General Advice

We are striving to balance the risk between maintaining a safe medical retinal service for our patients who are most at risk of visual loss, while not exposing them to the risk of contracting Covid-19. Like many other services, we must reduce normal activity within the hospital. We aim to minimise the movement of people to and from the hospital to ensure that it remains as safe as possible for staff and for those in need of urgent care. Therefore, we are deferring all non-urgent appointments.

Patients attending the Royal Victoria Eye and Ear Hospital (RVEEH) with medical retinal conditions may have appointments in outpatient clinics for review or appointments for treatment with injections into the eye in the Minor Procedure Unit (MPU). The healthcare team are carefully reviewing everyone’s notes and taking your condition and requirement for appointment/treatment into consideration. A decision will be made to continue with your appointment, undertake a phone consultation, or reschedule your appointment. Should your appointment for review or treatment be deferred as a result of the the current coronavirus COVID-19 pandemic, we would like to reassure you that we are still here to support you and are available to answer any queries you may have in relation to your care.

However, we do encourage you to monitor your vision daily and we still wish to advice that should your vision deteriorate, you should contact our Accident & Emergency Department. During this COVID-19 pandemic the A&E department is operating an appointment only system.

For Emergency Department appointments please phone; 1800 819 990
Monday to Friday: 0800hrs – 2000hrs
Saturday and Sunday: 0800hrs – 1700hrs

To manage queries from all our medical retinal patients we have established an advice helpline specifically for medical retinal care and it will be staffed on Mondays and Wednesdays 9am – 3pm only.

Nurse-led Medical Retina Helpline; 087 0618359

We may not always be available to answer your call but if you leave a message, we will answer your query as soon as possible.

Self-Monitoring at home

We encourage you to self-monitor your vision at home. There is a chance your vision may deteriorate during this time, hence the healthcare team have asked that you check your vision in each eye daily, and if you have any concerns/deterioration in vision you can contact the accident and emergency helpline on 1800 819 990.

An Amsler grid can be used to detect any deterioration in your condition. The Amsler grid is a simple square containing a grid pattern and a dot in the middle (see below).

 

Amsler Grid

Amsler Grid

To use the Amsler grid, follow these steps once a day, every day:

  1. Wearing any glasses you normally use to read, hold the grid at arm’s length (12 to 15 inches) away from your face in good light
  2. Cover one eye
  3. Look directly at the centre dot with your uncovered eye and keep your eye focused on it
  4. While looking directly at the centre dot, notice in your side vision if all grid lines look straight or if any lines or areas look blurry, wavy, dark or blank
  5. Follow the same steps with the other eye
  • Note: This test can be used sitting in front of your computer. 

If you notice a rapid deterioration or any areas of the grid that appear darker, wavy, blank or blurry, contact our emergency department on 1800 819 990

 

 

Medical Retina; Frequently Asked Questions (FAQs)

The information below relates to some of the more common conditions that are managed in medical retinal clinics at the RVEEH (It does not cover conditions treated in other clinics, such as vitreoretinal surgical diseases).

List of conditions

  1. Age-related macular degeneration (AMD)
  2. Diabetic eye disease
  3. Retinal vein occlusions
  4. Uveitis
  5. Other medical retinal conditions

 

1. Age-related macular degeneration (AMD)

I am receiving injections into my eye for wet age-related macular degeneration (AMD).
On-going treatment for active wet AMD is often required to halt or delay vision loss. The clinical team are prioritising these patients and patients will continue to receive these injections where possible but sometimes at an extended treatment interval. During your visit, the hospital is implementing social distancing measures and also a more streamlined pathway will ensure that the time spent at your appointment is kept to a minimum.

I am being monitored for age-related macular degeneration but am not receiving injections.
Patients with stable AMD who are being monitored are deemed to be low-risk of progression, therefore it is likely that your appointment will be postponed. In accordance with self-monitoring advice as outlined above, you should seek attention should you notice a sudden change in the vision of either eye (such as new distortion in your vision).

2. Diabetic eye disease

I am being monitored in the medical retinal clinics for Diabetic Eye Disease, but my appointment has been postponed, what should I do?

Maintaining good diabetic control is an important way of preventing sight loss. We encourage you to keep your blood sugar under control (as well as keeping blood pressure under control for patients with high blood pressure) and continue with your usual medication as advised by your GP or diabetes specialist.

Your notes will have been reviewed by the clinical team, and it is deemed that your condition is low risk. In accordance with self-monitoring advice as outlined above, you should seek attention should you notice an abrupt change in the vision of either eye, floaters, flashes of light, or blurred vision. You can contact our emergency department on 1800 819 990.

I am receiving injections into my eye for Diabetic Eye Disease.

Diabetic eye disease is sometimes treated with injections into the eye for a condition called diabetic macular oedema. This condition tends to change slowly and often treatment is not so urgent therefore your injection appointment may likely be postponed.

I have proliferative diabetic retinopathy; will my appointment be postponed?
Each individual case will be considered by the clinical team as to whether your condition has high-risk features. Proliferative diabetic retinopathy refers to the condition where new blood vessels have grown, usually on the retina and this is treated with retinal laser treatment called panretinal photocoagulation (PRP). However, if you have already had adequate treatment in the past for proliferative retinopathy, and your clinical team now considers your disease is stable, your appointment might be postponed in the current situation.

I am being monitored in the National Diabetic Retinopathy Screening Service (DRSS)?

Current information related to the DRSS appointment schedule in response to the COVID-19 pandemic can be accessed here www.diabeticretinascreen.ie

3. Retinal Vein Occlusions

I am attending the Medical Retinal Clinic for a retinal vein occlusion; will my appointment be postponed?

You may be monitored in the medical retinal clinics if you have been diagnosed with a central retinal vein occlusion (CRVO), hemi-retinal vein occlusion (HRVO) or a branch retinal vein occlusion (BRVO). Most of these conditions are not urgent, therefore appointments will be deferred. In some types of vein occlusion, rubeosis iridis may be present (new blood vessels on the iris), and this is felt to be high-risk therefore their appointments will not be postponed.

In line with current self-monitoring advice, please report to the A&E helpline at; 1800 819 990, if you experience any sudden deterioration in your vision, or increased pain or redness in the eye.

I am receiving injections into the eye for the treatment of macular oedema as a result of a retinal vein occlusion.

Often treatment for macular oedema due to a retinal vein occlusion is not usually urgent and can be postponed without visual outcomes being impacted. Some cases of retinal vein occlusion are deemed high risk, and, in this exception, treatment will proceed as planned. Decision to postpone/treat will be determined by the clinical team on an individual basis.

4. Uveitis

I’m attending the medical retinal clinic for review of my uveitis condition. Will my appointment be deferred?

Decision to proceed/postpone your appointment will be made on a case-by-case basis.

I’m taking immunosuppressant medication and my appointment has been postponed.

Continue to take your medications as prescribed. Your immunosuppression can be monitored virtually with blood test monitoring being carried out locally in your GP office.

We always recommend if you are on immunosuppressant therapy, to be extra vigilant in practicing universal precautions to avoid getting ill (ie. washing hands, avoid touching your face, disinfect surfaces you will need to touch). If you develop any signs of illness, infection, or fever; please notify your GP immediately and hold your immunosuppressant therapy.

I need another prescription for my medication, but my appointment has been postponed.

We can arrange a repeat prescription to be faxed or a telephone consultation with a clinician if needed. Please contact our medical retinal advice helpline on 087 0618359, Mondays and Wednesdays only 09.00 – 15.00.

5. Other Medical Retina Conditions

I am being reviewed in the medical retina clinic for another condition than those outlined above; will my appointment be postponed?

Of course, there are many other patients that are cared for in medical retinal clinics for conditions other than those outlined above. These may include but not limited to central serous chorioretinopathy (CSR), genetic retinal disease, sickle cell retinopathy, or Coat’s disease etc. Each case will be reviewed by the clinical team as to whether your appointment will proceed/ be postponed, but in most cases your appointment will be postponed in the current situation. Please continue to self-monitor your vision at home and if any deterioration noted you are advised to seek attention by contacting A&E helpline on 1800 819 990

Should I continue to take my eye drops/medications if my appointment has been postponed?

If you are taking any eye drops or medications for your condition, please continue to take as prescribed by your medical retina clinician. If you have any queries specific to your case you can contact the Medical Retina advice helpline on 087 0618359 (Mondays & Wednesdays, 09.00-15.00).

Questions about my appointment

Any appointment queries please see appointment section for more information

Nurse led Medical Retina Helpline Number is: 087 0618359

Mondays 0900hrs – 1500hrs only

Wednesdays 0900hrs – 1500hrs only