Mr Mike Lavin BSc MBChB FRCS FRCOphth
Consultant Ophthalmic Surgeon
Mr Lavin trained in general ophthalmology and vitreo-retinal surgery at Moorfields Eye Hospital London. Mr Lavin has been a consultant ophthalmic surgeon at Manchester Royal Eye Hospital for nearly 20 years. He has a very busy private practice specializing in modern small incision cataract surgery, vitreo-retinal surgery, glaucoma and general ophthalmology. Mr Lavin has consulting rooms at the Alexandra Hospital Cheadle, Fernleigh Consulting Centre in Wilmslow, The Downs in Altrincham and in St. John Street in Manchester. Mr Lavin undertakes cataract surgery at Face & Eye and anti-VEGF injections for age related macular degeneration (AMD).
AGE-RELATED MACULAR DEGENERATION (AMD)
Age-related Macular Degeneration (AMD) is a common eye disorder that damages the macula at the back of the eye and is the most common cause of severe loss of vision in patients over the age of 50. The macula is a tiny central area of the retina (the photographic plate at the back of the eye) which we use to see fine print, and colours. AMD can make it difficult for affected patients to read, recognise people, drive, or perform tasks that require the use of accurate central vision. Common early symptoms of AMD are blurring or distortion of central vision. Without treatment, vision loss may be quick, severe and irreversible.
It is sometimes necessary to carry out investigations, both at the time of referral and at regular intervals to determine whether you present the dry or the wet form of AMD, and whether the disease is active and treatable or not. In the wet form abnormal blood vessels grow at the macula and leak fluid. The tests most commonly performed are fundus fluorescein angiography (FFA) and Optical Coherence Tomography (OCT). During FFA a yellow dye is injected into a vein in the arm and photographs are taken of the back of the eye. This allows a detailed view of the blood vessels at the macula. OCT is simple test that uses a beam of light to produce pictures of the macula. OCT is commonly used to determine the thickness of the macula and the response to treatment.
Treatments for wet AMD most commonly include Photodynamic Therapy (PDT) and/or the injection into the eye of a special drug referred to as anti-vascular endothelial growth factor (anti-VEGF).
PHOTODYNAMIC THERAPY (PDT)
During PDT a special dye called Visudyne® is injected into an arm vein. A special contact lens is placed on the eye. A special laser is then applied to the eye which activates the dye within the abnormal macular blood vessels with the aim of destroying them.
LUCENTIS OR AVASTIN (Anti-VEGF Drugs)
The aim of treatment with these drugs is to prevent further loss of vision although some fortunate patients have actually regained vision following the use of these drugs. A tiny quantity of fluid containing the drug is injected into the vitreous, a jelly-like substance in the middle of the eye, after the eye has been numbed with anaesthetic drops.These drugs need to be injected into the eye at regular intervals (about every 4-6 weeks). How long this is continued for depends on the individual patient’s clinical circumstances.
At Face & Eye these injections are only given in our dedicated operating theatre and not in a room in a clinic. The injections are given by Mr Mike Lavin, consultant ophthalmic surgeon with expertise in vitreo-retinal surgery. "Twilight" anaesthesia can be offered for this procedure.
The main ain risk factors for ARMD are:
Smoking
Family history
Family history doubles the baseline ARMD risk and smoking more than triples it. Any patient with both is therefore at more than 6 times the baseline risk.
Other risk factors: light hair & blue eye colour, obesity, lightly pigmented skin and female gender (all of which increase ARMD risk, but to a lesser extent than smoking & family history). ?
The baseline risk of developing AMD from 55yrs age onwards is 1.3% over 5 years. In patients with medium size drusen this rises to a 26% 5yr risk of developing advanced ARMD. ? Therefore, patients who have medium sized, soft drusen & those with multiple risk factors would significantly increase their chances of maintaining retinal health by taking Ocuvite Complete (OC). The antioxidants have been shown to reduce risk by up to 25%, the pigments (lutein & zeaxanthin by 30-40%) and omega 3 oils, specifically DHA, by 34-64%.Ocuvite Complete contains all of the above.
