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Ophthalmology

Ophthalmology

 

Ophthalmology overview

  • Willows has an experienced team of Ophthalmology Specialists
  • All our ophthalmologists have advanced training in microsurgical techniques
  • Superb ophthalmic diagnostic and surgical facilities
  • Our Specialists are regularly invited to speak at conferences/CPD meetings in the UK and overseas
  • Unsurpassed, comprehensive service, 
    24 hours a day, 365 days of the year
 
  • Hospitalised patients benefit from 24-hour veterinary and nursing care
    • post-operative cases are closely monitored and treated throughout the night, as required
    • intensive care for ocular medical emergencies
  • BVA/KC/ISDS eye testing for hereditary eye disease provided on a daily basis
  • Free telephone advice given with
    the minimum of delay
  • Willows has one of the most experienced teams of Ophthalmology Specialists in the UK
  • All our ophthalmologists have advanced training in microsurgical techniques
  • Superb ophthalmic diagnostic and surgical facilities
  • Our Specialists are regularly invited to speak at conferences/CPD meetings in the UK and overseas
  • Unsurpassed, comprehensive service, 
    24 hours a day, 365 days of the year
  • Hospitalised patients benefit from 24-hour veterinary and nursing care
    • post-operative cases are closely monitored and treated throughout the night, as required
    • intensive care for ocular medical emergencies
  • BVA/KC/ISDS eye testing for hereditary eye disease provided on a daily basis
  • Free telephone advice given with the minimum of delay

Rodrigo
Pinheiro de Lacerda

DVM DipECVO MRCVS

European Specialist in Veterinary Ophthalmology

Samuela
Mazzucchelli

DVM DipECVO MRCVS

European Specialist in Veterinary Ophthalmology

Fully supported by a team of Imaging and Anaesthesia Specialists and, where necessary, by Neurology, Soft Tissue and Medicine Specialists.

 

Areas of special interest 

TOP

Cataract surgery

     
  • Our Specialists have performed over 2000 cataract surgeries
  • Routine and complex cases regularly managed
    • rapid onset diabetic cataracts
    • ruptured lenses
    • traumatic lens injuries
  • We have reported a long-term success rate of over 90%1
  • Electroretinography with state-of-the-art ERG system
  • 10 MHz ocular ultrasonography (interpretation supported by three Specialists in Diagnostic Imaging)
  • Muscle relaxant anaesthetics managed by Specialist-led anaesthesia team
  • State-of-the-art AMO 'cold' phacoemulsification unit
    • reduces ocular insult and post-op inflammation
  • Foldable acrylic lens implants used routinely
  • Capsular tension rings used where indicated
  • Intensive 24-hour post-operative monitoring and care
  • Internal Medicine team assistance with complex diabetics etc.
  Persistent hyaloid artery (left)  Spontaneous posterior lens capsule rupture and partial retinal detachment

Persistent hyaloid artery (left)

Spontaneous posterior lens capsule rupture and partial retinal detachment

 

Diabetic ESS pre-cataract surgery

3 years post-operatively – note the clear visual axis showing the acrylic lens implants

Diabetic ESS pre-cataract surgery and 3 years post-operatively – note the clear visual axis showing the acrylic lens implants

TOP

Cataract surgery

  • Our Specialists have performed over 2000 cataract surgeries
  • Routine and complex cases regularly managed
    • rapid onset diabetic cataracts
    • ruptured lenses
    • traumatic lens injuries
  • We have reported a long-term success rate of over 90%1
  • Electroretinography with state-of-the-art ERG system
  • 10 MHz ocular ultrasonography (interpretation supported by three Specialists in Diagnostic Imaging)
  • Muscle relaxant anaesthetics managed by Specialist-led anaesthesia team
  • State-of-the-art AMO 'cold' phacoemulsification unit
    • reduces ocular insult and post-op inflammation
  • Foldable acrylic lens implants used routinely
  • Capsular tension rings used where indicated
  • Intensive 24-hour post-operative monitoring and care
  • Internal Medicine team assistance with complex diabetics etc.
Persistent hyaloid artery (left)  Spontaneous posterior lens capsule rupture and partial retinal detachment

Persistent hyaloid artery (left)

Spontaneous posterior lens capsule rupture and partial retinal detachment

 

Diabetic ESS pre-cataract surgery

3 years post-operatively – note the clear visual axis showing the acrylic lens implants

Diabetic ESS pre-cataract surgery and 3 years post-operatively – note the clear visual axis showing the acrylic lens implants

 

TOP

Limbal melanoma

     

We recently published a review of our surgical management of limbal melanoma in dogs2. In 14 cases, our technique of partial lamellar excision, cryotherapy and adjunctive grafting was shown to be minimally invasive, efficient and well tolerated. No recurrence was observed with a mean 2.1 year follow up. Fewer serious long-term complications were seen compared to treatment with brachytherapy.

  Limbal melanoma in a crossbred dog

Limbal melanoma in a crossbred dog

The same eye intra-operatively and  7 months post-op

The same eye intra-operatively and
7 months post-op

TOP

Limbal melanoma

We recently published a review of our surgical management of limbal melanoma in dogs2. In 14 cases, our technique of partial lamellar excision, cryotherapy and adjunctive grafting was shown to be minimally invasive, efficient and well tolerated. No recurrence was observed with a mean 2.1 year follow up. Fewer serious long-term complications were seen compared to treatment with brachytherapy.

Limbal melanoma in a crossbred dog

Limbal melanoma in a crossbred dog

The same eye intra-operatively and  7 months post-op

The same eye intra-operatively and
7 months post-op

 

TOP

Laser treatment

     

Conditions treated using our Iris Medical® diode laser system include

  • Canine iris melanoma
  • Iris cysts
  • Retinal detachment
    • Prophylaxis in high risk cataract and lens luxation patients
    • To prevent progression of pre-existing partial retinal detachments
  • Cyclophotocoagulation in selected glaucoma cases
  Boxer 5 years following laser ablation of an iris melanoma – visual and comfortable with only focal endothelial scarring and mild dyscoria

Boxer 5 years following laser ablation of
an iris melanoma – visual and comfortable
with only focal endothelial scarring and
mild dyscoria

Heavily pigmented iris cyst before and after laser ablation

Heavily pigmented iris cyst before and after laser ablation

TOP

Laser treatment

Conditions treated using our Iris Medical® diode laser system include

  • Canine iris melanoma
  • Iris cysts
  • Retinal detachment
    • Prophylaxis in high risk cataract and lens luxation patients
    • To prevent progression of pre-existing partial retinal detachments
  • Cyclophotocoagulation in selected glaucoma cases
Boxer 5 years following laser ablation of an iris melanoma – visual and comfortable with only focal endothelial scarring and mild dyscoria

Boxer 5 years following laser ablation of
an iris melanoma – visual and comfortable
with only focal endothelial scarring and
mild dyscoria

Heavily pigmented iris cyst before and after laser ablation

Heavily pigmented iris cyst before and after laser ablation

 

TOP

Corneal surgery

     
  • Keratectomy for recurrent epithelial erosion (indolent or
    non-healing ulcer) and lipid keratopathies
    • allowing rapid healing of refractory cases of
      corneal ulceration
  • Direct surgical closure of corneal and scleral lacerations
  • Conjunctival grafting
  • Corneal and scleral allo-grafting; Biosist® grafting
  • Corneo-conjunctival transposition
    • providing maximal stabilisation for large and deep corneal defects
    • maintaining clarity of the central visual axis
  • Thermokeratoplasty
    • to manage cases of advanced endothelial cell function loss and associated ulcerative keratitis
  Conjunctival pedicle graft

Conjunctival pedicle graft

Keratoconjunctival transposition following removal of a corneal sequestrum

Keratoconjunctival transposition following removal of a corneal sequestrum

Thermokeratoplasty in progress under the operating microscope

Thermokeratoplasty in progress under the operating microscope

TOP

Corneal surgery

  • Keratectomy for recurrent epithelial erosion (indolent or
    non-healing ulcer) and lipid keratopathies
    • allowing rapid healing of refractory cases of
      corneal ulceration
  • Direct surgical closure of corneal and scleral lacerations
  • Conjunctival grafting
  • Corneal and scleral allo-grafting; Biosist® grafting
  • Corneo-conjunctival transposition
    • providing maximal stabilisation for large and deep corneal defects
    • maintaining clarity of the central visual axis
  • Thermokeratoplasty
    • to manage cases of advanced endothelial cell function loss and associated ulcerative keratitis
Conjunctival pedicle graft

Conjunctival pedicle graft

Keratoconjunctival transposition following removal of a corneal sequestrum

Keratoconjunctival transposition following removal of a corneal sequestrum

Thermokeratoplasty in progress under the operating microscope

Thermokeratoplasty in progress under the operating microscope

 

TOP

Management of lens luxation

     
  • Lens luxation is a potentially blinding ophthalmic emergency
  • Our team is available 24/365 to manage affected patients
  • Intracapsular extraction of luxated lenses combined with automated vitrectomy
  • Small incision surgery by phaco for subluxated lenses
    • +/- capsular tension rings and acrylic lens implants
    • we have documented the benefit of early intervention by small incision surgery3
  • Prophylactic lens removal is becoming increasingly important
    • for dogs tested DNA positive for primary lens luxation
    • for dogs with lens luxation in the other eye
  Lens luxation in a 4 year old Jack Russell

Lens luxation in a 4 year old Jack Russell

Jack Russell post phacolentectomy  for lens subluxation

Jack Russell post phacolentectomy
for lens subluxation

TOP

Management of lens luxation

  • Lens luxation is a potentially blinding ophthalmic emergency
  • Our team is available 24/365 to manage affected patients
  • Intracapsular extraction of luxated lenses combined with automated vitrectomy
  • Small incision surgery by phaco for subluxated lenses
    • +/- capsular tension rings and acrylic lens implants
    • we have documented the benefit of early intervention by small incision surgery3
  • Prophylactic lens removal is becoming increasingly important
    • for dogs tested DNA positive for primary lens luxation
    • for dogs with lens luxation in the other eye
Lens luxation in a 4 year old Jack Russell

Lens luxation in a 4 year old Jack Russell

Jack Russell post phacolentectomy  for lens subluxation

Jack Russell post phacolentectomy for lens subluxation

 

TOP

Dry eye

     
  • extensive experience of managing keratoconjunctivitis sicca cases
  • medical therapy
  • surgical therapy
    • for cases refractory or non-responsive to medical treatment
  • neurogenic cases welcomed

In a recent critical review of our success rates of parotid duct transposition in 92 eyes with a mean follow up time of 38 months, 90% of owners were satisfied with the outcome and would opt for it again4.

  WHWT with absolute KCS, refractory to medical treatment pre-PDTWHWT with absolute KCS, refractory to medical treatment six weeks post-PDT

WHWT with absolute KCS, refractory to medical treatment a) pre-PDT, b) six weeks post-PDT

TOP

Dry eye

  • extensive experience of managing keratoconjunctivitis sicca cases
  • medical therapy
  • surgical therapy
    • for cases refractory or non-responsive to medical treatment
  • neurogenic cases welcomed

In a recent critical review of our success rates of parotid duct transposition in 92 eyes with a mean follow up time of 38 months, 90% of owners were satisfied with the outcome and would opt for it again4.

WHWT with absolute KCS, refractory to medical treatment pre-PDTWHWT with absolute KCS, refractory to medical treatment six weeks post-PDT

WHWT with absolute KCS, refractory to medical treatment a) pre-PDT, b) six weeks post-PDT

 

TOP

Blepharoplastic procedures

     

Our team is experienced in a wide range of corrective and reconstructive eyelid surgeries tailored to each individual case.

  • Entropion/ectropion – correction using a range of techniques
  • 'Diamond eye' malformation
  • Macropalpebral fissure
  • Brachycephalic ocular conformation
  • Facial droop
  • Eyelid reconstruction using the Mustardé 'lid swap' technique
    • we specialise in the management of large eyelid defects
  Severe entropion in a Sharpei pre- and post-operatively

Severe entropion in a Sharpei pre- and post-operatively

2y Spinone – traumatic loss of almost the entire upper lid margin – before and after Mustardé's procedure

2y Spinone – traumatic loss of almost the entire upper lid margin – before and after Mustardé's procedure

TOP

Blepharoplastic procedures

Our team is experienced in a wide range of corrective and reconstructive eyelid surgeries tailored to each individual case.

  • Entropion/ectropion – correction using a range of techniques
  • 'Diamond eye' malformation
  • Macropalpebral fissure
  • Brachycephalic ocular conformation
  • Facial droop
  • Eyelid reconstruction using the Mustardé 'lid swap' technique
    • we specialise in the management of large eyelid defects
Severe entropion in a Sharpei pre- and post-operatively

Severe entropion in a Sharpei pre- and post-operatively

2y Spinone – traumatic loss of almost the entire upper lid margin – before and after Mustardé's procedure

2y Spinone – traumatic loss of almost the entire upper lid margin – before and after Mustardé's procedure

 

TOP

Orbital disease

     

With the support of our team of Diagnostic Imaging, Soft Tissue and Surgery Specialists, we are proud to offer unsurpassed diagnostic and management options for all cases of orbital disease:

  • Surgical and medical management of orbital neoplasia
  • Surgical management of orbital trauma
  • Surgical management of congenital orbital malformations
  An orbital meningioma in a crossbred dog, successfully managed by orbitotomy

An orbital meningioma in a crossbred dog, successfully managed by orbitotomy

TOP

Orbital disease

With the support of our team of Diagnostic Imaging, Soft Tissue and Surgery Specialists, we are proud to offer unsurpassed diagnostic and management options for all cases of orbital disease:

  • Surgical and medical management of orbital neoplasia
  • Surgical management of orbital trauma
  • Surgical management of congenital orbital malformations
An orbital meningioma in a crossbred dog, successfully managed by orbitotomy

An orbital meningioma in a crossbred dog, successfully managed by orbitotomy

 

TOP

Diagnosis and treatment of sudden onset blindness

     

Sudden onset blindness can be due to either ocular or central aetiologies.

Supported by our team of Diagnostic Imaging, Neurology and Internal Medicine Specialists, we provide a rapid service to diagnose and manage affected patients in the most efficient and effective way possible.

  MRI of a meningioma affecting the optic chiasm

MRI of a meningioma affecting the
optic chiasm

MRI showing optic neuritis

MRI showing optic neuritis

TOP

Diagnosis and treatment of sudden onset blindness

Sudden onset blindness can be due to either ocular or central aetiologies.

Supported by our team of Diagnostic Imaging, Neurology and Internal Medicine Specialists, we provide a rapid service to diagnose and manage affected patients in the most efficient and effective way possible.

MRI of a meningioma affecting the optic chiasm

MRI of a meningioma affecting the
optic chiasm

MRI showing optic neuritis

MRI showing optic neuritis

 

  1. BRAUS, B. K., RHODES, M., FEATHERSTONE, H. J., RENWICK, P. W. & HEINRICH, C. L. 2012. Cataracts are not associated with retinal detachment in the Bichon Frise in the UK - a retrospective study of preoperative findings and outcomes in 40 eyes. Veterinary Ophthalmology (In press).
  2. FEATHERSTONE, H. J., RENWICK, P., HEINRICH, C. L. & MANNING, S. 2009. Efficacy of lamellar resection, cryotherapy, and adjunctive grafting for the treatment of canine limbal melanoma. Veterinary Ophthalmology, 12, 65-72.
  3. MANNING, S., RENWICK, P., HEINRICH, C.L., CRIPPS, P. 2006. The surgical management of lens dislocation in the dog: a retrospective study of 102 cases (155 eyes) (1994-2004). BSAVA Congress Clinical Research Abstracts.
  4. RHODES, M., HEINRICH, C., FEATHERSTONE, H., BRAUS, B., MANNING, S., CRIPPS, P. J. & RENWICK, P. 2012. Parotid duct transposition in dogs: a retrospective review of 92 eyes from 1999 to 2009. Veterinary Ophthalmology (In press).