inflammation)
  • Assessment and treatment of corneal and ocular surface disease
  • Eye lid surgery incl. incl. lesions ‘see and treat’, eyelid malposition, droopy eyelid/ptosis, facial nerve palsy
  • Strabismus assessment and surgery
  • Plastic reconstructive surgery of eyelid
  • Assessment and management of tear duct and orbital disorders
  • Watery eye disorders
  • Dry eye disorders
  • Facial dystonia
  • Orbital disorders incl. thyroid eye disease, orbital decompression
  • Evisceration, enucleation, socket rehabilitation
  • Periocular skin cancer surgery and reconstruction

Age Related Macular Degeneration (AMD)

Age related macular degeneration (AMD) is the leading cause of sight loss in the over 50s in Ireland. Without treatment it is the most common cause of legal blindness affecting over 60,000 Irish people. At this time treatment is available for many forms of the condition. Early diagnosis and treatment is recommended which results in a better visual outcome.

Age Related Macular Degeneration (AMD)

Age Related Macular Degeration (AMD)

 

 

AMD is an ageing change in the macula. The macula is the central part of the light sensitive retina. The retina lines the inside of the back of the eye and is responsible for vision. Light focused on the retina is transformed to an electrical signal that is sent to the brain where 'seeing' takes place. The macula is responsible for central vision such as reading and recognising facial details.

 

Types of AMD

There are two main types of AMD, the 'Dry' and the 'Wet' type:

Dry AMD -  In this type there are typical age changes such as age spots or 'Drusen ' in the macula. Very often patients with Dry AMD maintain good central vision, needing perhaps more magnification and lighting for reading. A small percentage of patients with Dry AMD will develop more severe dry changes with consequential progressive difficulty with reading and fine vision. At this time there is no known cure for Dry AMD, but progression can be slowed by stopping smoking, eating a healthy diet rich in Lutein ( found in the leafy green vegetables), and looking after cardiovascular risk factors such as high blood pressure and elevated cholesterol . Dry AMD usually affects both eyes. Dry AMD can progress to Wet AMD.

Wet AMD - In this type an abnormal blood vessel complex grows in under the macula as part of the ageing change. This results in a cycle of leakage, bleeding and scar tissue growth in the macula leading to destruction of central vision and without treatment legal blindness. There is a significant risk of Wet AMD affecting the second eye over time (>50%). The second eye will  need to be carefully monitored.

 

 

Symptoms:

In Dry AMD symptoms are often mild, such as needing stronger glasses or better lighting for reading. When progression to Wet AMD occurs, the patient may notice the onset of blurring of reading vision with distortion ( due to fluid or blood under the macula ). Sometimes patients are unaware until they take a moment to cover or close one eye at a time. At this stage the progression can be rapid and patients should seek help promptly from their eye doctor.

 

 

An Amsler Grid is a simple test designed to pick up symptoms of Wet AMD. However it is not a substitute for an eye examination . The patient checks each eye separately with reading glasses on. If they notice blurring or distortion of the lines on the grid this could indicate the presence of Wet AMD and they should be examined promptly by their eye doctor.

 

Diagnosis of AMD

A Fluorescein angiogram is a photographic test used to assess AMD. The patient is given an injection of Fluorescein dye into a vein in the arm. The dye is followed with photographs as it goes through the retinal circulation and will show up changes due to AMD. An OCT is a special scan  which will instantly detect changes in the macula due to AMD. It is a quick and reliable test and is easy for the patient.

 

Treatment options for AMD

Intravitreal therapy

Intravitreal injection therapy has proven to be a major advance for patients with Wet AMD. We know that when Wet AMD develops abnormal blood vessels grow under the macula due to a chemical stimulant called vascular endothelial growth factor (VEGF). Intravitreal injections of anti- VEGF drugs, which block  VEGF, can break the cycle of leakage, bleeding and scar tissue growth. Anti-VEGF treatment offers stabilisation and very often improvement in vision. However treatment may be needed on a regular basis over several years.

 

Laser Photocoagulation

Laser photocoagulation is another treatment modality for Wet AMD. It is less commonly used now with the advent of intravitreal therapy. Laser light is used to seal the leaking blood vessels. Although laser can be effective, many patients with Wet AMD are not suitable candidates as often the leakage is centrally located and laser is therefore not the treatment of choice. Laser can stabilise the vision but is unlikely to improve it.

 

Photodynamic. Therapy (PDT)

PDT is another treatment option for Wet AMD. The patient is given an intravenous infusion of a light sensitive dye called verteporphyrin . When the dye accumulates in the abnormal blood vessel complex under the macula it is activated by a laser light resulting in closure of the blood vessel. PDT is less frequently used now following the advent of intravitreal therapy. PDT can stabilise the vision in certain circumstances but is unlikely to improve vision.

Age related macular degeneration is one of the commonest causes of vision loss in older adults. However its prognosis has been greatly improved with modern treatment modalities. Without treatment severe AMD can lead to loss of central vision. Usually, even in its most aggressive form, side or peripheral vision is preserved allowing the patient to move around independently and to continue those tasks that do not require fine central vision.

Prevention

Regular eye examination with the eye doctor are recommended especially if there a family history of the condition. This should be done every two years for the over 55s and annually if there is any hint of AMD. It is important that patients self monitor using an Amsler grid between visits.

Looking after general health, being a non smoker, eating a healthy diet rich in leafy greens (Lutein), and sensible use of sunglasses can all help to slow the progression of AMD. Often your eye doctor will recommend taking a Lutein based vitamin supplement. Monitoring the vision in each eye separately using an Amsler grid can lead to early detection of AMD and an improved visual outcome.

Links

Information on Age related Macular Degeration: www.amd.ie

NCBI - www.ncbi.ie

Fighting blindness - www.fightingblindness.ie

Astigmatism

Astigmatism is a condition in which the eye does not focus light ‘evenly’ onto the retina, the light-sensitive tissue at the back of the eye. The front surface of a normal eye is round like a football, but people with astigmatism have eyes shaped more like an oval rugby ball. This changes the path of light so that the image formed at the back of the eye is not sharply focused.

Astigmatism

 

 Astigmatism is a common type of refractive error. It is a condition in which the eye does not focus light ‘evenly’ onto the retina, the light-sensitive tissue at the back of the eye.

The front surface of a normal eye is round like a football, but people with astigmatism have eyes shaped more like an oval rugby ball. This changes the path of light so that the image formed at the back of the eye is not sharply focused. People with astigmatism will usually also be short or long sighted. 

 

People can be born with astigmatism or it can develop later in life. 

Many people have a little astigmatism and their sight is unaffected. If the astigmatism is more severe, you might notice.

  •  - Blurring and distortion of near or far-away objects.
  •  -   Headaches when trying to focus
  •  - Tired eyes
  •  - Squinting
  •  - Difficulty driving at night

The exact cause is usually unknown although genetics can play a part. Sometimes astigmatism can develop after an eye injury, surgery or because of an eye disease. Astigmatism is not caused by reading in bad light, using a computer or watching too much television.

Astigmatism can usually be treated with prescription glasses or contact lenses.

Cataract Surgery

Cataract is a common cause of visual impairment in the elderly but can also affect a small number of younger individuals. The number of cataract patients is greater than the number of glaucoma, macular degeneration and diabetic retinopathy patients combined. It is common in people over 65 years of age

Cataract Surgery

 

What is a cataract?

The eye is like a camera where the retina is the film at the back, and the lens is positioned at the front of the eye, just behind the pupil. A cataract is a clouding in the lens of the eye. The lens in your eye focuses light and is constructed of proteins and fluid. The proteins are arranged in a parallel fashion to allow the light to pass through the lens without interruption. The pupil dilates and contracts to control the level of light reaching the retina and the lens adjusts automatically to allow you see objects clearly at various distances.

As one ages, cataract begins when some of the parallel proteins become disorganised causing a small part of the lens to become cloudy and this becomes larger as the cataract progresses. Eventually the whole lens becomes opaque and blocks off light to the retina causing a major reduction in vision. In most medically advanced countries a cataract operation is readily available allowing vision to be restored quickly.

 

What are the symptoms?

The blurring of vision is gradual, hardly affecting the sight at first. It would seem like looking through an opaque glass at times. Light from the sun, a lamp or oncoming headlights cause dazzle and in daylight colours seem faded. Patients often remark that colours are more vibrant in one eye than the other.

Symptoms and their onset may vary depending on the cataract type. With nuclear cataract for example there may be an improvement in reading and close work for many months or even years, due to the development of short sightedness, but eventually this will also deteriorate as the cataract progresses. This phenomenon used to be known as ‘second sight’. Subcapsular cataract can occur rapidly and affect the vision in a shorter period of time than other types of cataracts.

It is best to visit an eye doctor if you suspect you are developing a cataract

 

What are the different types of cataract?

Nuclear Cataract - The most common type of cataract is the one that people get as they become older it is called a nuclear cataract because it affects the central core of the lens. This develops quite slowly sometimes taking many years to affect the vision significantly.

A cortical cataract - A  cortical cataractoccurs in the peripheral part of the lens and often looks like the spokes in a bicycle wheel. It takes some time for these ‘spokes’ to grow centrally to affect the vision and doctors often see signs of this cataract before the patient’s vision is affected.

A subcapsular cataract - A subscpsular cataract occurs at the back of the lens typically afflicting people with diabetes and those on steroid therapy. This causes a ‘stippling’ on the surface of the lens like a semi-opaque bathroom window and can occur quite quickly sometimes blocking off the vison within a year.

 

What are the causes?

Despite studies, it is unknown exactly why cataracts form as the lens ages.

The following are risk factors that are said to be associated with cataract formation.

- Ultraviolet light has been said to damage the proteins in the lens and induce cataract. Eye doctors advise the use of sunglasses and wide-brim hats to protect against UV light exposure.

- Poor nutrition is a cause of cataract formation and the prevalence of cataract increases geographically as one travels towards the equator from the poles.

- Diabetes mellitus There is evidence to show that diabetics are more prone to cataract formation especially those suffering from Type 2 diabetes.

- Steroids and some other drugs are implicated in cataract formation.

- Other risk factors include too much salt, alcohol, air pollution and smoking. Again all these processes are difficult to prove.

 

How is cataract treated?

At an early stage cataract can be treated by changing the power of your glasses. This can go on for years at a time and an annual review is indicated. Later as the cataract becomes more opaque the only effective treatment is surgery.

 

When should I have my cataract removed?

This depends on your circumstances. If you are a car driver surgery is indicated at a much earlier stage than for people who don’t drive. In Ireland, a binocular vision of 6/12, adequate contrast sensitivity and a normal field of vision is necessary for driving. Driving is very important to most people and no one wants to lose their independence, so if the above parameters are being threatened by cataract formation then early surgery is indicated. However, if you don’t drive or are happy to give it up, and you have adequate vision to carry out your normal daily activities then cataract surgery can be postponed indefinitely. You personally have a big say about when cataract surgery should be performed on your eyes and if you are happy with your current vision then there is no need to undergo cataract surgery. There can be many years difference in the timing of cataract surgery depending on your life-style or circumstances.

 

What does a cataract operation entail?

In most cases cataracts surgery is performed under local anaesthetic which may just be eye drops alone, or an injection around the eye (a bit like for a filling at your dentist’s), but often a combination of both of these methods is used. If you are really nervous then you should speak with your surgeon about the possibility of a general anaesthetic. You are normally admitted to hospital at 8 am and you will usually be home by lunchtime. Nowadays the procedure is straight forward and takes about 20 minutes, nonetheless great skill is required to perform one of these operations which involves a team of doctors and nurses in a theatre setting, where important precautions are taken to prevent infection. The media often portray this operation as a simple procedure which it is definitely is not, but in skilled hands it is very successful in most cases. During the operation a tiny plastic lens (an IOL) is placed in the eye to help focus the light post-operatively. Prior to surgery a special test called biometry is carried out to decide on the power of the IOL to be inserted.

 

Will I need to use glasses following surgery?

You will be asked by your surgeon if you would like to have your eyes focussed for the distance following surgery. Most people wish for this, but if you are short-sighted your surgeon will probably suggest that enough short-sightedness should be left post-operatively, so that you may continue to read without glasses. Short sighted people really value this facility that they naturally have. However, if you are a short sighted golfer, or other sportsperson, then you may wish to be able to see in the distance without glasses poster-operatively. This all needs to be discussed with your surgeon prior to the operation. If you are happy wearing bifocals or varifocals then you may wish to continue with these following surgery for convenience sake and it is worth mentioning this to your eye doctor before your operation.

Further improvements are being developed on surgical procedures and IOLs. Presbyopia (reading) correcting IOLs for instance may allow clear vision at any distance. Another IOL type, one that can block retina-damaging UV and UVB rays, is being developed. In future in Ireland cataract surgery will be laser assisted and machines for this are currently being fine-tuned in trials around the world. The current operation used by most surgeons is called ‘phako-emulsification’ and is the least traumatic cataract operation you can have. The lens is broken up with the help of ultra-sound, suctioned from the eye and the IOL is positioned behind the pupil – all of this done through a 2 mm incision.

 

Post-operative Care

Most patients recover very quickly following cataract surgery. A plastic eye-guard is worn at night for a couple of weeks to prevent inadvertent rubbing of the eye during sleep. Many recommence driving after one to two weeks.

You will be required to use post-operative steroid/antibiotic drops for 4 weeks to prevent infection and to settle post-operative inflammation. Usually you return for follow up one week after surgery but if undue soreness or blurring occurs a few days following discharge, then you should return to the clinic or hospital immediately for a check-up.

Most patients return to normal activities such as work after two weeks.

Diabetic Retinopathy

Diabetic retinopathy is a leading cause of new blindness among adults in Ireland. Pregnancy and high blood pressure may worsen this condition in diabetic patients

Diabetic Retinopathy

 

Diabetes is a condition in which there is too much glucose (a type of sugar) in the blood. Over time, high blood glucose levels can damage the body's organs.  Possible complications include damage to large and small blood vessels, which can lead to heart attack, stroke, and problems with the eyes,  kidneys, feet and nerves.

The commonest complication of diabetes is diabetic retinopathy. Chronically high blood sugar is associated with a deterioration of the blood vessels in the light-sensitive tissue called the retina, that lines the back of the eye. If these weakened vessels leak fluid or blood, they can damage or scar the retina and ultimately blur vision. In its most advanced stage, new abnormal blood vessels proliferate (increase in number) on the surface of the retina, which can lead to scarring and cell loss in the retina.

Diabetic retinopathy is a leading cause of new blindness among adults in Ireland. Pregnancy and high blood pressure may worsen this condition in diabetic patients.

 

Controlling diabetes—by taking medications as prescribed, staying physically active, and maintaining a healthy diet—can prevent or delay vision loss.

 

All forms of diabetic eye disease have the potential to cause severe vision loss and blindness.

For Type 1 diabetics ( insulin-dependent) about 25% have any retinopathy after 5 years, and  approximately 80%  have retinopathy after 15 years of disease .

For Type 2 diabetics (non-insulin-dependent), the onset date of diabetes is frequently not precisely known and therefore more severe disease can be observed soon after diagnosis. Up to 3% of patients first diagnosed after age 30 (Type 2) can have clinically significant macular oedema or high-risk PDR (proliferative diabetic retinopathy) at the time of initial diagnosis of diabetes.

Diabetic eye disease also includes cataract and glaucoma:

  • Cataract is a clouding of the eye’s lens. Adults with diabetes are 2-5 times more likely than those without diabetes to develop cataract. Cataract also tends to develop at an earlier age in people with diabetes.
     
  • Glaucoma  is the name for a group of eye conditions in which the optic nerve is damaged at the point where it leaves the eye. This nerve carries information from the light sensitive layer in your eye, the retina, to the brain where it is perceived as a picture.

 

Why is prevention so important?

Vision lost to diabetic retinopathy is sometimes irreversible. However, early detection and treatment can reduce the risk of blindness by 95 percent. Because diabetic retinopathy often lacks early symptoms, people with diabetes should get a comprehensive dilated eye exam at least once a year. People with diabetic retinopathy may need eye exams more frequently. Women with diabetes who become pregnant should have a comprehensive dilated eye exam as soon as possible. Additional exams during pregnancy may be needed. 

Further information is available on the Diabetes Ireland website - www.diabetes.ie

 

What are the symptoms of diabetic retinopathy and DME?

The early stages of diabetic retinopathy usually have no symptoms. The disease often progresses unnoticed until it affects vision. Bleeding from abnormal retinal blood vessels can cause the appearance of “floating” spots. These spots sometimes clear on their own. But without prompt treatment, bleeding often recurs, increasing the risk of permanent vision loss. If DME occurs, it may cause blurred vision.

Diabetic retinopathy may progress through four stages:

  1. Mild nonproliferative retinopathy. Small areas of balloon-like swelling in the retina’s tiny blood vessels, called microaneurysms, occur at this earliest stage of the disease. These microaneurysms may leak fluid into the retina.
  2. Moderate nonproliferative retinopathy. As the disease progresses, blood vessels that nourish the retina may swell and distort. They may also lose their ability to transport blood. Both conditions cause characteristic changes to the appearance of the retina and may contribute to DME (Diabetic macular oedema).
  3. Severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving blood supply to areas of the retina. These areas secrete growth factors that signal the retina to grow new blood vessels.

  4. Proliferative diabetic retinopathy (PDR). At this advanced stage, growth factors secreted by the retina trigger the proliferation of new blood vessels, which grow along the inside surface of the retina and into the vitreous gel, the fluid that fills the eye. The new blood vessels are fragile, which makes them more likely to leak and bleed. Accompanying scar tissue can contract and cause retinal detachment—the pulling away of the retina from underlying tissue  ( like wallpaper peeling away from a wall). Retinal detachment can lead to permanent vision loss.

 

Diabetic macular oedema


DME -Diabetic macular oedema , is the build-up of fluid in a region of the retina called the macula. The macula is important for the sharp, straight-ahead vision that is used for reading and fine detail work, recognizing faces, and driving. DME is the most common cause of vision loss among people with diabetic retinopathy. About half of all people with diabetic retinopathy will develop DME. Although it is more likely to occur as diabetic retinopathy worsens, DME can happen at any stage of the disease.

 

How are diabetic retinopathy and DME detected?

Diabetic retinopathy and DME are detected during a comprehensive dilated eye exam that includes:

  • Visual acuity testing: This eye chart test,  measures a person’s ability to see at various distances.
     
  • Optical coherence tomography (OCT):  is a complex technology used to measure your eye and to illustrate the different layers that make up the back of your eye . An OCT scan is similar to an MRI or CAT scan for the eyes. OCT can image in 3D, allowing your doctor to see any  problems within your eye that could not easily be seen before.
     
  • Tonometry: This test measures pressure inside the eye.
     
  • Fluorescein angiogram :  may be used to look for damaged or leaky blood vessels. In this test, a fluorescent dye is injected into the bloodstream, often into a vein in the  arm . Pictures are then  taken of the retinal blood vessels  as the dye reaches the  back of the eye.
     
  • Physical Examination: Drops placed on the eye’s surface dilate (widen) the pupil, allowing a physician to examine the retina and optic nerve. A comprehensive dilated eye exam allows the doctor to check the retina for:
  •  - Changes to blood vessels
  •  - Leaking blood vessels or warning signs of leaky blood vessels, such as fatty deposits
  •  - Swelling of the macula (DME)
  •  - Changes in the lens
  •  - Damage to nerve tissue

 

Reduce your risk of diabetic retinopathy

You can reduce your risk of developing diabetic retinopathy, or help prevent it getting worse, by:

  • Attending all your screening appointments The National Diabetic Retinal Screening Program
  • Controlling your blood sugar, blood pressure and cholesterol levels
  • Taking your diabetes medication as prescribed
  • Getting medical advice quickly if you notice any changes to your vision
  • Maintaining a healthy weight, eating a healthy, balanced diet, exercising regularly and stopping smoking

 

What is The National Diabetic Retinal Screening Program?

This is a government-funded screening program that offers free,  regular diabetic retinopathy screening.  Everyone with diabetes who is 12 years old or over is invited for eye screening once a year.  Screening is offered because:

  • Diabetic retinopathy doesn't tend to cause any symptoms in the early stages
  • The condition can cause permanent blindness if not diagnosed and treated promptly
  • Screening can detect problems in your eyes before they start to affect your vision
  • If problems are caught early, treatment can help prevent or reduce vision loss
  • The screening test involves examining the back of the eyes and taking photographs. Depending on your result, you may be advised to return for another appointment a year later, attend more regular appointments, or discuss treatment options with a specialist. If you have diabetes and would like to check you are on our register, please ring Free phone 1800 45 45 55

Further information on the screening program is available at  https://www.diabeticretinascreen.ie/news-events/diabetic-retinopathy-video-launched.1885.html

 

Treatments for Diabetic Retinopathy

Treatment for diabetic retinopathy is only necessary if screening detects significant problems that where the vision is at risk. Treatment for diabetic retinopathy is often delayed until it starts to progress to PDR, or when DME occurs. Comprehensive dilated eye exams are needed more frequently as diabetic retinopathy becomes more severe.

The main treatments for more advanced diabetic retinopathy are:

1. Laser Treatment  - This is used to treat new blood vessels at the back of the eyes in the advanced stages of diabetic retinopathy. This is done because the new blood vessels tend to be very weak and often cause bleeding into the eye.

Treatment can help stabilise eye changes caused by diabetes and stops the vision from further deteriorating, although it won't usually improve sight.

Laser treatment involves shining a laser into the eyes – a local anaesthetic drops are administered to numb the eyes; eye drops are used to widen your pupils and special contact lenses are used to hold the eyelids open and focus the laser onto the retina . It normally takes around 20-40 minutes, and  is usually carried out on an outpatient basis, which means there is no requirment to stay in hospital overnight.  The patient may require more than one visit to a laser treatment clinic. The laser isn't usually painful, although you may feel a sharp pricking sensation when certain areas of the eye is being treated.

 

2. Anti-VEGF Injection Therapy into the eyes

In some cases of diabetic maculopathy, injections of a medicine called anti-VEGF may be given directly the eyes to prevent new blood vessels forming at the back of the eyes.

The main medicines used are called ranibizumab (Lucentis) and aflibercept (Eylea) and  now less commenly, bevacizumab (Avastin). These can help stop the problems in the eyes getting worse, and may also lead to an improvement in vision.

During treatment the skin around the eyes will be cleaned and covered with a sheet . Small clips will be used to keep the eyes open and local anaesthetic drops are administered to numb the eyes. A  very fine needle is carefully guided into the eyeball and the injection is given.

The injections are usually given once a month to begin with. Once the vision starts to stabilise, they'll be stopped or given less frequently.

Injections of steroid medication may sometimes be given instead of anti-VEGF injections, or if the anti-VEGF injections don't help.

 

3. A vitrectomy  is the surgical removal of the vitreous gel in the center of the eye in order to remove blood or scar tissue from the eyes. The procedure is used to treat severe bleeding into the vitreous, and is performed under local or general anesthesia. The same instruments used during vitrectomy also may be used to repair a detached retina.

 

Links

Diabetes Ireland: www.diabetes.ie

NCBI: www.ncbi.ie

Fighting blindness: www.fightingblindness.ie

 

Dry Eyes

Dry eye is a disorder of inadequate tear film which is due to reduced tear production by the lacrimal gland and/or excessive evaporation from the eye surface. Dry eye is a very common phenomenon and is dependent on the surrounding environment.

Dry Eyes

 

 

 

 

Dry eye is a disorder of inadequate tear film which is due to reduced tear production by the lacrimal gland and/or excessive evaporation from the eye surface. Dry eye is a very common phenomenon and is dependent on the surrounding environment. It is more common in women especially after menopause.

 

What are the symptoms?

Patients notice discomfort, irritation, photophobia, redness and blurring of the vision. In very severe cases the eye surface can become permanently scarred. Symptoms are worse in dry, windy conditions as well as indoors such as prolonged computer work, air-conditioning and fluorescent lights.

 

What are the treatments available?

Initially lubricants in the form of drops, gels or ointments can be used. They can be taken as required or on a regular basis throughout the day. If lubrication is not adequate, then occlusion of the tear drainage can be undertaken with small plugs or cautery.

 

 

 

 

 

 

 

 

 

Flashes and Floaters

Flashes are due to the vitreous jelly traction on the retina giving the effect of a small flash of light and floaters are as a result of debris in the vitreous jelly that may float pass through the visual axis and cause the patient to see an image such as a fine line, a “blob”, or a ‘cobweb” which may move.

Flashes and Floaters

 

 

Flashes are due to the vitreous jelly traction on the retina giving the effect of a small flash of light, which often happens in the peripheral vision. Floaters are as a result of debris in the vitreous jelly that may float pass through the visual axis and cause the patient to see an image such as a fine line, a “blob”, or a ‘cobweb” which may move.

Flashes and floaters are usually not concerning, but one in ten patients with these symptoms may have a retinal tear, which requires treatment. Symptoms may persist for months or even years.

These types of symptoms may suggest development of a “retinal tear” or “retinal detachment”, they are:

  • - Sudden increase in the flashes
  • - They become persistent such as being present all day
  • - Floaters which become much larger
  • - Loss of vision
  • - The impression of a curtain coming down, coming up or moving sideways

If you experience these symptoms, you should be seen by your Optometrist or Ophthalmologist as soon as you can

Glaucoma

Glaucoma is the name for a group of eye conditions in which the optic nerve is damaged at the point where it leaves the eye. This nerve carries information from the light sensitive layer in your eye, the retina, to the brain where it is perceived as a picture.

Glaucoma

 

What is Glaucoma?

Glaucoma is the name for a group of eye conditions in which the optic nerve is damaged at the point where it leaves the eye. This nerve carries information from the light sensitive layer in your eye, the retina, to the brain where it is perceived as a picture.

Glaucoma is often associated with high intraocular pressure (fluid pressure inside the eye) resulting from a problem with the drainage system of the eye.  Your eye needs a certain amount of pressure to keep the eyeball in shape so that it can work properly. Eye pressure is largely independent of blood pressure.

Causes

What controls pressure in the eye?

A layer of cells behind the iris (the coloured part of the eye) produce a watery fluid, called aqueous.  The fluid passes through the pupil to leave the eye through tiny drainage channels (trabecular meshwork- whose role is absorbing aqueous humour). Flow is reduced through these channels . These are in the angle between the front of the eye (the cornea) and the iris and return the fluid to the blood stream. Normally the fluid produced is balanced by the fluid draining out, but if it cannot escape, or if too much is produced, then your eye pressure will rise. (The aqueous fluid has nothing to do with tears).

   

Why can increased eye pressure be serious?

If the optic nerve comes under too much pressure then it can be injured. How much damage there is will depend on how much pressure there is and how long it has lasted, and whether there is a poor blood supply or other weakness of the optic nerve. A really high pressure will damage the optic nerve immediately. A lower level of pressure can cause damage more slowly, and then you would gradually lose your sight if it is not treated.

 

Types of Glaucoma

There are several  types of glaucoma, but the main two are..

1. Chronic glaucoma or  open-angle glaucoma or POAG  -  This  is sometimes called "the silent thief of sight" because in the early stages of the disease there are no warning signs, no pain or vision loss or other hints that something is wrong. The aqueous fluid can get to the drainage channels (open angle) but they slowly become blocked over many years. The eye pressure rises very slowly and there is no pain to show there is a problem, but the field of vision gradually becomes impaired.

2. Acute glaucoma -  Acute glaucoma is much less common in western countries. This happens when there is a sudden and more complete blockage to the flow of aqueous fluid to the eye. This is because a narrow “angle” closes to prevent fluid ever getting to the drainage channels. This can be quite painful and will cause permanent damage to your sight if not treated promptly.

 

 

Chronic Glaucoma

Are some people more at risk of chronic glaucoma?

Yes. There are several factors which increase the risk.

  • Age: Chronic glaucoma becomes much more common with increasing age. It is uncommon below the age of 40 but affects one per cent of people over this age and five per cent over 65.
  • Race: If you are of African origin you are more at risk of chronic glaucoma and it may come on somewhat earlier and be more severe, so make sure that you have regular tests.
  • Family: If you have a close relative who has chronic glaucoma then you should have an eye test at regular intervals. You should advise other members of your family to do the same. This is especially important if you are aged over 40 when tests should be done every year.
  • Short sight: People with a high degree of short sight are more prone to chronic glaucoma.
  • Diabetes:  is believed to increase the risk of developing glaucoma
  • Use of steroids:  either in the eye or systemically (orally or injected).
  • History of injury to the eye.

 

Why can chronic glaucoma be a risk to sight?

The danger with chronic glaucoma is that your eye may seem perfectly normal. There is no pain and your eyesight will seem to be unchanged, but your vision is being damaged. Some people do seek advice because they notice that their sight is less good in one eye than the other.

The early loss in the field of vision is usually in the shape of an arc a little above and / or below the centre when looking ‘straight ahead’. This blank area, if the glaucoma is untreated, spreads both outwards and inwards. The centre of the field is last affected so that eventually it becomes like looking through a long tube, so-called ‘tunnel vision’. In time even this sight would be lost.

 

How is chronic glaucoma detected?

As glaucoma becomes much more common over the age of 40 you should have eye tests at least every two years and. An eye doctor (ophthalmologist) can usually detect those individuals who are at risk for glaucoma  before nerve damage occurs. The doctor also can diagnose patients who already have glaucoma by observing their nerve damage or visual field loss. The following tests, all of which are painless, may be part of this evaluation.

  • Ophthalmoscopy is an examination in which the doctor uses a handheld device, a head-mounted device or a special lens and the slit lamp to look directly through the pupil into the eye
  • Tonometry measures the pressure in the eye .
  • Visual field testing  produces a computerized map of the visual field, outlining the areas where each eye can or cannot see.
  • Pachymetry measures the thickness of the cornea.
  • Gonioscopy is done to examine the drainage angle and drainage area of the eye.
  • OCT (optical coherence tomography) is a noninvasive imaging system that create a three-dimensional image of the optic nerve and retina.

 

How is chronic glaucoma treated?

The main treatment for chronic glaucoma aims to reduce the pressure in your eye. Treatment to lower the pressure is usually started with eye drops. These act by reducing the amount of fluid produced in the eye or by opening up the drainage channels so that excess liquid can drain away.

Some treatments also aim to improve the blood supply to the optic nerve. Your Doctor  may suggest either laser treatment or an operation called a Trabeculectomy to improve the drainage of fluids from your eye. You will need to go to hospital for treatment and have regular check-ups afterwards.

 

Can chronic glaucoma be cured?

 Although damage already done cannot be repaired, with early diagnosis and careful regular observation and treatment, damage can usually be kept to a minimum, and good vision can be enjoyed indefinitely.

 

Acute Glaucoma

What is acute glaucoma?

In acute glaucoma the pressure in the eye rises rapidly. This is because the periphery of the iris and the front of the eye (cornea) come into contact so that aqueous fluid is not able to reach the tiny drainage channels in the angle between them. This is sometimes called closed angle glaucoma.

 

What are the symptoms of acute glaucoma?

The sudden increase in eye pressure can  cause  severe eye pain, and headache. The affected eye becomes red, the sight deteriorates and may even black out. There may also be nausea and vomiting. In the early stages you may see misty rainbow coloured rings around white lights.

 

Is acute glaucoma always severe?

Sometimes people have a series of mild attacks, often in the evening. Vision may seem ‘misty’ with coloured rings seen around white lights and there may be some discomfort in the eye. If you think that you are having mild attacks you should contact your doctor without delay. In routine examinations the structure of the eye may make the examiner suspect a risk of acute glaucoma and advise further tests.

 

What is the treatment?

If you have an acute attack you will need to go into hospital immediately so that the pain and the pressure in the eye can be relieved. Drugs will be given which both reduce the production of aqueous liquid in the eye and improve its drainage. An acute attack, if treated early, can usually be brought under control in a few hours. Your eye will become more comfortable and sight starts to return.

When the pain and inflammation have gone down, your surgeon will advise making a small hole in the outer border of the iris to relieve the obstruction, allowing the fluid to drain away. This is usually done by laser treatment or by a small operation.

Usually the surgeon will also advise you to have the same treatment on the other eye, because there is a high risk that it will develop the same problem.

This treatment is not painful. Depending on circumstances and the response to treatment, it may not require admission to hospital. Sometimes a short stay in hospital may be advised.

 

Can acute glaucoma be cured?

If diagnosed without delay and treated promptly and effectively there may be almost complete and permanent recovery of vision. Delay may cause loss of sight in the affected eye. Occasionally the eye pressure may remain a little raised and treatment is required as for chronic glaucoma.

Links

Irish Glaucoma Association : www.glaucoma-assoociation.com  

NCBI: www.ncbi.ie

Fighting blindness: www.fightingblindness.ie

 

Macula Hole

The macula is the central part of the light sensitive retina which is responsible for vision. Sometimes, a hole forms in the macula, which prevents it from working normally affecting vision, particularly for reading and other visually demanding tasks, but it does not cause total blindness.

Macula Hole

 

The macula is the central part of the light sensitive retina. The retina lines the inside of the back of the eye and is responsible for vision. Light focused on the retina is transformed to an electrical signal that is sent to the brain where 'seeing' takes place. The macula is responsible for central vision such as reading and recognising facial details.

Sometimes, a hole forms in the macula, which prevents it from working normally.  This affects your vision, particularly for reading and other visually demanding tasks, but it does not cause total blindness.

What causes a macular hole?

The vitreous body is the clear gel that fills the space between the lens and the retina of the eyeball and  helps it maintain a round shape. As we age, the vitreous slowly shrinks and pulls away from the retinal surface. Natural fluids fill the area where the vitreous has contracted. This is normal. In most cases, there are no adverse effects. Some patients may experience a small increase in floaters, which are little “cobwebs” or specks that seem to float about in your field of vision.

However, if the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole.

Macular holes can also occur in other eye disorders, such as high myopia (nearsightedness), injury to the eye, retinal detachment, and, rarely, macular pucker.

Treatment for a macular hole

The only way to treat a macular hole is by having an operation. Eye drops or glasses won’t help..

Some patients decide not to have an operation and accept the poor central vision in the affected eye. This is reasonable, especially if the vision in the other eye is not affected. There is no “right” or “wrong” decision as every person has different needs and priorities.

You should discuss your reasons for wanting to proceed with an operation or for deciding not to have surgery with your consultant.

The operation to repair your macular hole is called a vitrectomy and usually takes about an hour. This procedure is  performed by an experienced surgeon.

 

 

 

 

Retinal Vein Occlusion

Retinal vein occlusion (RVO) is a condition where veins of the retina become blocked, causing a leakage of blood and plasma into the retinal tissue.

Retinal Vein Occlusion

 

Retinal vein occlusion (RVO) is a condition where veins of the retina become blocked, causing a leakage of blood and plasma into the retinal tissue. The bleeding known as a haemorrhage and swelling (oedema) in the retina can trigger symptoms such as distorted, blurred or loss of central vision. RVO usually happens to individuals older than 50 years of age and is more common in patients with high blood pressure, diabetes, glaucoma, cardiovascular diseases, blood clotting disorders, or other inflammatory conditions.

If there is suspected RVO in patients, they will undergo tests  such as OCT and fluorescein angiogram which helps determine the severity and specific area of the blockage. From here the doctors can verify which type of RVO the patient has. These two types of retinal vein occlusion are central retinal vein occlusion (CRVO) which is when the blockage occurs in the main vein leaving the optic nerve and branched retinal vein occlusion (BRVO) which is when the blockage occurs in one of the branches before reaching the main optic nerve vein.

RVO can be treated with intravitreal injection therapy using a number of medications. Retinal laser can also be performed and can be effective in reducing the swelling.

Uveitis

Uveitis usually affects people aged 20 to 59 and occurs when the uvea becomes inflamed causing pain in one or both eyes; redness of the eye; blurred vision; sensitivity to light (photophobia) and floaters (shadows that move across your field of vision).

Uveitis

The uvea is made up of the iris (coloured part of the eye), the ciliary body (ring of muscle behind the iris) and the choroid (layer of tissue that supports the retina). Uveitis occurs when the uvea becomes inflamed. Common symptoms of uveitis include: pain in one or both eyes; redness of the eye; blurred vision; sensitivity to light (photophobia) and floaters (shadows that move across your field of vision).

Uveitis usually affects people aged 20 to 59, but it can occur at any age, including in children. Men and women are affected equally.

There are a wide range of potential causes for uveitis. Many cases are thought to be the result of a problem with the immune system, called an autoimmune disorder , this is where the body's defense against illness and infection attacks the body tissues.  Less common causes of uveitis include an infection or injury to the eye.

 

Types of uveitis

The type of uveitis depends on which part of the eye is affected but the most common forms are:

  •  - Anterior uveitis – this is inflammation of the iris (iritis) or inflammation of the iris and the ciliary body,  and is the most common type of uveitis, accounting for about three out of four cases
  •  - Intermediate uveitis – this affects the area around and behind the ciliary body
  •  - Posterior uveitis – this affects the area at the back of the eye, the choroid and the retina

In some cases, uveitis can affect both the front and back of the eye. This is known as panuveitis.

         

Treatments for uveitis

The main treatment of uveitis is steroid medication which can reduce inflammation inside the eye.

Several different types of steroid medication may be used, depending on the type of uveitis you have. Eye drops are often used for uveitis affecting the front of the eye, whereas injections, tablets and capsules are more often used to treat uveitis affecting the middle and back of the eye.

In some cases, other treatments may also be needed in addition to steroids. These include eye drops to relieve pain or dilate the pupil, a type of medication called an immunosuppressant, and, rarely, surgery.

The sooner uveitis is treated, the more likely the condition can be successfully treated.

 

Complications

Although most cases of uveitis respond quickly to treatment and cause no further problems, there is a risk of complications.

The risk is higher in people who have intermediate or posterior uveitis, or who have repeated episodes of uveitis.Complications of uveitis include glaucoma and retinal damage and can cause permanent damage of the eye and loss of vision.

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Paul Connell
Consultant Ophthalmic Surgeon
Ophthalmology
Bon Secours Hospital Dublin

Prof. Paul Connell

Consultant Ophthalmic Surgeon

Biography

Prof. Paul Connell graduated from University College Dublin in 1997 and completed his postgraduate training in Ophthalmology and Ophthalmic Surgery through the Irish College of Ophthalmologists higher surgical training program.  Under the auspices of Royal College of Surgeons, he went on to complete two internationally renowned surgical vitreoretinal fellowships at Bristol Eye Hospital and subsequently the Royal Victorian Eye and Ear Hospital Melbourne, Australia. There Prof Connell was appointed to a consultant post in 2009. He returned to Ireland in 2011 and was appointed to the Mater Misericordiae University Hospital. Prof Connell is active academically with an extensive publication record and his primary research interests include diabetic retinopathy, aetiology and treatment and is an Associate Clinical Professor (UCD).

Areas of Interest

Medical & Surgical Retinal Eye Disease. Age Related Macular Degeneration. Cataract. Diabetes. Epiretinal Membrane. Macular Hole. Medical Retina. Retinal Detachment. Surgical Retina. Trauma. Uveitis. Vein Occlusions, Vitreoretinal Surgery

Qualifications

M.B. B.Ch. B.A.O. M.Med.Sci. F.R.C.S.I.(Ophth) F.R.A.N.Z.C.O.

Appointments

Mater Misericordiae University Hospital

Contact Details

  • Prof. Paul Connell
  • 60 Eccles Street, Dublin 7

Secretary

Yvonne Delaney
Consultant Ophthalmic Surgeon
Ophthalmology
Bon Secours Hospital Dublin

Ms Yvonne Delaney

Consultant Ophthalmic Surgeon

Areas of Interest

Glaucoma

Qualifications

M.B., B.Ch. B.A.O., M.R.C.P.I., F.R.C.Ophth.

Appointments

Mater Misericordiae University Hospital Eccles Street Dublin 7

Contact Details

  • Ms Yvonne Delaney
  • Suite 4, 69 Eccles Street, Dublin 7

Secretary

Edward Dervan
Consultant Ophthalmic Surgeon
Ophthalmology
Bon Secours Hospital Dublin

Mr Edward Dervan

Consultant Ophthalmic Surgeon

Biography

Mr. Dervan completed his ophthalmic surgical training in Ireland and was awarded fellowship of the Royal College of Surgeons in Ireland (Ophthalmology) in 2013. He also completed an advanced surgical fellowship in Perth, Australia specialising in anterior segment disease, focusing primarily on glaucoma and complex cataract surgery.

He previously worked as a Consultant Ophthalmologist in Perth before accepting a position as Consultant Ophthalmologist specialising in glaucoma at the Mater Misericordiae University Hospital.

His research interests include understanding the basic science of glaucoma, improving the clinical outcomes and the provision of services to patients with glaucoma. He was awarded a research medical doctorate from University College Dublin for his research on pseudoexfoliation glaucoma.

Areas of Interest

Glaumcoma, complex cataract surgery

Additional Information

Referrals to Mr Dervan can be sent via Healthlink, posted to his private rooms in the Bon Secours Consultants Clinic or sent by secure email.

Qualifications

MB BCh BAO, MSc, MD, MRCophth, FRCSI (Ophth)

Contact Details

  • Mr Edward Dervan
  • Suite 4, Bon Secours Consultants Clinic, Glasnevin, Dublin 9

Secretary

Aoife Doyle
Consultant Ophthalmic Surgeon
Ophthalmology
Bon Secours Hospital Dublin

Ms Aoife Doyle

Consultant Ophthalmic Surgeon

Biography

Ms Doyle graduated from UCD in 1994 and obtained her Masters of Medical Science (Physiology) in 1996.  She underwent Fellowship training at The Glaucoma Institute,  Foundation Hospital St Joseph,  Paris between 2004 and 2005.  She has held the position of Consultant Ophthalmic Surgeon at Royal Vistoria Eye and Ear Hospital and St. James’s Hospital since 2005.  She is a Glacoma Specialist at RVEEH specialises in all forms of glaucoma laser and surgery including trabeculectomy,  non-penetrating surgery,  Baerveldt tubes and Ahmed valves.

Areas of Interest

Glaucoma Surgery and Glaucoma Filtration Surgery, Laser, Intraocular Drug Delivery

Qualifications

M.B. F.R.C.Ophth

Appointments

Royal Victoria Eye and Ear Hospital St James Hospital

Contact Details

  • Ms Aoife Doyle

Secretary

Susan FitzSimon
Consultant Ophthalmic Surgeon
Ophthalmology Ophthalmic Surgery
Bon Secours Hospital Dublin

Ms. Susan FitzSimon

Consultant Ophthalmic Surgeon

Areas of Interest

Anterior Segment, Refractive Surgery, Glaucoma, Paediatric Ophthalmology.

Qualifications

M.D. F.R.C.S.I., F.R.C.Ophth.

Appointments

The Childrens University Hospital Temple Street Dublin 1

Contact Details

  • Ms. Susan FitzSimon
  • Bon Secours Consultants Clinic, Glasnevin, Dublin 9

Secretary

Claire Hartnett
Consultant Ophthalmic Surgeon
Ophthalmology Ophthalmic Surgery
Bon Secours Hospital Dublin

Ms Claire Hartnett

Consultant Ophthalmic Surgeon

Biography

Ms. Claire Hartnett is a Consultant Ophthalmic Surgeon and  completed her Ophthalmic Surgery Higher Surgical Training in Ireland in 2017. She undertook her fellowship training in Paediatric and Adult Ophthalmic Surgery in Great Ormond Street Hospital and The Royal Hospital, London.

In February 2019, she commenced her role as Consultant Ophthalmic Surgeon in Temple Street Children's University Hospital, Dublin and In June 2019 her private practice in the Bon Secours Hospital Dublin.

Areas of Interest

  • Cataract
  • Strabismus
  • Diabetic Retinopathy
  • Macular Degeneration
  • Glaucoma

Additional Information

Referrals to Ms Hartnett can be sent via Healthlink, posted to the Bon Secours Hospital Dublin or sent by secure email.

Qualifications

MB BCh BAO, BMedSc, FRCSI Ophth, FEBO

Contact Details

  • Ms Claire Hartnett
  • Bon Secours Hospital Dublin, Glasnevin, Dublin 9

Secretary

Brid Morris
Consultant Ophthalmic Surgeon
Ophthalmology
Bon Secours Hospital Dublin

Ms Brid Morris

Consultant Ophthalmic Surgeon

Biography

Ms. Morris graduated with an honours medical degree from University College Dublin in 1998. She undertook her initial Ophthalmology surgical training in the Mater University, Beaumont and Temple St Hospitals, Dublin before moving to the U.K. Bríd completed her Specialist Registrar training in Cardiff and Edinburgh, qualifying as a Consultant Ophthalmic Surgeon in 2009. She undertook higher surgical training fellowships in Glaucoma and Medical Retina, before returning to Ireland.

Bríd works in the Retinal Department in the Mater University Hospital and is a Consultant Ophthalmologist in James Connolly Hospital, Blanchardstown. She has published several peer reviewed papers and has a special interest in Medical Retina and Glaucoma.

Areas of Interest

  • Medical Retina – age-related macular degeneration, diabetes and other retinal conditions
  • Glaucoma
  • General Ophthalmology

Qualifications

M.B, B.Ch, B.A.O.(Hons), M.Sc (Physiology)(Hons), FRCOphth, FRCSI(Ophth)

Contact Details

  • Ms Brid Morris
  • Bon Secours Hospital, Glasnevin, Dublin 9

Secretary

Louise O Toole
Consultant Ophthalmic Surgeon
Ophthalmology
Bon Secours Hospital Dublin

Ms Louise O Toole

Consultant Ophthalmic Surgeon

Areas of Interest

Medical Retina. Age Related Macular Degeneration. Diabetic Eye Disease. Medical Neuro Ophthalmology

Contact Details

  • Ms Louise O Toole
We Fong Siah
Consultant Ophthalmic Surgeon
Ophthalmology
Bon Secours Hospital Dublin

Ms We Fong Siah

Consultant Ophthalmic Surgeon

Biography

Ms Siah is a consultant eye surgeon specialising in Ophthalmic Plastic Reconstructive and Aesthetic surgery at the Bon Secours Hospital, Dublin. Her subspecialty interests include Cataract surgery, Eyelid surgery (eyelid malposition, eyelid lumps, eyelid cancer, facial nerve palsy, aesthetic eyelid surgery), Oculofacial Aesthetics (non-surgical), Watery Eye disorder, Dry Eye disorder, Facial Dystonia (Blepharospasm and Hemifacial spasm), Orbital disorder (including Thyroid Eye Disease) and Socket reconstruction.

 

Specialty

General Ophthalmology and Ophthalmic surgery

 

Sub Specialties

  • Cataract surgery
  • Eyelid lesions (‘see and treat’)
  • Eyelid surgery (eyelid malposition, droopy eyelid/ptosis, facial nerve palsy)
  • Periocular skin cancer surgery and reconstruction
  • Aesthetic eyelid surgery (blepharoplasty)
  • Brow lift
  • Oculofacial aesthetics (fillers, botox)
  • Watery eye disorders
  • Dry eye disorders
  • Facial dystonia
  • Orbital disorders including thyroid eye disease, orbital decompression
  • Evisceration, enucleation, socket rehabilitation

Additional Information

Ms Siah has over 20 publications in reputable peer-reviewed journals and has presented her work at national and international ophthalmology conferences. She has been awarded with research grants and was involved in clinical trials in the past.

 

Ms Siah is a member of the British Oculoplastic Surgery Society (BOPSS), the Royal College of Ophthalmologists and the Irish College of Ophthalmologists.

Qualifications

MB BCh BAO, BA, MRCPI, FRCSI(Ophth), FRCOphth

Appointments

Referrals to Ms Siah can be sent via Healthlink, posted to her private rooms or sent by secure email.

Contact Details

  • Ms We Fong Siah
  • 60 Eccles Street, Dublin 7 or c/o Eye Dept. Bon Secours Hospital Dublin, Glasnevin, Dublin 9

To arrange an appointment to see one of our Specialist you must first obtain a referral from either your GP, Optometrist or another specialist. Please ask them to email your referral to us or in the case of GPs they can also send us your referral securely via Healthlink. This helps us determine how urgent  your case may be.

You are welcome to call our office and / or the individual Consultant secretaries to check a referral has been received and if you have any general enquires we can answer your questions via email or call.

The Bon Secours Hospital Dublin has excellent insurance coverage in place with all private health insurance companies. To check if your health insurance policy covers you in the Bon Secours Hospital Dublin please call 1890 50 40 30 or 01 8082300.

The hospital also has competitive self pay price options for all procedures. For more information on costs, please contact patient accounts on 01 8065351

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