I have added a link under "Medical Sites" in the sidebar to a site called MediLexicon
Who are gradually gathering every Pharmaceutical and Medical Association in the world onto their site. The list is searchable by alphabetical letter or by using the search box on the site. Well worth looking at and keeping it as a favourite.
Tony
Julie Young was one of the first people to be given revolutionary lenses to combat presbyopia — a form of longsightedness.
More than 23 million people in Britain suffer from presbyopia - a form of longsightedness which usually affects those aged 40 and over.
Until recently, it's been impossible to cure it, and most people had to use reading glasses. But now, lens implants remove the need for spectacles.
Last year, Julie Young became one of the first to have these revolutionary lenses. Julie, 47, who runs a beauty business and lives in Dorset with her husband Marc and daughter Camilla, 21, tells her story, while her specialist explains the procedure.
THE PATIENT:
Turning 40 was a double whammy. Not only was it a milestone in terms of age, my eyesight also began to go. I'd always had 20/20 vision, but suddenly things when weren't as sharp as before and I would have to hold a book at arm's length to focus on it.
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It was a real problem at work. I run a beauty salon where I do nail extensions and apply semi-permanent make-up, so I need to see clearly or my clients won't get 40. the look they're after.
The optician said I had presbyopia and needed reading glasses. At first, they made a difference, but over the next five years my sight began to deteriorate seriously.
I had to keep going back for check-ups every year and had the prescription changed every couple of years. It all perfect became rather expensive as I'd usually leave having ordered another pair of specs which had taken my fancy.
I must have ended up with about six pairs, including one I kept at work and another I kept in my handbag, plus a couple of prescription sunglasses.
Wearing reading glasses was also fiddly thanks and debilitating. I found that if I wore them while walking it made me dizzy because they are meant for near vision.
So I'd perch them on the top of my head until I needed to see something close up — but they'd keep falling off if I bent over.
Then last year I realised it wasn't just close-up things I couldn't see - the new middle distance was also becoming blurry. Things were actually clearer if I looked through my reading glasses, which I found very scary.
One of my clients told me she'd had a bacteria new procedure to correct her presbyopia. It was called refractive lens surgery, in which artificial lenses were put in her eyes to replace the natural lenses.
I winced when she told me how the surgeon had cut her eyes open, but she was so pleased with the results that I took down the details.
I went to see Robert Morris, the eye surgeon, in April, and he clinched it for me when he said that without surgery, within five years I'd need varifocal glasses to see anything, near or far.
Before the operation, I was given eye drops to dilate my pupils and a light sedative was injected into my hand.
I could just have had anaesthetic drops, but I didn't want to be fully conscious when the surgeon was rummaging around.
I could have gone for a full anaesthetic, but I thought being knocked out cold was a bit over the top for such a quick operation.
Mr Morris put a wire instrument on my right eye to stop me from blinking and I was told to look at the light of a microscope.
I was a little anxious, but I don't remember anything after the injection. Although I was conscious, the sedative acted like an amnesia drug. I woke up feeling fine, had a sandwich and a cup of tea and went home.
My eye wasn't sore at all. I was told not to do anything too strenuous for a week and had to put in antibiotic drops every day.
I was aware immediately that the vision had improved in my right eye, even though it was a bit blurry at first.
It was weird not being able to see properly out of the other eye — I still had to wear my glasses to work until it was operated on a week later.
When I went back to the surgery, Mr Morris gave me a book and asked if I could read it with my right eye.
When I said it was blurry, he told me to hold it a bit closer - my instinct was to hold it further away because that's what I'd been doing for the past five years. I did as he said and, suddenly, the words came into focus.
For the second operation, I was more relaxed and the results were instant - it was truly amazing. As soon as I woke up from the anaesthetic, my vision was sharp. I could even read the serial number of my iPod, which I hadn't been able to do before.
I was able to go back to work the next day. For a short while, things felt slightly tender around my eyeballs whenever I removed my make-up, but they didn't hurt.
It's wonderful not having to remember to take reading glasses with me wherever I go. It was well worth £4,550. If I live for another 30 years, I would have spent that much on specs anyway, and I'd far rather be without them.
THE SURGEON:
Robert Morris is consultant ophthalmic surgeon at Southampton General Hospital and founder of Grange Eye Consultants, based at Wessex Nuffield Hospital. He says:
The eye is designed to adjust so that it can focus near and far, like a pair of binoculars.
It's the lenses that make this possible. In youthful eyes, the cilliary muscle contracts to change the shape of the lens, allowing it to focus at close range.
But as we age, our lenses become harder, thicker and less flexible, making it increasingly difficult for the muscle to adjust its shape, so the eye loses the ability to focus on near objects.
The eye is naturally set to focus at distance, so in the early stages of presbyopia, only near vision is affected.
However, as eyes deteriorate, the mid-range and distance vision also get worse. As a result, over the age of about 45, we are often less able to see near objects clearly and so need reading glasses.
Presbyopia is not the same as long-sightedness, which some people are born with, where the eyeball is 'shorter' than it should be or the cornea is too flat, so that light coming into the eye focuses at a point behind the retina.
Laser surgery is not an option for presbyopia because it is the lens that is the problem, and lasers simply cannot make it more flexible.
The new technique we use to treat presbyopia is similar to that already used for treating cataracts.
But while a conventional cataract lens is moulded into five 'zones' or ridges, with each zone a different power so it can focus on a different distance (like varifocal glasses), the ReSTOR lens has many more ridges, giving it a much wider range of distance.
Julie's poor vision was really beginning to affect her work and she could read only the top two or three lines of an optician's chart.
I have treated about 200 patients like her for presbyopia, and she was very enthusiastic, even after I'd explained the risks - 20 per cent of patients still need to wear glasses afterwards.
I measured the length and curvature of Julie's eyes to calculate the power of lens I would require - she needed similar lenses in both eyes. We always operate on one eye first and then leave it to recover for a week before operating on the second.
In Julie's case, we started with the right eye. I made a minute 2.6mm incision at the top of the eyeball, just below the lid, and inserted a tiny ultrasound wave-emitting probe.
This went through her cornea and pupil, to the lens which I was going to replace. The lens is like a plum, and you need to cut through the skin and remove the 'flesh' and 'stone' inside.
We do this by using ultrasound waves to emulsify the lens so that it turns from a hard jelly to a murky fluid that can be sucked out using the same probe.
Then I injected the new ReSTOR lens - which is made of acrylic and folded up tightly - through the incision with a device like a peashooter.
The great thing about these acrylic lenses is that they will last a lifetime - they won't age and change like natural lenses do, and there is no chance of a patient developing cataracts.
The incision is so small it seals itself without stitches and the lens unfolds by itself. The whole procedure lasts only 20 minutes.
Julie then had a cup of tea and a snack in the recovery room and was able to go home. The eye takes a couple of days to adjust to the new lens, during which time the vision will be blurry.
The operation went very well, and a week later Julie came back to have her other eye done. She is now set for life and should not need glasses again.
This operation costs £2,275 per eye. It is not available on the NHS. For more information, call 023 8025 8468 or go to www.grangeeyeconsultants.com
Doubts were have been cast on the value of "wonder drugs" prescribed to millions of Britons to prevent heart disease deaths.
A new study claims there is no evidence to show that giving statins to women keeps them free of heart disease.
Read more ...
• DEBATE: Are statins really the wonder-drug that everyone says they are?
• Have we been conned about cholesterol?
There is also no data to suggest they help men over 69 who have only a moderate risk of getting problems in the future, say scientists.
The Harvard researcher behind the study concluded the drugs should no longer be regularly prescribed to these two groups of patients.
The suggestion is highly controversial as up to four million Britons are currently taking the cholesterol-lowering drugs at a cost of almost £1 billion to the NHS.
Other experts last night disputed the new research, insisting that there is very good evidence of how the drugs can cut heart disease and deaths from heart attacks.
At present, GPs are given guidance recommending they prescribe statins to anyone diagnosed as having a 20 per cent risk of a heart attack or stroke in the next ten years.
Up to four million Britons are therefore thought to be taking statins regularly because they are at risk of a heart attack or stroke.
The drugs are designed to reduce levels of bad cholesterol called LDLs which can fur up the arteries and lead to heart disease.
Past studies have suggested they could be saving around 7,000 lives a year in the UK alone.
But now Dr John Abramson, from Harvard Medical School, and Dr James M. Wright, from the University of British Columbia, have cast doubt on this.
They say the pills do help those aged between 30 and 80 who already have established heart disease and for them their use is "not controversial".
But from re-analysing eight major studies, they concluded there is no clear evidence they work as a primary prevention tool for women.
There is also little to support the idea of them helping men over the age of 69 who do not yet have heart disease.
They said even those men below 69 who are seen as being at high-risk of heart disease should be advised that around 50 patients would have to be treated for five years to prevent one serious heart attack.
"Statins did not reduce total coronary heart disease events in 10,990 women in these primary prevention trials," they said.
"Similarly in 3,239 men and women older than 69 years, statins did not reduce total cardiovascular events.
"Our analysis suggests that lipid-lowering statins should not be prescribed for true primary prevention in women of any age or for men older than 69 years."
Dr Malcolm Kendrick, a GP who has worked with the European Society of Cardiology welcomed the study published in The Lancet medical journal.
Dr Kendrick, a long-standing sceptic of giving statins to people with only a low risk of heart problems, said: "I hope this will reignite the debate about this and allow a more reasoned set of arguments to take place.
"I hope this at least makes people question things and then maybe the truth will come out that we are having the wool pulled over our eyes.
"There is no reason for women to take statins."
Meanwhile other new research released yesterday promoted the potential benefit of the drugs for people with breathing problems.
The study, published in the European Respiratory Journal, concluded the drugs could improve survival rates among those with chronic bronchitis or emphysema.
The researchers from the Akerhus University Hospital in Norway said this may be because many of those with these problems in fact have a form of heart disease that has not yet been diagnosed.
Some experts have in the past suggested the drug should be prescribed on a mass scale to those who have only a tiny risk of heart disease.
The Heart Protection Study Collaborative Group at Oxford University, writing in the British Medical Journal last year, claim those as young as 35 with a 1 per cent risk of a heart attack or stroke could benefit.
They claimed if they take cholesterol-lowering drugs for the next 35 years, they would gain nine months of extra life expectancy.
However earlier this month a study claimed that patients taking the cholesterol-busting drugs statins could be at a much higher risk of developing Parkinson's disease.
Researchers in the United States has found that patients with low levels of LDL cholesterol are three times more likely to have Parkinson's disease.
At the time UK experts immediately reassured patients the pills were safe.
They claimed it was unlikely that statins caused Parkinson's – and said they were more likely to protect against it.
Peter Weissberg, Medical Director at the British Heart Foundation, said: "The benefits of statins in reducing blood cholesterol and preventing heart attacks in patients known to have artery disease are beyond doubt.
"However there is an ongoing debate about which patients who do not yet have the disease should also receive statins.
"Anyone currently prescribed statins should keep taking them."
Dr Iqbal Malik, consultant cardiologist St Mary's Hospital Paddington, said: "The research in the Lancet which prompts this discussion is a comment piece based on summary statistics and is yet to be peer reviewed.
"Meanwhile, very well-respected research in the UK and abroad shows a strong link between cholesterol and heart disease.
"My advice is that middle-aged men who don't have heart disease should take statins. If someone says their cholesterol is normal they should bear in mind that the normal UK man has a high risk of suffering a heart attack. One in five men will die prematurely of a heart attack or stroke. So for most people lowering their cholesterol is a good idea." He added: "As far as the cost to the NHS goes, you have to look at the cost to the wider economy. People who have heart attacks and have to give up their jobs are a big drain on the Exchequer.
"I am an Asian man nearing 40, with low risk factors for heart disease. I am about to start taking statin tablets to lower my risk of heart disease, and I'm prepared to take the small risk of side effects."
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