UK Opthalomologists

[np1981]

Has anyone from the UK had any appointments with Prof Dua (Nottingham)? I have made an initial appointment in 4 weeks time and was wondering if anyone here has any comments etc.

[sazy123]

Susie has, susie will give you the low down..

have you seen the UK opthmapologist in the europe open forum that i posted?

[SusieD]

Are you the same np1981 from the another forum - healthboards?

If you are and you've already travelled to Miami to see Dr Tseng, then I cant see Prof. Dua doing anything that he hasnt already. Prof. Dua will do all the regular stuff e.g. schirmers TBUT etc but I dont think he does the kind of tests Dr Tseng does. If you've already had a diagnosis of conjunctivochalasis, Prof Dua is a corneal specialist but I dont think he does any of the transplant surgery (amniotic membrane) that Dr Tseng does. In fact I think Dr. Tseng is the only one who does it - but I may be wrong.

[np1981]

Yes. The problem is that if I do have surgery, I will need longer term aftercare, and travelling back and forth routinely is going to be an issue. I was hoping to find someone here in the UK who is at least familiar with the problem. I actually emailed Prof Dua at the University of Nottingham and asked him, and he replied that he does have "considerable experience and expertise in treating dry eyes and conjunctival chalasis".

I'm not sure whether he does/has performed surgery, but I've seen a few papers by HS Dua, et al in the use of amniotic membrane transplantation for ocular surface reconstruction. If he has past experiance then that may be good enough. I had planned to see Dua prior to going abroad, but the price of a return ticket to Miami was too good at the time to delay (before the holiday season).

If I did have the operation, it will inevitably be by Dr Tseng.

[SusieD]

Did he say what it would cost - for the surgery?

I thought Dr Tseng was the only one who could do the amniotic membrane transplants - but if Prof Dua is knowledgeable about them and he agrees to look after some of your after care then that would be ideal for you.

[np1981]

It would be ideal, unfortunately I am in a bit of a battle with my local NHS Primary Care Trust, they will not refer me to Dua from Cheltenham for some reason. I've got a private appt but in the long term that would not be sustainable. It seems strange to me, cos from what I understand the refusal is a bureaucracy issue not a medical one. They can only refer you to certain hospitals that have contracts with the GP surgery. However if local drs cant help, what are you supposed to do I wonder?

[Rebecca Petris]

I thought Dr Tseng was the only one who could do the amniotic membrane transplants

Actually there are quite a few others, in Florida (such as Dr. ****** in Tampa and Dr. Gulani in Jacksonville) as well as other parts of the US.

[SusieD]

It would be ideal, unfortunately I am in a bit of a battle with my local NHS Primary Care Trust, they will not refer me to Dua from Cheltenham for some reason. I've got a private appt but in the long term that would not be sustainable. It seems strange to me, cos from what I understand the refusal is a bureaucracy issue not a medical one. They can only refer you to certain hospitals that have contracts with the GP surgery. However if local drs cant help, what are you supposed to do I wonder?

Yeah, Nottingham is not far from me so I didnt have any trouble, having said that Queens Med is not part of the PCT Im under. It is bureacracy. See what Professor Dua says when you see him. He might be able to arrange to see you under the NHS. Mind you if you can afford the thousands of dollars for the surgery, a few private appointments in the UK are nothing! Let me know how you get on with it.

Take care.

[np1981]

Actually I would have to take out a sizeable loan for the surgery. I may be able to appeal for part of the cost of the operation by appliying to the PCT for Interventions Not Normally Funded (or INNF). But this route needs a doctor to make the appeal on my behalf, and I don't know anything about Proff Dua and whether he would support my case. I guess I'll find out soon.

I really don't want to borrow any more than I need to.

[SusieD]

Prof Dua is good and if he sees what Dr Tseng saw and believes you need this surgery I would think he would support you if he could.

Good luck anyway.

[sazy123]

Beucracy not madical that sounds about right! its all about money with PCTs.
Why do you need a referal from them? i was going to see P dua, i didnt in the end but i just got a referal off my gp and i dont live anywhere near nottingham.

[np1981]

I tried to get a referral from my GP but was told that she can only refer me to hospitals they had "contracts" with. I don't even know what that means.

[SusieD]

Like I say, wait and see what he says. A top consultant like that can see whoever he wants - he may be able to sort something out for you. You're doing the right thing anyway in seeing him privately first its worth a try. My PCT is Doncaster and Bassetlaw but they also have 'contracts' with the sheffield hospitals. Nottingham is not part of it, yet I just asked to be referred and my GP did it (tbh, I think he was getting fed up with me and probably just did it to keep me quiet and get rid of me!). But yes, ultimately you have to wade through a sea of red tape with the NHS - does wonders for your already high stress levels eh!

[np1981]

Apparently.....

"Amniotic membrane transplantation is sometimes (not always) necessary to restore a large conjunctival defect created during surgical removal of conjunctivochalasis. In this situation, surgery with or without amniotic membrane is an easy procedure and many English surgeons are able to perform such a procedure"

according to a Dr Muraine in France

[SusieD]

Maybe you wont need to go to Miami for it after all then - that would make things a bit easier.

Do you have a lot of redness in your eyes as a result of this?