Reflections on sight loss - RNIB

A patient’s eye view: AMD treatments
colleagues in the medical and nursing team –
led by Dr Bal Dhillon, who is also an Honorary
Professor at Heriot Watt University – been
able to achieve so much for patients with
macular degeneration.
“He never loses an opportunity
to point out just how serious the
consequences can be of failing
to provide the treatment for a
person who stands to lose his
or her sight”
John Legg, the Director of RNIB Scotland,
regards all of this as a striking achievement.
Just like the consultant ophthalmologists with
whom he stays closely in touch, he looks
forward to the continued funding of Lucentis
injections and to the prospect of a growing
number of people throughout Scotland
gaining access to this vital treatment. He
never loses an opportunity to point out just
how serious the consequences can be of
failing to provide the treatment for a person
who stands to lose his or her sight. These
negative consequences can include loss of
confidence, social isolation, falls and eventual
residential or nursing care.
Along with a growing number of other
patients I now go to the Eye Pavilion every
four weeks, sometimes dropping into the very
helpful RNIB Visual Support Centre on the
third floor. My left eye is examined and –
usually – I receive an injection. It sounds
rather alarming since the injections are given
by needle directly into the eye. But everything
possible is done to minimise the risk of
infection and it is all carried out with
consummate skill by the surgeons,
complemented by exemplary nursing care.
What with all the antibiotics, anaesthetics and
bright lights I hardly feel a thing and am fit to
go home a couple of hours later.
For the vast majority of people the injections
halt the downhill slide towards blindness, and
in about 30 to 40 per cent of cases some of
the lost sight is regained. Dr Armbrecht
estimates that about 400 people in Edinburgh
and the Lothians stand to benefit every year.
For me the treatment has worked, brilliantly.
I have not regained all my lost sight and will
be going to the Eye Pavilion for some time to
come as the surgeons try to stabilise the
macula. But the overall improvement is
remarkable, which is why I was able to read a
poem at a Burns supper this January – and
why I am able to write this article.
This article is based on an article which
appeared in the Scotsman, 4 March 2008.
NICE – the final hurdle
There are 26,000 new cases of ‘wet’
(leaking or bleeding) AMD in the UK each
year. The condition can lead to blindness in
as little as three months if left untreated.
NICE (the National Institute for Health and
Clinical Excellence) issued its final guidance
on sight-saving drugs on 27 August 2008,
recommending that the NHS in England
and Wales should cover the cost of the first
14 injections of ranibizumab (Lucentis),
while the manufacturer, Novartis, has
undertaken to cover the cost of further
injections. Another drug, pegaptanib
(Macugen), was not approved for use on
the NHS. Since then, a growing number of
Lucentis clinics have been set up, including
a number of nurse-led clinics.
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