Contact Essex Eye Surgery to book a private consultation with Mr Alex Baneke. Clinics in Southend and Brentwood, Essex. Call 07398 997 592 or email info@essexeyesurgery.co.uk. Contact Us Contact us to arrange a private consultation: 07398 997 592 / 01702 667 819 info@essexeyesurgery.co.uk BOOK ONLINE: SOUTHEND Paige Meader, Private secretary BOOK ONLINE: BRENTWOOD NHS referrals via your GP or optician Consulting rooms: Southend Private Hospital 15-17 Fairfax Drive Westcliff-on-Sea, Essex SS0 9AG 01702 667 819 Spire Hartswood Hospital Eagle Way, Brentwood CM13 3LE 01277 232525 Orsett Hospital Rowley Road, Orsett, Grays RM16 3EU 01268 524 900 Southend University Hospital Southend-on-Sea, SS0 0RY 01702 435 555

Mr Baneke's research and publications RESEARCH & PUBLICATIONS Scroll Down 01. Eye. 2024. Hussain A, Baneke A. Comment on: "Effect of trabeculectomy on the rate of progression of visual field damage." Read All 03. Eye. 2022. Jayaram H, Baneke AJ, et al. Managing risk in the face of adversity: design and outcomes of rapid glaucoma assessment clinics during a pandemic recovery. Read All 05. Am J Ophthalmol. 2019. Alaghband P, Baneke AJ, Galvis E, Madekurozwa M, Chu B, Stanford M, Overby D, Lim KS. Aqueous Humor Dynamics in Uveitic Eyes. Read All 07. Cur Eye Res. 2016. Baneke AJ, Lim KS, Stanford M. T he pathogenesis of raised intraocular pressure in uveitis. Read All 09. Travel Med Infect Dis. 2012 Mar;10(2):92-6. Winner of the Travel Medicine and Infectious Disease “First Look – Student Research” Best accepted paper for 2012. Baneke A. Review: Targeting trachoma: Strategies to reduce the leading infectious cause of blindness. Read All 11. Journal of Paediatrics and Child Health. March 2014. Baneke A. The junior doctor, an untapped paediatric teaching resource? Read All 02. Eye. 2023. Nair A, Baneke A. Comment on: "Could the AREDS formula benefit patients with glaucoma?" Read All 04. Eye (Lond). 2019. Baneke AJ, Aubry J, Viswanathan AC, Plant GT. The role of intracranial pressure in glaucoma and therapeutic implications. Read All 06. Graefes Arch Clin Exp Ophthalmol. 2018. Baneke AJ, Williams KM, Mahroo OA, Mohamed M, Hammond CJ. A twin study of cilioretinal arteries, tilted discs, and situs inversus. Read All 08. Retin Cases Brief Rep. 2020. Baneke AJ, Vakros G, Sharma V, Wong SC. Bleb-related endophthalmitis after use of the invitrea injection guide. Read All 10. Br J Hosp Med (Lond). 2019. Radotra A, Baneke A, Paul B. Mydriasis secondary to use of glycopyrrolate cream. Read All

Private glaucoma treatment in Essex from specialist consultant Mr Alex Baneke. SLT laser, trabeculectomy, tube surgery, MIGS, and Preserflo. Clinics in Southend and Brentwood, serving Chelmsford, Hornchurch, and East London. Glaucoma Treatment What is glaucoma? Contact us If you've been diagnosed with glaucoma it's important to know that the most effective treatments focus on reducing eye pressure, which is key to slowing the progression of the condition. There are several ways to lower eye pressure including medications, laser treatments and surgical options. With the right treatment plan we can help protect your vision and manage your glaucoma effectively. Scroll to learn more Eye drops and tablets for Glaucoma Eye drops Tablets Surgical Treatments for Glaucoma Trabeculectomy Tube Surgery Preserflo MIGS Laser Treatments for Glaucoma SLT Cyclodiode Yag PI

Private glaucoma treatment in Essex from specialist consultant Mr Alex Baneke. Medical treatment. Clinics in Southend and Brentwood, serving Chelmsford, Hornchurch, and East London. Eye drops and tablets for Glaucoma Eye drops Tablets More Surgical Treatments for Glaucoma Trabeculectomy Tube Surgery Preserflo MIGS Laser Treatments for Glaucoma SLT Cyclodiode Yag PI Understanding Your Glaucoma Medications: Eye drops On this page... Latanoprost (Xalatan™), Travoprost (Travatan™), Bimatoprost (Lumigan™) Timolol (Timoptol™, Tiopex™), Betaxolol (Betoptic™) Pilocarpine Dorzolamide (Trusopt™), Brinzolamide (Azopt™) Brimonidine (Alphagan™), Apraclonidine (Iopidine™) Latanoprostene bunod (Vyzultar™), Netarsudil (Rhokiinsa™), Latanoprost and Netarsudil (Roclanda™) When it comes to managing glaucoma, reducing eye pressure is key to slowing the progression of the condition. There are several treatment options available, including eye drops, tablets, and even some newer treatments. Here's a guide to help you understand the different medications used in glaucoma treatment and what to expect from each. An expert guide: How to Apply Eye Drops Step 1: Shake the bottle well. Step 2: Tilt your head back, pull down your lower eyelid with one hand, and hold the bottle with your other hand resting on your forehead or nose. Step 3: Place a drop into your eye. Step 4: If you're not sure the drop went in, it's okay to try again. Step 5: After applying the drop, close your eyes and press gently between your lower eyelid and nose for 1-2 minutes. This helps prevent the medication from draining into your nose and throat, which can reduce side effects. Step 6: Wait 5 minutes between applying different drops. Some people struggle to administer their own eye drops. Dispensers like the one below can sometimes help. Opticare Eye-Drop Dispenser Eye Drops: Your First Line of Defence Most patients with glaucoma will be treated with eye drops. With many different types available, it can be a bit confusing to know which one is right for you. Each type of drop works to lower eye pressure, but the effectiveness and side effects can vary from person to person. Some drops are also available in preservative-free formulations, which may be helpful if you have dry eyes or wear contact lenses. Prostaglandin Analogues Prostaglandin analogues such as Latanoprost (Xalatan™), Travoprost (Travatan™), and Bimatoprost (Lumigan™), are highly effective at reducing eye pressure, often by around 30%. These drops are frequently the first line of treatment. They work by increasing fluid outflow from the eye. Common side effects include mild stinging, eye redness, and increased eyelash growth. In some cases, they can cause changes in eye colour and fat loss around the eyes. Bimatoprost may be slightly more effective at reducing your eye pressure but comes with a higher chance of side effects. Beta-blockers Beta-blockers like Timolol (Timoptol™/Tiopex™) and Betaxolol (Betoptic™) reduce fluid production in the eye and can also increase fluid outflow. They are slightly less effective than prostaglandin analogues but have fewer aesthetic side effects. Cholinergic agonists Cholinergic agonists, like Pilocarpine, help by constricting the pupil and increasing fluid outflow. They’re usually used in emergencies and can cause headaches and reduced night vision. Carbonic anhydrase inhibitors Carbonic anhydrase inhibitors include drops like Dorzolamide (Trusopt™) and Brinzolamide (Azopt™). These medications reduce fluid production in the eye and can lower pressure by around 20%. Side effects may include stinging, redness, and a metallic taste. In rare cases, they can affect your blood cells. Alpha-agonists Alpha-agonists, such as Brimonidine (Alphagan™) and Apraclonidine (Iopidine™), lower fluid production and increase fluid outflow. They can cause redness, itching, and dry mouth. Some patients may develop conjunctivitis (a bright red, itchy, watery eye), which means the drops need to be stopped. It's also important to avoid using these if you're on certain antidepressants like amitriptyline. New options Newer options include nitric oxide donating prostaglandins such as Latanoprostene bunod (Vyzultar™), which are similar to prostaglandin analogues but also increase fluid outflow through the eye's internal drainage system. Rho-kinase/ norepinephrine transport inhibitors, like Netarsudil (Rhokiinsa™) or the combination of Latanoprost and Netarsudil (Roclanda™), are new drugs that work by several mechanisms to reduce eye pressure. Roclanda became available in the UK in 2024. These newer drugs may cause side effects like eye redness and increased watering. Prostaglandin analogues Beta blockers Pilocarpine Carbonic anhydrase alpha agonists New meds Anchor 1 Understanding your Glaucoma Medications: Tablets If you’re considering any tablet-based treatments, it’s crucial to have a detailed discussion with your eye specialist to ensure it’s the best option for your specific situation and health conditions. Acetazolamide Tablets (Diamox™) Acetazolamide (Diamox™) is a carbonic anhydrase inhibitor, similar to certain eye drops used in glaucoma treatment. It's very effective at reducing eye pressure, but because of its potential side effects, it’s typically used only for short periods, such as when your eye pressure is particularly high or while you're waiting for surgery. Acetazolamide is available in both regular and slow-release (SR) formulations, and there's little difference in their effectiveness, so either can be used depending on your needs. Side Effects of Acetazolamide While Acetazolamide is effective, it can cause some side effects. Commonly, you might experience dizziness, tiredness, tingling in the fingers, and increased urination. In rare cases, it may lead to changes in your blood cells or worsen kidney stones. It’s particularly important to avoid or use a lower dose of Acetazolamide if you have sickle cell anaemia, kidney stones, or severe kidney or liver disease. The medication can also reduce potassium levels, so you might be advised to consume high-potassium foods or drinks, such as a banana, a serving of spinach, or a glass of tomato juice, with each tablet. In some cases, your doctor may prescribe Sando-K potassium supplement tablets to take alongside Acetazolamide. Nicotinamide There is ongoing research investigating whether oral nicotinamide tablets - at a dose of 1.5g daily for 6 weeks followed by 1.5g twice daily - may slow glaucoma progression. Nicotinamide does not reduce eye pressure but may slow glaucoma progression via a different mechanism: improving mitochondrial function. Rarely, nicotinamide may cause serious liver damage, so patients must check their liver function blood tests regularly while treatment continues. As trials on nicotinamide are ongoing, it is not currently recommended as a treatment by most glaucoma specialists. Side Effects of Nicotinamide Nicotinamide may not be suitable for everyone. It is contraindicated if you have impaired liver function, are pregnant, have a history of cancer, or are taking certain medications such as doxycycline, isoniazid, pyrazinamide, or carbamazepine. Nicotinamide can rarely cause life-threatening liver damage. It’s important to consult your doctor before considering nicotinamide as part of your treatment plan.

Suffering from dry, sore or gritty eyes? Learn about dry eye and blepharitis causes and treatments. From Mr Alex Baneke, consultant ophthalmologist in Essex. A Guide for Patients Dry eyes and blepharitis Dry eyes and blepharitis are both common conditions, which often occur together. Dry eye, also known as keratoconjunctivitis sicca, occurs when your eyes don't produce enough tears, or the tears they do produce aren't of the right quality. Blepharitis occurs due to inflammation of the eyelids, which is often associated with the growth of bacteria. Eyelids become red, and may have a crusty or sticky discharge, more noticeable in the mornings. Although uncomfortable, these conditions are not usually serious and there are things you can do to help. Management of dry eyes It is not uncommon for glaucoma patients to suffer with dry eyes. Symptoms include the feeling of dry, gritty eyes, increased redness, and increased watering. Some patients feel like there is something in their eyes and may experience episodes of blurring. Symptoms usually improve if the eyes are closed and if a preservative-free dry eye drop is applied. Unfortunately, dry eyes can be worsened by the use of eye drops to treat glaucoma. Some sensible advice to reduce the symptoms of dry eyes is set out below: Ensure you are well hydrated by increasing your intake of water and reducing your intake of drinks containing caffeine Reduce your heating, air conditioning and car fan settings Use wrap-around glasses if outside on a windy day, or when driving Stop or reduce contact lens wear Consider flaxseed oil or omega 3 supplement tablets Use a preservative free dry eye drop containing sodium hyaluronate or carmellose, 4-6 times per day (available over the counter) Use a preservative free gel for dry eyes containing carbomer or white soft paraffin, last thing at night before sleeping (available over the counter) Ask your ophthalmologist about switching to a preservative free glaucoma drop Ask your ophthalmologist to consider changing drops that are more likely to cause dry, uncomfortable eyes, such as Lumigan (bimatoprost) and Alphagan (brimonidine), to an alternative If using glaucoma drops, close your eyes after applying the drops and ensure you wipe any excess off your eyelids using a clean damp tissue. This will reduce eyelid irritation In severe cases, asking your ophthalmologist for a short course of steroid and antibiotic eye drops may help. Management of blepharitis Blepharitis is a condition causing inflammation of the eyelid margins. Though not infectious, it is associated with the growth of bacteria, and symptoms may be worsened by the use of glaucoma eye drops. Blepharitis can worsen symptoms of dry eyes. Patients with blepharitis may notice red, crusty or sticky eyelids on waking. Blepharitis is usually a long-standing condition and requires long term changes to manage. Sensible advice includes: Use a heated eye bag/eye mask (available online and from some opticians and pharmacies) 1-2 times a day before cleaning your eyelids Clean your eyelids every morning and evening with your eyes closed, using a clean flannel and warm tap water (this does not need to be boiled). Massage the lids towards the lid margins (the top eyelid down and the bottom eyelid up) Some people advocate using a gentle cleaner such as baby shampoo, or a pre-made wipe containing a cleaning agent, but the evidence is limited and it is probably better to use warm water alone If using glaucoma drops, close your eyes after applying the drops and ensure you wipe any excess off your eyelids using a clean damp tissue. This will reduce eyelid irritation Ask your ophthalmologist whether switching to a preservative free glaucoma drop would help Ask your ophthalmologist to consider changing drops that are more likely to cause dry, uncomfortable eyes, such as Lumigan (bimatoprost) and Alphagan (brimonidine), to an alternative Ask your ophthalmologist whether you would benefit from a course of oral antibiotics such as doxycycline or azithromycin In severe cases, asking your ophthalmologist for a short course of steroid and antibiotic eye drops may help. For a video explaining lid cleaning techniques in more detail please see below:

A Guide for Patients Eye care services in Essex There is an excellent range of eye-care services accessible to people residing in and around Essex, ranging from NHS or private hospital care, to high street opticians. This page summarises some of the services available. Eye Clinic Liaison Officers (ECLOs) ECLOs have lots of knowledge on eye conditions and on helpful local and national services. They provide emotional and practical support to anyone affected by sight loss, free of charge. They can advise on living with sight loss, management and treatment of eye conditions, visual aids, equipment and technology, availability of benefits and concessions, education and employment, certification and registration and other support and services that might be appropriate. By offering dedicated individual care, ECLOs can talk to you about your worries and give you advice on how to lessen the impact your eye condition may have on your life. ECLOs act as an important bridge between health and social services and are central to the support and wellbeing of patients in eye clinics. They also help prevent avoidable sight loss, by talking through treatment and helping people to understand their medication if necessary. The Southend ECLO is Tracey Meddle, who is employed by Southend-in-Sight, a local sight loss charity. Email: tracey@southendinsight.co.uk Tel: 01702 342131 The Orsett/Basildon ECLO is Sarah Jane Piper, who is employed by the charity BASIS. Email: sarah-jane.piper@nhs.net Tel: 01268 522817 The Chelmsford ECLO is Holly Muncey, who is employed by the RNIB. Email: mse.eclomidsouthessex@nhs.net Tel: 07901 513416 Local charities BASIS is a sight loss charity providing help for patients with visual impairment in South Essex. Tel: 01268 522817 Email: admin@basissouthessex.org.uk Southend in Sight is a sight loss charity for Southend, providing help for patients with visual impairment. Tel: 01702 342131 Email: info@southendinsight.org.uk High street opticians offering glaucoma services Humfrey Eye Care offers HVF, OCT services and emergency appointments. Humfrey Eye Care is run by Stuart Humfrey. He is an experienced optometrist with a higher qualification in glaucoma. 223 London Road Hadleigh Essex SS7 2RD Tel: 01702 599068 Goldsmith Webb offers Goldmann Applanation Tonometry (GAT) which is a procedure that measures intraocular pressure (IOP), Humphrey Visual Field (HVF) analysis and Optical Coherence Tomography (OCT) which is a non-invasive imaging technique used to create cross-sectional images of the eye. Several Goldsmith Webb stores have optometrists with higher qualifications in glaucoma and offer emergency appointments. Goldsmith Webb has stores in multiple locations, including: Bodys The Opticians 25 Queens Road, Southend-on-Sea Essex, SS1 1LT Tel: 01702 354553 Goldsmith Webb 8 Grover Walk Corringham SS17 7LY Tel: 01375 677577 Goldsmith Webb 37-43 Broadway West, Leigh-on-Sea Essex, SS9 2BX Tel: 01702 710031 David Wood Opticians offer visual field tests (not HVF), OCT and eye pressure checks. West House 9 High Street Burnham-on-Crouch, Essex CM0 8AG Tel: 01621 782048 email: info@dwopticians.com Euin Steele offers GAT, HVF and OCT services. Euin Steele has optometrists with higher qualifications in glaucoma and offers emergency appointments. 58 Orsett Road Grays Essex RM17 5EH Tel: 01375 37300 James Bryan Opticians offers GAT, HVF and OCT services. James Bryan Opticians has optometrists with higher qualifications in glaucoma and offers emergency appointments. 33 The Meadows Shopping Centre Chelmsford Essex CM2 6FD Tel: 01245 357766 Forbes Opticians offers GAT, HVF and OCT services. Forbes Opticians has optometrists with higher qualifications in glaucoma and offers emergency appointments. 198 London Rd Hadleigh, Benfleet Essex SS7 2PD Tel: 01702 555345 Karen Castle offers GAT, HVF and OCT services. 78 Hart Road, Thundersley, Essex, SS7 3PF Tel: 01268 793538 Emergency eye care If you have an emergency condition you can contact your GP, a local optometrist offering emergency appointments on the high street (self refer via www.primaryeyecare.co.uk , or contact one of the optometry practices on this page) or attend your local hospital Accident and Emergency Department. If you want private care, you are welcome to contact Mr Baneke’s private secretary to check whether he has any last-minute availability. The Mid and South Essex hospitals with an eye casualty department (referral is via GP, main A&E or a local optometrist) are: Southend University Hospital, Prittlewell Chase, Southend-on-Sea, SSO 0RY Broomfield Hospital, Court Road, Broomfield, Chelmsford, CM1 7ET Queens Hospital, Rom Valley Way, Romford, RM7 0AG (Part of Barking, Havering & Redbridge NHS Trust rather than MSE NHS Trust) For London patients: Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD (virtual assessment and phone triage service available via https://www.moorfields.nhs.uk/ae ) Essex Local Optical Committee Essex LOC is funded by Ophthalmic Contractors in the Essex area and acts on behalf of the Contractors, Performers, and others registered with the GOC in dealing with the NHS.

Private glaucoma treatment in Essex from specialist consultant Mr Alex Baneke. Trabeculectomy, tube surgery, MIGS, and Preserflo. Clinics in Southend and Brentwood, serving Chelmsford, Hornchurch, and East London. Surgical Treatments for Glaucoma Trabeculectomy Tube Surgery Preserflo MIGS More Eye drops and tablets for Glaucoma Eye drops Tablets Laser Treatments for Glaucoma SLT Cyclodiode Yag PI Surgical Treatment for Glaucoma: What You Need to Know If you’ve been diagnosed with glaucoma, and other treatments haven't sufficiently controlled your eye pressure, your doctor may recommend surgery. One of the most common surgical procedures for glaucoma is a trabeculectomy. This surgery aims to lower the pressure inside your eye to prevent further damage to your optic nerve and preserve your vision. It’s important to know that while trabeculectomy can help stop or slow down vision loss, it won’t improve your vision from its current level, and your vision might temporarily worsen before it stabilises. Trabeculectomy surgery is a highly effective option for reducing eye pressure and slowing the progression of glaucoma for most patients. While it won’t improve your current vision, it can help prevent further vision loss and reduce your need for eye drops. As with any surgery, there are risks involved, but with careful monitoring and follow-up, most patients achieve good outcomes. Trabeculectomy Surgery Trabeculectomy surgery works by creating a new pathway for fluid to drain out of the front part of your eye (the anterior chamber). During the procedure, your surgeon creates a small “trap door” in the wall of your eye (the sclera). This allows fluid to flow into a tiny reservoir called a “bleb,” which is located under the conjunctiva—the thin, clear tissue that covers the white of your eye. After the operation, you might notice a small blister-like bump on the top of your eye when you look in the mirror. The trap door is carefully closed with stitches that can be adjusted after surgery to control the flow of fluid and the pressure inside your eye. The conjunctiva is also stitched, and these stitches are usually removed about a month after the operation. To help prevent the trap door from scarring and closing, an anti-scarring agent called mitomycin C is applied during the surgery. How Successful is Trabeculectomy? Trabeculectomy is successful in about 7 to 8 out of 10 patients. However, about 1 in 20 patients may need to return to the operating theatre for an adjustment in the months following the initial surgery. Vision can reduce immediately after surgery before stabilising. The risk of a sight-threatening complication is around 1 in 200 patients. Serious complications include infection, bleeding, or very low eye pressure. A serious infection called blebitis can occur at any time after surgery, so it’s crucial to seek immediate medical attention if your eye becomes increasingly red, sticky, or painful. After trabeculectomy surgery, approximately 1 in 3 patients develop a cataract within two years, and your glasses prescription could change. You should wait three months after surgery before getting a new prescription from your optician and avoid using contact lenses during this time. Additionally, 1 in 20 patients may develop a droopy eyelid as a result of the surgery. In very rare cases, the eye can become persistently uncomfortable, which may require further surgery to correct. What to Expect on the Day of Surgery On the day of your trabeculectomy, plan to spend several hours in the hospital. After checking in, you’ll be taken to the operating theatre, where a sterile blue drape will be placed over your face, and your eye will be cleaned with iodine. An oxygen tube will provide oxygen under the drape. You’ll receive a local anaesthetic, which involves an injection around the eye. If you’re having a local anaesthetic, you can eat and drink as normal on the day of surgery. Some patients find it helpful to take a mild sedative, such as diazepam, to relax during the procedure. If you do opt for sedation, it’s important to have a friend or relative accompany you home. The operation itself takes about an hour, and you should not feel any pain. However, if you start to feel uncomfortable, let your surgeon know so that more anaesthetic can be administered. After Surgery: Recovery and Care Most patients go home the same day after surgery. It’s a good idea to have someone accompany you home, especially if you’ve had general anaesthetic, sedation, or have poor vision in your other eye. You’ll need to clean your eye when you remove the dressing the next morning—simply wash your hands and use cooled boiled water on a clean cotton pad to do this. For the first month after surgery, avoid swimming, bending, and heavy lifting. You can wash your hair a few days after surgery, but take care to avoid getting water in your eye. If you have help at home, consider washing your hair backwards over a sink. You’ll be given an eye shield to wear at night for the first 2 to 4 weeks. Most patients need 2 to 3 weeks off work, and it’s important to avoid contact sports. In the future, always wear protective goggles when playing ball sports. Your eye may be red, uncomfortable, and slightly swollen after surgery, and your eyelid might droop. In most cases, these symptoms will improve over time. However, if you experience increasing redness, pain that doesn’t improve with paracetamol, significant blurred vision, or a sudden very watery eye, seek urgent care at an eye casualty. Surgical Treatment for Glaucoma: Understanding Tube Surgery If you're dealing with glaucoma and other treatments haven't effectively managed your eye pressure, tube surgery might be recommended. This procedure is designed to lower the pressure inside your eye, helping to slow down or stop the progression of vision loss. While tube surgery won’t improve your current vision, it can be an important step in preserving the vision you still have. Here’s what you need to know about this surgical option. Tube surgery is a highly effective option for reducing eye pressure and slowing the progression of glaucoma. It is especially suitable for patients who have complex glaucoma or who have had previous surgery. While it won’t improve your current vision, it can help prevent further vision loss and may reduce your need for eye drops. As with any surgery, there are risks involved, but with careful monitoring and follow-up, most patients achieve good outcomes. For more information, please click here to access a presentation, including a video of a Paul™ tube surgery being performed (please note that this is a video of surgery on a real patient, which some individuals might find challenging to watch). Tube Surgery Tube surgery involves inserting a small tube, usually about half a millimetre in diameter, into the front chamber of your eye. This tube is attached to a soft plastic or silicone plate, which is positioned about 1 centimetre behind the cornea (the clear front part of the eye). The plate sits between or under the muscles that move your eye, and the tube drains fluid from the eye into a small reservoir known as a “bleb.” The bleb, which lies over the tube plate, helps to reduce scarring. This makes tube surgery particularly useful for eyes that are more prone to scarring, such as those that have already undergone multiple operations. The tube is covered with a patch made from donor tissue, typically from the pericardium (the sac surrounding the heart). Because donor tissue is used, you won’t be able to donate blood following tube surgery. There is a very small theoretical risk of infections that cannot be screened for, although this risk is extremely low. After the operation, you may notice a small raised area under your eyelid and a whitish patch next to the cornea when looking in the mirror. These changes usually become less noticeable over time. Types of Tubes There are different types of tubes used in this surgery, including Paul™, Baerveldt™, and Ahmed™ tubes. They all work in a similar way, but there are some differences in how they manage fluid flow. For example, the Ahmed™ tube has a built-in valve that controls the flow of fluid, so stitches aren’t needed to regulate pressure. However, some studies suggest that the Baerveldt™ tube might be slightly more effective at reducing eye pressure than the Ahmed™ tube. In Paul™ and Baerveldt™ tubes, stitches are often used to control fluid flow initially and are usually removed about 2-3 months after surgery. Success Rates and Risks Tube surgery is successful in about 7 out of 10 patients. However, about 1 in 20 patients may need to return to the operating theatre for an adjustment within a few months of the initial operation. The risk of a complication that could permanently damage your vision is about 1 in 200. Potential serious complications include tube exposure, infection, bleeding, corneal failure (which may require a corneal transplant), and problems with either high or low eye pressure. A serious infection called blebitis can occur at any time after surgery, so it’s crucial to seek immediate medical attention if your eye becomes red, sticky, or painful. You might develop a cataract after tube surgery, and your glasses prescription could change. It’s best to wait about three months after the operation before getting a new prescription from your optician. You should also avoid using contact lenses during this time. Approximately 1 in 20 patients may experience a droopy eyelid after surgery, and because the tube plate is placed near or under the eye muscles, some patients may experience double vision. In most cases, this double vision resolves within 3-6 months. What to Expect on the Day of Surgery On the day of your operation, you can expect to spend several hours in the hospital. After arriving on the ward, your details will be checked, and you’ll be taken to the operating theatre. A sterile blue drape will be placed over your face, and your eye will be cleaned with iodine. You’ll receive a local anaesthetic, which involves an injection around the eye. If you’re having local anaesthetic, you can eat and drink as normal on the day of surgery. A mild sedative, such as diazepam, may also be given, as the operation can take some time. Some surgeons prefer to perform tube surgery under general anaesthetic or with stronger sedatives administered through a vein. If this is the case, your anaesthetist may ask you not to eat on the day of the operation and to only drink clear fluids until two hours before the surgery. The operation itself typically takes about one to one and a half hours. You shouldn’t feel any pain during the procedure, but if you start to feel uncomfortable, let your surgeon know so they can administer more anaesthetic. After Surgery: Recovery and Care Most patients go home the same day after surgery. It’s important to have someone accompany you home. The morning after surgery, you may need to clean your eye. Wash your hands and use cooled boiled water on a clean cotton pad to do this. For the first month, avoid swimming, bending, and heavy lifting. You can wash your hair a few days after surgery, but take care to avoid getting water in your eye. If you have help at home, you can wash your hair backwards over a sink. You’ll need to wear an eye shield at night for the first 2 to 4 weeks after surgery. Most patients need 2-3 weeks off work. It’s important to avoid contact sports and to wear protective goggles when playing any ball sports in the future. Your eye will be more vulnerable after the operation. Initially, it may be red, uncomfortable, and slightly swollen, and your eyelid might droop. In most patients, the appearance of the eye returns to normal in the months following surgery. However, if you notice increasing redness, pain that doesn’t improve with paracetamol, or significant blurred vision, seek urgent care at an eye casualty. Understanding Preserflo™ Surgery for Glaucoma If you’re living with glaucoma, you know how important it is to manage the pressure inside your eye to protect your vision. Preserflo™ surgery is one option that may help reduce this pressure, slowing down or even stopping further damage to your visual field. While Preserflo™ won’t improve your current vision, it can be a crucial step in preserving what you have. Here’s everything you need to know about this procedure. Preserflo™ surgery is a promising option for reducing eye pressure and slowing the progression of glaucoma. While it won’t improve your current vision, it can help preserve what you have and may reduce your need for regular eye drops. Although there’s less evidence supporting Preserflo™ compared to trabeculectomy, many surgeons now prefer it due to its similar success rate, fewer variables, shorter procedure time, and potentially lower risk of serious complications. For more information, you can explore the following resources: EyeWiki: Preserflo™ Ab-Externo MicroShunt Video: Preserflo™ Surgery in a Real Patient (Please note this is a surgical video which some individuals may find challenging to watch) Preserflo™ Surgery Preserflo™ surgery involves inserting a small tube, known as the Preserflo™, into the front chamber of your eye. This tube drains fluid into a reservoir, called a “bleb,” which forms under the conjunctiva—the delicate skin covering the white part of your eye. After the operation, you might notice a shallow blister at the top of your eye when you look in the mirror. The bleb created during Preserflo™ surgery is usually positioned further back and is shallower than the one formed during trabeculectomy surgery. This positioning often makes it less visible, making Preserflo™ a good option for patients who wear contact lenses. Unlike traditional tube surgeries, the Preserflo™ tube is smaller (about 1/3 of a millimetre in diameter) and does not require a plate or stitches to control fluid flow. This can make the procedure quicker and potentially more comfortable during recovery. Success Rates and Risks Preserflo™ surgery is relatively new, and while there’s less long-term evidence compared to other procedures like trabeculectomy, early results are promising. Success rates from studies suggest that Preserflo™ is effective in 5 to 8 out of 10 patients. A minority of patients experience low eye pressure after surgery, which might require injections of a gel into the front chamber of the eye, or a follow-up procedure to place a stitch in the Preserflo™ to increase the pressure. Serious complications are rare but can include infection, bleeding, corneal failure (which might require a corneal transplant), and high or low eye pressure. The risk of a complication that could permanently damage your vision is around 1 in 250. A serious infection called blebitis can occur at any time after surgery, so it’s important to seek immediate medical attention if your eye becomes increasingly red, sticky, or painful. You may develop a cataract after surgery, and your glasses prescription could change. It’s best to wait three months before getting a new prescription from your optician. If you’re a contact lens wearer, discuss this with your surgeon as some patients may be advised not to wear them post-surgery. About 1 in 20 patients develop a droopy eyelid, and in rare cases, the eye can become persistently uncomfortable, which may require further surgery to correct. What to Expect During and After Surgery On the day of your surgery, you’ll spend several hours in the hospital. After arriving on the ward, your details will be checked, and you’ll be taken to the operating theatre. A sterile blue drape will be placed over your face, and your eye will be cleaned with iodine. You’ll receive a local anaesthetic, which involves an injection around the eye. If you’re having local anaesthetic, you can eat and drink as normal on the day of surgery. Some patients also opt for a mild sedative, such as diazepam, to help them relax during the procedure. If you choose sedation, a friend or relative should accompany you home. The operation itself takes about 45 minutes. You shouldn’t feel any pain, but if you do start to feel uncomfortable, let your surgeon know so they can top up your anaesthetic. After surgery, most patients go home the same day. It’s important to have someone accompany you, especially if you’ve had general anaesthetic, sedation, or have poor vision in your other eye. The morning after surgery, you may need to clean your eye—simply wash your hands and use cooled boiled water on a clean cotton pad. For the first month, avoid swimming, bending, and heavy lifting. You can wash your hair a few days after surgery, but take care to avoid getting water in your eye. If you have help at home, you can wash your hair backwards over a sink. You’ll need to wear an eye shield at night for the first 2 to 4 weeks after surgery. Most patients need 2 to 3 weeks off work. It’s also important to avoid contact sports and wear protective goggles when playing any ball sports in the future. Exploring Minimally Invasive Glaucoma Surgery (MIGS) If you’re managing glaucoma, there are several surgical options available to help lower the pressure in your eye and protect your vision. Minimally Invasive Glaucoma Surgery (MIGS) is a newer category of procedures that have gained popularity in recent years due to their lower complication rates and the fact that they can often be performed quickly, often alongside cataract surgery. However, it’s important to know that while MIGS can be effective, the evidence supporting these procedures isn’t as strong as that for more established surgeries like trabeculectomy or tube surgery. MIGS offers a less invasive approach to managing glaucoma, with the potential for lower complication rates and quicker recovery times. However, the evidence supporting these procedures is still evolving, and they may not be suitable for everyone. Discussing your options with your eye specialist will help you determine if MIGS is the right choice for you. For more detailed information, you can explore the following resources (please note they are designed for use by health professionals): Hydrus™ Overview Miniject™ Information Cochrane Reviews on MIGS Minimally Invasive Glaucoma Surgery (MIGS) MIGS, or Minimally Invasive Glaucoma Surgery, refers to a range of procedures that aim to lower eye pressure using various methods, typically without creating a reservoir (or “bleb”) under the conjunctiva, as is done in more traditional glaucoma surgeries. The procedures can be grouped into three main categories: Trabecular Bypass Devices: These devices, such as iStent™ and Hydrus™, bypass the eye’s natural drainage system (the trabecular meshwork) to improve fluid flow into the second part of the drain, known as Schlemm’s canal. Trabecular Meshwork Excision Devices: Devices like the Kahook™ Dual Blade, Trabectome and Omni, remove or cut the trabecular meshwork to enhance fluid drainage into Schlemm’s canal. Suprachoroidal Drainage Devices: These devices, including Miniject™, drain fluid from the front chamber of the eye into the deeper tissues of the eye (the suprachoroidal space). Another device, Cypass™, was previously used for this purpose but has been withdrawn from the market due to safety concerns. What Do We Know About the Effectiveness of MIGS? The effectiveness of MIGS varies depending on the specific device used, and the overall evidence supporting these procedures is still developing. Most specialists recommend that these procedures should not be used for patients with advanced glaucoma. The aim of MIGS is usually to reduce the number of eye drops needed to control early or mild disease. Almost all evidence on these devices relates to patients with Primary Open Angle Glaucoma (POAG), not other types of glaucoma. Here’s a summary of what we know: Hydrus™: There is limited evidence suggesting that combining cataract surgery with a Hydrus™ implant may reduce the need for intraocular pressure-lowering medication and further reduce eye pressure compared to cataract surgery alone, especially in patients with mild to moderate open-angle glaucoma. Hydrus™ may be more effective than iStent™ in these cases. iStent™: The evidence for iStent™ is less robust than for Hydrus, with lower-quality studies suggesting it may help some patients achieve better control of their eye pressure and reduce their reliance on eye drops. However, there is variability in the reported complications, and more high-quality research is needed. Trabectome and Omni: Some single arm studies have shown promising results, but currently there is no strong evidence supporting the effectiveness of Trabectome or Omni in treating open-angle glaucoma. Cypass™: While early trials showed that Cypass™ could help patients achieve medication-free control of glaucoma, long-term concerns about damage to the cornea led to its withdrawal from the market. Miniject™: The Miniject™ device is designed to work similarly to Cypass™ but without the associated risks of corneal damage. Early trials are promising, and suggest Miniject™ may reduce eye pressure by 35-40% and eliminate the need for eye drops in about half of patients. However, these trials were funded by the manufacturer and did not have a control group. Further independent research is needed to confirm these results and to ascertain the risks involved in surgery. What to Expect During and After MIGS These operations are usually performed alongside cataract surgery. The surgery typically takes less time than more invasive glaucoma surgeries, and most patients can go home the same day. After surgery, you’ll need to follow specific care instructions to help your eye heal properly. This includes using prescribed eye drops, avoiding heavy lifting, and wearing an eye shield at night for a few weeks. You’ll have follow-up appointments to monitor your recovery and make any necessary adjustments. Fewer follow up appointments are usually needed compared with traditional glaucoma surgery. As with any surgery, there are risks involved, which can include worse or even loss of vision, so it’s important to report any unusual symptoms to your doctor right away.

Transparent pricing for private cataract surgery and glaucoma treatment in Essex. Self-pay and insurance options available. Mr Alex Baneke, consultant ophthalmologist. New appointments: £250 Included: full clinical examination, pressure checks, gonioscopy and a formal report to your GP/Optometrist. Excluded: specialized scans (OCT/VF) may incur a separate hospital fee. Cataract surgery: Conventional surgery with monofocal lens One eye: £3388 Both eyes: £6776 Trabeculectomy surgery: Price estimate including first 3 months of follow up visits (depending on hospital): £5800-£6200 Selective Laser Trabeculoplasty (SLT): Price estimate (depending on hospital) One eye: £900-£1000 Both eyes: £1400-£1600 Yag Laser Periperal Iridotomy (Yag PI) : One eye: £700-900 Both eyes: £1000-£1300 Follow-up appointments: £200 Cataract surgery: Conventional surgery with premium (toric/EDOF/multifocal) lens One eye: £4470-£5063 Both eyes: £8940-£10126 Preserflo surgery: Price estimate including first 2 months of follow up visits ( depending on hospital ): £5800-£6500 Paul Tube surgery (including first 2 months of follow ups): £5800-£6500 Insured patients: Mr Baneke is fee-assured for all the major insurers and is a recognized provider for all major insurers including BUPA/AXA in Southend and Brentwood Fee queries? Contact us

Private Eye Surgeon Serving East London Spire Hartswood Hospital, Brentwood Spire Hartswood Hospital is approximately 25–35 minutes by car from most of East London via the A12 or A13. The full address is Eagle Way, Great Warley, Brentwood, Essex, CM13 3LE. Free parking is available on site — unlike most central London hospitals. Mr Baneke holds clinics at Spire Hartswood on alternate weeks. Appointments can be booked online or by calling Mr Baneke's secretary on 07398 997 592 . Looking for a private cataract surgeon or glaucoma specialist accessible from East London? Mr Alex Baneke offers private cataract surgery and glaucoma treatment at two clinics within easy reach of East London, often at lower cost than central London clinics. Free parking is available. From Barking or Dagenham: Approximately 25 minutes by car via the A13 and A127. From Ilford or Redbridge: Approximately 25 minutes via the A12. From Stratford or Canary Wharf: Approximately 30–35 minutes via the A12. BOOK NOW Orsett Hospital, Grays (self-pay patients only) Orsett Hospital is approximately 30 minutes from East London by car via the A13. The full address is Rowley Road, Orsett, Grays, Essex, RM16 3EU. Free parking is available on site. Mr Baneke offers private appointments on Tuesday mornings. This clinic is available to self-pay patients only (not insured patients). By train, West Horndon station is 10 minutes by taxi from the hospital and 30 minutes from London Fenchurch Street (via Barking and Upminster). Also available: Southend Private Hospital For more frequent appointment availability, Mr Baneke holds private clinics at Southend Private Hospital twice weekly. Southend is well connected by train from East London: Prittlewell station is just 16 minutes from Stratford, and Southend Central is 28 minutes from Upminster. Prittlewell station is a 12-minute walk from the hospital. Free parking is also available on site. What to expect at your consultation During your first visit, Mr Baneke will carry out a thorough examination of your eyes, discuss your symptoms and explain your treatment options. Most new consultations last around 30 minutes. Before your appointment BOOK NOW You can drive to most routine follow-up appointments. However, some appointments (including your initial consultation, your first post-operative consultation, and any consultation where your symptoms have changed) may involve dilating eye drops, which blur your vision for around 3 hours. You should not drive during this time. To book a private consultation, use the " Book Online " link on our website (available for Southend Private Hospital and Spire Hartswood only), call Paige on 07398 997 592 , or email info@essexeyesurgery.co.uk . Mr Baneke is a consultant ophthalmologist specialising in cataract surgery and glaucoma. He trained at Moorfields Eye Hospital and sees patients from across Essex and East London, including Barking, Dagenham, Ilford, Stratford, Canary Wharf, Walthamstow and Newham. No GP referral is needed for a private appointment.

What is glaucoma and how is it treated? A guide from Mr Alex Baneke, consultant glaucoma & cataract specialist in Southend and Brentwood, Essex. A Guide for Patients Understanding Glaucoma: An Introduction Glaucoma is a condition that damages the optic nerves, leading to a gradual reduction in your field of vision. Since this damage usually happens slowly, most people with glaucoma don’t realise there’s a problem until they’ve already lost a significant amount of vision. The good news is that with proper treatment, most patients with glaucoma do not go blind. Glaucoma is a manageable condition with early detection and appropriate treatment. By lowering eye pressure through eye drops, laser treatment, or surgery, it’s possible to slow the progression of the disease and protect your vision. Always discuss with your eye specialist which treatment options are best suited for your specific needs. What Causes Glaucoma? The main risk factors for glaucoma are increased eye pressure and age. The goal of treatment is to reduce eye pressure, which can significantly slow down the progression of the disease. Risk Factors and Prevention Advanced Treatment Options For more advanced glaucoma, surgical options may be necessary. These include: Trabeculectomy: A traditional surgical procedure that helps to lower eye pressure by creating a new drainage pathway for the eye fluid. Preserflo™ : A newer surgical option that also helps to reduce eye pressure with fewer potential complications than traditional surgery. Tube Surgery: This involves placing a small tube in the eye to help drain fluid and lower eye pressure. Additionally, there are various devices available under the category of "Minimally Invasive Glaucoma Surgery" (MIGS) , such as the Miniject™. These devices generally cause fewer complications than more traditional surgeries, but it’s important to note that many of them still lack strong evidence to fully support their long-term effectiveness. Read More How is Glaucoma Treated? Treatment for glaucoma typically begins with eye drops or laser therapy. Eye Drops: The most commonly prescribed eye drop in the UK is latanoprost. This medication reduces eye pressure by around 30% in most patients by increasing the flow of fluid out of the anterior chamber of the eye. Latanoprost is generally well tolerated, but it can cause some side effects such as slight redness, stinging, and increased eyelash growth. Laser Treatment: For initial laser treatment, Selective Laser Trabeculoplasty (SLT) is a safe and effective option for people with open-angle glaucoma. SLT works in about 70-80% of patients and can help control eye pressure for up to 5 years, potentially avoiding the need for eye drops. Read More TYPES OF GLAUCOMA AVAILABLE TREATMENTS CONTACT TO BOOK

Private glaucoma treatment in Essex from specialist consultant Mr Alex Baneke. SLT laser. Clinics in Southend and Brentwood, serving Chelmsford, Hornchurch, and East London. Laser Treatments for Glaucoma SLT Cyclodiode Yag PI More Eye drops and tablets for Glaucoma Eye drops Tablets Surgical Treatments for Glaucoma Trabeculectomy Tube Surgery Preserflo MIGS Laser Treatments for Glaucoma: Your Guide If you’re living with glaucoma, you know how crucial it is to manage the pressure in your eye to prevent further damage to your vision. Laser treatments offer effective ways to reduce eye pressure, often as a complement or alternative to eye drops and surgery. Here’s a guide to understanding the different laser options available for treating glaucoma. Laser treatments for glaucoma, including SLT, Yag PI, and Cyclodiode, offer valuable options for reducing eye pressure and protecting your vision. While each procedure has its benefits and risks, they are generally safe and can be highly effective in managing glaucoma. Your eye specialist will help you determine the best treatment option based on your individual needs and the stage of your glaucoma. For more information on Yag PI, please see the animated video explaining the procedure: Yag PI Laser Treatment Video . Selective Laser Trabeculoplasty (SLT) Selective Laser Trabeculoplasty (SLT) is a relatively straightforward laser treatment that can help reduce eye pressure. It’s often used as an alternative to, or in addition to, eye drops. SLT works for around 7 out of 10 patients and can keep eye pressure lower for up to 5 years. It tends to work best in patients with high pressures who have not already been treated with multiple eye drops. For this reason, it is often recommended as an initial treatment. If needed, it can be repeated. SLT uses short pulses of low-energy light to target melanin-containing cells in the trabecular meshwork, which is the part of your eye responsible for fluid drainage. This laser treatment activates cells called macrophages, which help remodel the trabecular meshwork and improve fluid outflow. On the day of your SLT treatment, your eyes will be numbed with anaesthetic drops, which may cause temporary blurring and a mild headache. The laser procedure is quick, taking about 5-10 minutes per eye, and is performed on a machine similar to the one used in routine eye exams. After the procedure, you might need to wait for an hour to have your eye pressure re-checked, and you’ll be given drops to use for up to a week. The laser may take up to 6 weeks to fully take effect, so you’ll have a follow-up appointment around that time to check your eye pressure. Although SLT is generally safe, it’s still surgery, so there’s a small risk of complications such as temporary blurred vision, mild headaches, or a slight rise in eye pressure. In rare cases, inflammation or persistent blurred vision may occur, but these are usually manageable. Yag Laser Peripheral Iridotomy (PI) Yag Laser Peripheral Iridotomy (PI) is a laser treatment primarily used for patients with angle-closure glaucoma or those at risk of developing it due to a narrow drainage angle in the eye. This procedure involves creating a tiny hole in the iris (the coloured part of the eye) to open up the drainage angle and reduce the risk of pupil block, which can lead to increased eye pressure. Yag PI helps lower the risk of developing or worsening angle-closure glaucoma, though it doesn’t eliminate the risk entirely. In some cases, cataract surgery may be a better option, particularly for patients over 50, as it provides more space for fluid to drain and can be more effective than Yag PI. However, younger patients might want to avoid cataract surgery due to the loss of near-focus ability and higher complication risks compared to Yag PI. The procedure itself is quick and usually requires one or two visits to the laser room. You’ll receive anaesthetic drops and a contact lens will be placed on your eye to help focus the laser. Some patients might feel slight pressure or mild pain during the procedure, and temporary blurring is common afterwards, usually clearing by the next day. Yag PI is a very safe procedure, but like any surgery, there are potential risks. These include a temporary rise in eye pressure, slight blurring or ghosting of images, and very rarely, inflammation, bleeding, or damage to the retina. Your doctor will discuss whether Yag PI is right for you based on your specific risk factors. Cyclodiode Laser Treatment Cyclodiode is a laser treatment used primarily for reducing eye pressure in advanced or end-stage glaucoma, particularly when other treatments haven’t been successful. It’s performed in an operating theatre, and a strong local anaesthetic injection is given around the eye before the laser is applied over the sclera (the white part of the eye). Cyclodiode works by damaging the ciliary body, the part of the eye that produces aqueous fluid. By reducing fluid production, this treatment lowers eye pressure. Traditionally, Cyclodiode was reserved for end-stage glaucoma because of the potential for severe damage to the ciliary body and the eye itself. However, newer techniques, using lower doses or micropulse diode, have made it possible to use Cyclodiode earlier in the disease process with a lower risk of complications. While Cyclodiode can be an effective treatment, it’s still primarily used for patients with significant vision loss or those whose glaucoma hasn’t responded to other surgeries. Yag PI SLT Cyclodiode

What are cataracts and when do you need surgery? A patient-friendly guide from Mr Alex Baneke, consultant cataract surgeon in Southend and Brentwood, Essex. A Guide for Patients Understanding Cataracts Cataracts are a common eye condition that can make your vision cloudy and blurry, much like looking through a foggy window. As we age, the proteins in our eye’s natural lens can start to change, leading to the formation of cataracts. If you’ve noticed your vision becoming less clear, particularly in low light or when driving at night, it might be due to cataracts. The good news is that cataract surgery is a highly successful procedure that can restore clear vision. What Exactly is a Cataract? A cataract happens when the normally clear lens inside your eye becomes cloudy. The word "cataract" actually comes from the Latin word for waterfall, "cataracta," because the cloudiness can resemble the appearance of water cascading down. Cataracts typically develop slowly over time, so you might not notice them at first. As they progress, you may find it harder to see clearly, especially in low light or when facing bright lights, such as headlights at night. Colours might appear duller, and you might struggle to distinguish contrasts as well as you used to. Most cataracts are simply a part of getting older, and they’re not usually linked to other diseases. However, certain factors can cause cataracts to develop earlier in life, such as diabetes, eye injuries, or the use of steroid eye drops. NHS CATARACT INFORMATION How is Cataract Surgery Performed? Cataract surgery is a procedure that involves removing the cloudy lens and replacing it with a clear artificial lens. The most common technique used today is called “phacoemulsification.” During the surgery, tiny incisions are made in the eye, and a small probe is used to break up the cloudy lens into smaller pieces. Once the cloudy lens is removed, it’s replaced with a clear plastic lens that is carefully chosen to focus light correctly onto your retina, restoring clear vision. About cataract surgery About different lenses