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A Conversation with Stephen Lash on Vitreoretinal Surgery-Consultant Vitreo Retinal Surgeon

Stephen Lash is a Consultant Vitreoretinal Surgeon at Optegra Eye Hospital and University Hospital Southampton. In today’s post, we will dive deep into Vitreoretinal Eye Surgery and tackle some common questions that patients frequently have whilst considering eye surgery. 

The most common reasons for seeking Vitreoretinal surgery include the most common ‘emergency condition’ which is sight-threatening- Retinal detachment, and the most common ‘non-emergency’ or elective conditions of the macula- including macular hole and Epiretinal membrane. Retinal detachment presents with loss of sight from the edge of sight and requires urgent treatment. Most GPs and Optometrists will be able to diagnose this condition. Macular hole and Epiretinal membrane are difficult for GPs to diagnose as specialist equipment is required and this equipment is often available to Optometrists. These two macula pathologies cause loss of central sight with distortion and blurring centrally and are usually slowly progressive

Choosing the Right Treatment 

With retinal detachment speed is the key and patients should seek urgent treatment within 48 hours if possible. Private options give the choice of a consultant surgeon however in most cases getting urgent treatment is more important. With the more slowly progressive conditions of Macular hole and Epiretinal membrane speed is less important although we know small macular holes progress rapidly compared to larger holes and so treatment speed is important but not urgent. This is less so again with the Epiretinal membrane but again over time more permanent damage can occur.

Balancing Pricing and Necessity 

Private surgery for VR is expensive as the kit required is more extensive than for cataract surgery and the staff mix requires a greater degree of training and experience. However, for retinal detachment speed is the primary concern and the NHS does extremely well in covering these emergencies 7 days per week. Mr. Lash is on call for such emergencies on a 1 in 3 basis at weekends. For the slower elective conditions private care gives access to more timely treatment (usually within a few weeks) and an experienced consultant grade surgeon and more convenient and consistent follow-up.

Lastly, for surgeons like Mr. Lash, he concludes that it is a privilege to restore sight to those that have lost it due to retinal detachment and it is fantastic to see the recovery of sight in eyes affected by the macular hole and epiretinal membrane which continues out to one year after surgery and can often mean driving vision is restored.


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