Innovative thinkers

Prof Andrew Lotery, consultant ophthalmologist

Age related macular degeneration is a common eye condition which can be improved by using intra-vitreal injections. We were only able to treat about ten patients per doctor previously, which was a drop in the ocean compared to the number of patients who could benefit from the injection. We decided to look at how we could increase the number of patients treated in a session and how we might improve the patient experience. The result was the creation of the medical retinal injection suite.

This four bed unit enables us to get the patients ready for the treatment, allowing the doctor giving the injections to move from room to room while the next patients are prepped. This approach speeds up delivery and increased the number of patients we can see in one session. Now we can treat up to 40 patients in one session.

We also developed a care pathway which reduced the number of times a patient needs to visit the hospital in a year from ten to three, as well as streamlined the injection process. We used to have see patients ten times a year and on average inject them eight times a year. Now we see them just three times and they have seven injections. This makes it much easier for patients and their carers to come to the hospital as their appointments can be planned a year in advance and they know at each visit whether they will have an injection or not ahead of time. Our outcomes have increased significantly as patients get their treatment exactly when they need it, thus allowing many more people to maintain or improve their sight. And another benefit is that it saves a considerable amount of money in reduced clinic visits, reduced clinic administration and fewer injections so that money is available for other critical services.

We are currently training ancillary staff (nurses and optometrists) to perform these sight saving injections too so that we can treat even more patients in the most effective manner. 

To find out more about how the ophthalmology service developed and led by Andrew has progressed, read our 2019 update below.

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In 2019, the intra-vitreal injection service has moved on considerably from where it was a few years ago, and is increasingly offering patients the chance to maintain or improve their sight.

‘We now have six allied health professionals offering our injections as a treatment for macular degeneration and it’s going very well. Patients are very satisfied with the service and having an expanding team has really helped our capacity.'

Andrew has recently been awarded a Wellcome Trust grant for research into the use of artificial intelligence in better understanding and treating macular degeneration.

‘Going forward, we’re increasingly going to be using digital technology; using high quality cameras to take detailed photos of the back of the eye. We’ll also be moving towards having virtual clinics, where patients wouldn’t have to see a doctor – they’d just have their eye photographed and that image would then be analysed. This would enable the clinic to see twice as many patients and improve our service to an even greater extent.’