2408 Apple APR MAY 2016 A4 Bleed 5

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Caroline Katz knows how precious time can be. When someone in the family needs to see a doctor, time can be of the essence. Not everything demands urgent attention though. Sometimes Mrs Katz can wait to see her NHS doctor - after all, they do a fantastic job. Sometimes you need to see a doctor sooner rather than later. That’s when Mrs Katz and her family turn to JDoc365. Mrs Katz is a fitness instructor and her husband is CEO of a telecoms business. The family have been members of JDoc365 since the practice was first established in 2006. Mr and Mrs Katz and their children are relatively healthy despite a busy lifestyle, pressure of work and school, family commitments and the demands of a close-knit and active community. They really appreciate the fact that Dr. Abelman and his team always find the time to see them, often at short notice. It’s not always a medical crisis needing emergency attention, it’s more that time is such a precious commodity, and scheduling everything into busy days can be quite a challenge. Mina Mikram, the JDoc365 Golders Green Clinic Manager, always recognises Mrs Katz when she visits the surgery, and his warm greeting is much appreciated. It’s the time, care and attention given by Dr. Abelman that Mrs Katz is particularly grateful for though. Mrs Katz explains, “It’s all in the detail. Dr. Abelman makes it his business to understand his patients – whether it’s me, my husband, one of my sons or my mother. He is so calm and knowledgeable. On one occasion I brought my eleven year old in three times in ten days. Whilst we were there, chest x-rays were organised and we just went straight downstairs for them. Because of that, my son was diagnosed accurately, quickly and conveniently. A precise dose of antibiotics were prescribed and I collected them from the pharmacy whilst I was there. My son made a speedy recovery, and the impact on my business through my own absence was minimised. Even when Dr. Abelman himself isn’t available, he has such a good team around him, it makes no difference who you see. Dr. Lewin saw us on one occasion and he was great. Dr. Abramov is also a fantastic doctor. She is so understanding and has such a caring bedside manner. My family and I owe them all a huge vote of thanks.” 12 JDOC365 APPLE MAGAZINE
SEEING RED By Mr. Daniel Ezra MA(Cantab) MBBS MMedEd MD(Cantab.) FRCS FRCOphth FHEA Mr. Ezra is consultant ophthalmic surgeon to Moorfields Eye Hospital, and practices privately. Without doubt, almost all of you will have experienced an episode of red eyes at some point. There are many conditions that cause this, and some can be quite alarming. Eye problems contribute up to 7% of GP visits, and the majority of these relate to red eyes No discussion of red eyes in primary care can be made without mention of blepharitis - an inflammatory disorder of the eyelid margins. It is extremely common, affecting up to 20% of people, and tends to present with non-specific symptoms of redness, grittiness and dryness. There are approximately 30 oil producing glands in each eyelid that supply oil for the tear film. This oily layer covers the watery layer of the tear film preventing evaporation and providing stability. Changes in the constitution of the oil secretions make them solid rather than liquid at body temperature, clogging the glands and allowing bacteria to colonise the eyelid margins. These bacteria in turn produce toxins that cause irritation (see figure 1). The best treatment is hot compresses and massage which act to heat the eyelid margin and liquefy the secretions. For more persistent or serious complaints, steroids and antibiotics may be required but this is unusual. Another option may be deep cleaning using specialised equipment which usually gives relief for 6-9 months. Another very common condition is infective conjunctivitis. This usually arises after an upper respiratory tract infection such as a cold or the flu. There are two types of infective conjunctivitis: bacterial and viral. Bacterial conjunctivitis is easy to recognise; it is characterised by significant mucous discharge which typically causes the eyelids to stick together in the morning, requiring considerable effort to reopen them (see figure 2). Bacterial conjunctivitis is treated with antibiotic eye drops. The viral form of conjunctivitis feels very different. It causes a more watery discharge with less stickiness, but paradoxically causes more irritation and grittiness. Viral conjunctivitis is not cured by antibiotic drops, but is treated with supportive measures such as lubricants until the infection resolves, usually after just a few days. Infective conjunctivitis, especially the viral type is highly contagious. It is important to prevent the spread of infection by ensuring that hands are always washed and not to share towels or bedsheets. The red eye condition with probably the most alarming appearance is also probably the most benign; subconjunctival haemorrhage. This is a condition where blood collects under the conjunctiva after a small capillary ruptures. This is usually entirely benign and tends to resolve after a few days (see figure 3). Figure 1 Figure 2 Figure 3 Whilst these conditions are not sight threatening, please remember that if you have a red eye with symptoms of significant pain, aversion to light or decrease in vision, this may indicate a more serious problem and you should see an Ophthalmologist (eye specialist) or a GP at the earliest opportunity. APRIL/MAY 2016 13
Page 1 and 2: THEApple TODAY’S NEWS FROM YOUR D
Page 3 and 4: Accidents will happen By Dr. Dalia
Page 5 and 6: MEET THE DOCTOR Dr. Stacey Hoffman
Page 7 and 8: AFFILIATE PARTNER FEATURE PROFBIOTI
Page 9 and 10: ASH gentle neck exercises. neck and
Page 11: AN AUDIENCE WITH THE CONSULTANTS OH
Page 15 and 16: They meet the quality, medical and

2408 Apple APR MAY 2016 A4 Bleed 5

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