Birmingham Midland Eye Centre

The eye emergency department provides an emergency service for adults and children with serious sight-threatening eye diseases and eye injuries.

The department uses triage – making sure we see patients with the most serious conditions first and to direct patients to the right treatment for the fastest possible service.

Opening hours
Monday – Saturday: 9am-7pm.
Sunday and Bank Holiday: 9am-6pm.

Out of hours patients should attend their local hospital’s accident and emergency department.

A cataract is a cloudy area in the lens of your eye which can obstruct the passage of light through to the back of the eye and impair vision. This is often a result of getting older. The cloudy lens (cataract) is broken up using soundwaves and replaced with a clear plastic artificial lens inside the eye.

Cataract surgery is the most commonly performed operation in the UK and is generally very successful. However, no operation is risk free and the following are potentially serious complications:

• Swelling, bleeding, or infections
• Vision loss or double vision
• Unusual changes in eye pressure
• Retinal detachment
• Posterior capsule opacity (clouding of the back part of the bag the lens sits in)

The cornea is the clear front window of the eye. It can be affected be a variety of conditions which can change its shape and/or transparency. This often causes blurring of vision and can significantly affect people’s life.

The corneal team is made of highly skilled professionals dedicated to provide the best service to improve our patients’ ability to see.

Please note many of our corneal transplant procedures are only possible due to the generosity of people who sign up and inform their relatives of their wish to donate their eyes. We would encourage everyone to consider making their wishes for donation clear on the UK Transplant Register and discussing this with your family.

Investigations

A wide range of high-tech imaging devices are available in our department to assess the shape and health of the cornea (i.e. Pentacam corneal topography, specular microscopy, anterior segment OCT, anterior segment USG, anterior segment digital photography and confocal microscope). These instruments provide an essential aid for the corneal team in deciding the best management for our patients.

Treatment

Most corneal conditions can be managed with drops and tablets in the outpatient department. For conditions which require urgent and intensive treatment such as complex corneal infections we offer inpatient care on our eye ward.

In addition, our well-established consultants have the expertise to perform a wide range of interventions. We provide modern corneal surgery including automated endothelial keratoplasty, deep anterior lamellar keratoplasty and amniotic membrane grafts.

In addition, we offer specialised services for a variety of corneal conditions including a Supra-regional service in ocular surface and inflammatory eye diseases.

The day surgery unit is based on the first floor of BMEC.

The unit caters for four operating theatres and surgery is scheduled for morning and afternoon lists.

The unit deals specifically with patients who require eye surgery and investigations into eye disorders.

Surgery includes:

• Cataract
• Glaucoma surgery
• Ocular-plastic surgery
• Correction of squint
• Vitreo-retinal surgery
• Minor lid surgery
• Laser procedures
• Avastin / Ozurdex / Triamcinalone injections

Glaucoma is a condition where raised eye pressure causes damage to the optic nerve at the back of the eye and can lead to permanent loss of vision. It is the second leading cause of blindness in the world.

Investigations

The service also has state of the art diagnostic service providing advanced glaucoma imaging, including OCT optic disc imaging and high definition ultrasound scan for angle closure.

Treatment

We offer a full range of treatments from medical treatment, selective laser trabeculoplasty to advanced glaucoma surgeries. The service is at the forefront of innovation in glaucoma surgeries including glaucoma tube implant surgery, minimally invasive angle surgery, complex angle closure cataract surgery, endoscopic laser and endoscopic cataract surgery.

The glaucoma service is supported by a multidisciplinary team including doctors, nurses, orthoptists and optometrists. Our highly trained diagnostic technicians provide accurate tests to allow for both face to face and virtual patient reviews.

The inflammatory eye diseases service focuses on severe sight-threatening immune-mediated inflammatory eye diseases.

The service offers a range of highly-specialised diagnostic and monitoring strategies such as:

• Imaging
• Electrodiagnostic tests
• Aqueous and vitreous humour sampling.
• Corneal, conjunctival and oral mucosal biopsies

The oculoplastics department treats adults and children with a large range of conditions affecting the eyelids and the surrounding area of the face, tear drainage system and the eye socket.

Investigations:

We offer a range of investigations including radiological assessment of the orbit and surrounding structures with ultrasonography, CT, MRI and scintillography (imaging of the tear drainage system); various haematologic, immunologic and biochemical investigations in relation to orbital diseases; histopathology to assist diagnosis of suspicious lesions and electrodiagnostic testing to assess the function of the optic nerve which can become compressed in certain orbital conditions.

Treatment

We treat patients in a variety of ways depending on the specific condition. These can range from drops or oral medication to surgical procedures.

The optometry department offers a range of services

A range of services are provided including:

• Complex refraction
• Paediatric refraction
• Spectacle dispensing
• Medical contact lenses
• Low vision aid
• Glaucoma, medical retina / macula shared care

Opening hours

Monday – Friday, 8.30am – 4.30pm

The paediatric ophthalmology department manages a large range of eye conditions affecting children. These include common conditions such as eye infections, allergic eye disease, squints and refractive error. In addition we also see children with a range of other conditions including eye problems associated with hearing impairment,  developmental problems and inherited eye diseases. We work closely with the orthoptic team who play a vital role is assessing vision in children.

The visual function department provides a full range of electrodiagnostic tests to patients referred from the Midlands and Wales. The department also provides a regional clinical genetics service in paedietric and adult inherited disorders.

As well as ocular electrophysiology the department specialises in ocular ultrasound including ultrabiomicroscopy (UBM) and high frequency posterior segment ultrasound.

The vitreo-retinal Department treats a wide variety of conditions that affect the structures at the back of the eye, including the retina (the light-sensitive film in the eye).

The team undertakes surgical treatment for conditions such as retinal detachment, macular holes, epiretinal membranes, bleeds in the gel of the eye, diabetic eye disease, complex cataracts and complications from cataract surgery.

Operations under local anaesthesia: What to Expect:

Most eye operations at BMEC are performed under local anaesthesia. The eye is gently numbed using an injection in the eye, preventing accidental eye movement, and allowing the surgeon to perform the operation with precision.

While the idea of receiving an injection into the eye may sound daunting, it’s important to note that the pain associated with the injection is comparable to what you might experience at the dentist. Any discomfort during the injection quickly goes within seconds. Some simpler surgical procedures may even utilise local anaesthetic eye drops to numb the surface of the eye.

Under local anaesthesia, you will typically remain awake throughout the operation, but the eye will be numb, ensuring you feel no pain. As the effects of the local anaesthetic gradually wear off, sensation will return over the next few hours. If a sedative is administered by the anaesthetist before the local anaesthetic injection, you may not remember the injection process.

One advantage of local anaesthesia is that you can eat and drink as usual on the day of surgery so you don’t need to fast. Recovery is quicker, with reduced chances of feeling sick or vomiting. Additionally, the pain relief effect of the local anaesthetic persists for a few hours after the operation, allowing you to return to your normal state faster than with general anaesthesia.

On the day of surgery, an anaesthetist will visit you in the ward or day unit. They will assess your condition, address any concerns, explain the anaesthetic technique, and answer your questions. In certain cases, sedation may be offered to enhance your comfort during the procedure, and anaesthetists will oversee its administration.

Operations under general anaesthesia: what to expect:

In certain eye procedures, you may need general anaesthesia, which is a carefully controlled state of unconsciousness. This approach is particularly suitable for various situations, such as complex surgeries, paediatric cases, or instances where patients may struggle to remain still or face communication challenges.

Some patients may also opt for general anaesthesia based on personal preferences. If your upcoming procedure involves general anaesthesia, the confirmation letter detailing your operation date will include specific instructions. Notably, you will be advised to refrain from eating or drinking for six hours prior to the surgery, though water is permissible up until the time of the procedure.

On the day of your operation, your dedicated anaesthetist will visit you to provide a detailed explanation of the anaesthesia process. While most individuals experience a temporary dry throat sensation post-surgery, lasting less than a day, a few may feel nauseous. In such cases, appropriate medications will be administered to alleviate discomfort.

Your anaesthetist will also discuss any relevant risks associated with the anaesthesia tailored to your situation. This is also an opportunity for you to ask any questions or express concerns you may have. It’s important to note that, with advancements in technology and the use of modern anaesthetic agents, serious risks associated with general or local anaesthesia are exceedingly rare for the majority of patients.

Following the procedure even under general anaesthesia, most patients recover swiftly, often allowing them to return home on the same day.

We understand that the prospect of undergoing surgery can be daunting, and we are committed to ensuring your safety and comfort throughout the entire process. If you have any further inquiries or require additional information, please feel free to reach out to our medical team.

The impatient eye ward at BMEC is located on the first floor of Sheldon Block at City Health Campus.

Contact details: 0121 507 6875 or 6876

BMEC offers the following types of laser treatment, mostly on an outpatient basis.

YAG Laser:
YAG lasers are used in ophthalmology to treat posterior capsular opacification, a condition that may occur after cataract surgery, and for peripheral iridotomy in patients with acute angle-closure glaucoma.

Argon laser:
We currently have two Argon laser machines in the outpatient department.

This laser is used to treat:

• Diabetic eye problems at the back of the eye
• Retinal breaks and small localized or chronic retinal detachments
• Retinal vascular problems
• Glaucoma

Occasionally, Argon laser treatment is carried out in the theatre under local or general anaesthesia as a day case procedure.

SLT Laser:
Selective laser trabeculaplasty – this is used to treat raised pressures due to glaucoma.