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Jun
19

For our professional colleagues: Angle closure glaucoma

Dear all,

We hope you and yours are all well. Things seem to be gradually going back to some sort of normal [fingers massively crossed]…

We have been running small clinics for the last 4 weeks and they’ve been going well. We started off with 1 patient an hour, but found that such a large separation wasn’t really necessary with the social distancing and hygiene measures already in place (although Mark was FINALLY getting on top of his email inbox in the gaps…). So we will increase the number of patients slightly over the coming weeks. It has also forced us to do things slightly differently – we have an afternoon devoted to video consultations, with patients coming into the London Clinic for quick pressure checks/scans with the nurses beforehand.

We hope that most of you are back in your practices or planning to do so – we understand that the guidance has been somewhat mixed, which must be frustrating. But as one of you said to me: ‘If Primark are open then I think we should open’ – I suspect people need you more than Primark…..

As you may have quiet periods over the next few weeks and hopefully your inbox is in slightly better shape than Mark’s, here’s another lecture to take a look at, on angle closure glaucoma:

https://www.dropbox.com/s/6wv3yliv9c5fnc4/ACG_2020.pdf?dl=0

Some of you heard through the grapevine that Mark caught the coronavirus – he had it during the lockdown (almost certainly caught from a patient) and was pretty unwell although thankfully not hospitalised. He is now fully recovered and is the proud owner of a positive antibody test! Despite joking that he can lick door handles with impunity, he says it’s a nasty disease and is covering himself with the requisite PPE as immunity is likely but not guaranteed – and he’d really rather not go through it again.

All the best to you all as we slowly find our way back to some sort of normality. Keep safe.

With kind regards,

Mark, Sandrine, Avni and Anabela

May
29

Practice re-opening and our safety measures

Dear patients and professional colleagues,

I hope that you are all keeping well.

The purpose of this message is to highlight some changes to the clinic visit that we have made in the light of the coronavirus pandemic.  This is primarily for the safety of our patients and  staff.  Just as your visit to a supermarket is different now, compared to before lock down, your visit to us will likewise be different, and please be reassured by this.  This is in everyone’s interest. Things to note:

  • Patients arriving at the Clinic will be given a sterile face mask, asked questions about current health and asked to sanitise their hands.
  • Only the patient will be allowed to enter the London Clinic Eye Centre. We have to maintain social distancing where at all possible. Whilst we have ample space, this is jeopardised if patients are accompanied by relatives, partners or friends. This rule currently applies to the vast majority of private and NHS hospitals. Relatives who come by car will be asked to wait in the car. The only exception to this rule is designated carers. If there are concerns or problems with this then please let us know in advance of any visit.
  • Rest assured that strict social distancing rules are applied in our waiting rooms.  We’re fortunate in that even on our floor we have 4 separate areas for patients – although with appointments more spaced out, it’s highly unlikely they would ever all be used.

My team and I have redesigned and streamlined the patient journey in order to reduce the waiting time by:

  • Minimising essential tests – for example we will not usually dilate patients’ pupils. Where possible, we will avoid performing visual fields when another test will do.  For example, with the OCT scan, we can broadly maintain the 2-meter separation rule, so I will be relying more on these tests. We have a new eye pressure machine which is quicker, more comfortable and minimises close-up examination time (Icare tonometer).  Where possible, I and my optometrist, Avni, will avoid the slit-lamp test as this involves closer doctor/patient contact (although patients are protected by a plastic screen for when it’s necessary). We will also minimise the use of drops.
  • Booking your follow-up appointments, any further tests or treatments, and invoicing will not be done “face to face” and we would kindly ask patients to contact our administration staff via telephone or email. My practice manager, Sandrine, and Anabela are all working at home but will be pleased to help you.  The practice is (thankfully) totally electronic and we all have secure access to everyone’s notes and accounts.
  • For some routine follow up appointments, we are asking patients to come into the London Clinic for pressure readings and scans, and I will follow this up with a video consultation on another day.

Please rest assured that coming in to see us is as safe as it possibly can be.  We started small clinics this week and they went very well.  We are hoping to re-start surgery towards the end of June (depending on the release of operating theatres from the NHS, who leased them during the pandemic).

Things will be different for a while, and I look forward to the day when our waiting rooms are full of chatter again, and we have the whole team working together in the Clinic.  But for now our priority is to manage our patients’ care as safely as possible, and I’m confident that we’re set up to do that.

All the very best and keep safe.

Mark

May
15

For our professional colleagues: Retinal Disease

We hope you, your families and all in your practices are well.

As we head towards some slight loosening of the lockdown rules (picnics! garden centres!), we are beginning to make plans for resuming our clinics in this new environment, as we hope you are too. Things will be rather different: social distancing means separate or spread-out waiting areas, and no accompanying relatives; investment in and use of diagnostic equipment that minimises risk and can be thoroughly disinfected, or with disposable parts; seamless patient flow to ensure they spend as little time as possible in the building; follow up admin taking place by phone or email. It will be less personal and distanced, but very safe – certainly more so than many supermarkets, for example. But we’ll look ahead to a time when the waiting rooms are buzzing and our regular patients are greeted by the team like the old friends they are….

Anyway, please find below the link to the latest in the series of Mark’s slides to give you something to mull over. This one looks at retinal disease, and the importance of understanding a patient’s history to help you make sense of the clinical signs:

https://www.dropbox.com/s/8jq3e88d7y4umxd/macular%20tips_2020%20.pdf?dl=0

(Note: Some browsers seem to only show the first slide. If so, try another browser or download the pdf file using the arrow button next to the ‘Sign in’ button at the top.)

We are open, as always by phone and email. We are planning to start running our small, socially distanced clinics at the end of May and into June. Mark has been going into the clinic mainly to carry out AMD injections, which generally can’t be postponed (for those of you who know him primarily for glaucoma, he is also Medical Retina trained, and does a lot of this with his uveitis clinics at Moorfields). We hope that you are also in a position to plan a return to work – please let us know if there’s anything we can do.

Meanwhile, enjoy the picnics and gardening this weekend!

Apr
17

For our professional colleagues: Examining the optic disc

Dear all,

We hope that you and yours are all safe and well.

As promised, we have posted another of Mark’s lectures on an educational topic. This lecture is a refresher on how to examine the optic disc in order to detect glaucoma and other conditions.

We hope you find it of interest, and we welcome any feedback.

https://www.dropbox.com/s/ey6jkxx5os7gghu/Optic%20disc%202020.pdf?dl=0

(Note: Some browsers seem to only show the first slide. If so, try another browser or download the pdf file using the arrow button next to the ‘Sign in’ button at the top.)

We have quite a broad collection of lectures on many topics, and if there’s any subject area you’d particularly like a refresher on, we will do our best.

Our practice is currently partially open – we’re available by phone and email as usual, but for the moment we’re only seeing sight-threatening conditions at the London Clinic (fairly rare in Mark’s specialities of cataracts and glaucoma). All elective surgery has been cancelled as the London Clinic and Moorfields have offered their theatres for urgent NHS surgery, freeing up space in NHS hospitals for Covid-19 patients.

Mark is reviewing every patient we have booked in April/May to see just how far we can postpone their appointments. He also held his first video consultations this week with patients who needed to be seen more urgently – this worked surprisingly well, although if anyone can tell us how to measure pressures over the internet, we’d be grateful…..

We wish you all the very best – stay safe!

Mark, Sandrine, Anabela and Avni

Mar
31

For our professional colleagues: Online lesson on the interpretation of visual fields

Firstly, we hope that you and yours are all safe and well. These are quite extraordinary times we’re going through.

We would normally be contacting you now to invite you to one of our regular lectures + wine tasting at the Royal Society of Medicine. Sadly, we’re going to have to put that off for the time being.

We recognise that much regular work is not taking place at the moment and many of you are facing uncertainties over your businesses, staff, etc. However, this ‘down time’ can at least be useful for brushing up on your clinical knowledge – so we thought we would put one of Mark’s lectures online every 2 weeks or so. This week’s lecture is on visual fields and Mark hopes that it’s a useful refresher for you:

https://www.dropbox.com/s/f3wei9u0e5zjy6f/Automated%20visual%20field_Marks%202020.pdf?dl=0
(Note: Some browsers seem to only show the first slide. If so, try another browser or download the pdf file using the arrow button next to the ‘Sign in’ button at the top.)

Please let us know what you think, or if there’s a subject area you would find particularly interesting.

Our practice is currently partially open – we’re available by phone and email as usual, but for the moment we’re only seeing sight-threatening conditions at the London Clinic (fairly rare in Mark’s specialities of cataracts and glaucoma). All elective surgery has been cancelled as the London Clinic and Moorfields have offered their theatres for urgent NHS surgery, freeing up space in NHS hospitals for Covid-19 patients. Mark is reviewing every patient we have booked in April/May to see just how far we can postpone their appointments. We are also looking at telephone and video consultations.

We’ve heard of several optometrists forming local networks to manage emergency cases across their practices. If we can help facilitate this at all, please get in touch.

We wish you all the very best – stay safe!

Mark, Sandrine, Anabela and Avni

Mar
23

Coronavirus update 23rd March

As a result of the global Coronavirus pandemic, and in line with NHS and worldwide best practice in affected areas, we have decided to partially close the practice from today until after Easter.  All patients who were due to come in have been informed – Mark is reviewing their notes and we are contacting them individually in order to reschedule.  Fortunately the specialties of cataracts and glaucoma don’t tend to require urgent care, so most patients can safely postpone their appointments for 2 months or more.

The practice is only partially closed as we’re still available by phone Monday-Friday and via email on secretary@mark-westcott.com.  The practice is fully electronic so we have access to all our patients’ files.  Mark will be able to answer queries, usually on the same day.  We are also planning to manage patients by video consultation and telephone consultation after Easter.

If you have an appointment/procedure after Easter: We are monitoring the situation and will be in touch in the next week or two to confirm or reschedule.

If you have a concern or query: Please contact us on 020 7402 0724 or secretary@mark-westcott.com

If you need a prescription: Please contact your GP in the first instance – they will have your last clinic letter and can prescribe without requiring you to attend their practice.  If you need your last clinic letter, please let us know.  If it’s really not possible for you to get a prescription via this route, Mark will be sending out prescriptions twice a week, but obviously under the circumstances this is not his highest priority.

If you require urgent care: Please go to Moorfields Eye Hospital A&E.  As this is a specialist eye hospital, they are not currently treating patients with acute cases of Coronavirus.  If you are unable to get to Moorfields, we would recommend your nearest private or NHS A&E.

Please ensure you follow Government advice and stay safe!  We look forward to seeing you again soon.

Mark, Sandrine, Anabela and Avni

Mar
15

Coronavirus update 15th March

Many of our patients are concerned about the coronavirus. Obviously for the moment the number of confirmed cases in the UK is relatively low. We all hope that it will stay that way, but realistically it is likely to get worse before it gets better.

So what do we recommend to our patients?

Firstly, please follow the government’s advice.

If you have EITHER a new, continuous cough OR a high temperature then you should self-isolate.  There is no need to call 111 unless you need medical help.

The government advice can be found here:

https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public

For those not at immediate risk the best thing you can do is WASH YOUR HANDS!! Simple and effective.

What about my appointment/surgery?

For the moment the risk is low. The London Clinic Eye Centre is a self-contained specialist ophthalmic centre with no other specialists consulting in the building (e.g. GPs or respiratory specialists). All staff and consultants work solely in ophthalmology. Patient turnover is relatively low and we have 10 waiting areas spread over 6 floors.

Everyone arriving in the building is being asked to wash their hands, and in addition there are hand sanitisers on the walls throughout the building.  We are wiping down all equipment (medical and administrative, e.g. credit card machines) between patients with disinfectant wipes.  The examining equipment is being fitted with clear guards for your protection.

Surgery, by definition, takes place within a highly regulated and sterile environment. Both Moorfields and The London Clinic have issued strict protocols around this virus, with similar actions to those detailed above. We are also planning to hold video and telephone consultations for those patients who are self-isolating (or if/when high risk groups are advised not to attend in person) – please call us if you’d like to find out more.

We hope that you find this information helpful in your decision-making and we will update this blog as needed. As ever, please don’t hesitate to contact us if you need any further information.

Mar
03

Coronavirus update 3rd March

Many of our patients are concerned about the coronavirus. Obviously for the moment the number of confirmed cases in the UK is low. We all hope that it will stay that way, but realistically it may well get worse before it gets better.

So what do we recommend to our patients?

Firstly, please follow the government’s advice. At the time of writing, anyone coming from areas with a known high incidence of the virus should self-isolate and call 111: certain parts of China and South Korea, Iran and named cities in Northern Italy.

If you have a cough, high temperature or shortness of breath and have recently returned from: other parts of mainland China or South Korea, Hong Kong, Japan, Macau, Malaysia, Singapore, Taiwan, Thailand, other parts of northern Italy (anywhere north of Pisa, Florence and Rimini), Cambodia, Laos, Myanmar or Vietnam – then you should also self-isolate and call 111.

The government advice can be found here:

https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public

For those not at immediate risk the best thing you can do is WASH YOUR HANDS!! Simple and effective.

What about my appointment/surgery?

For the moment the risk is low. The London Clinic Eye Centre is a self-contained specialist ophthalmic centre with no other specialists consulting in the building (e.g. GPs or respiratory specialists). All staff and consultants work solely in ophthalmology. Patient turnover is relatively low and we have 10 waiting areas spread over 6 floors.

Everyone arriving in the building is being asked to wash their hands, and in addition there are hand sanitisers on the walls throughout the building. Within the consulting rooms and office, we are wiping down equipment between patients with disinfectant wipes.

Surgery, by definition, takes place within a highly regulated and sterile environment. Both Moorfields and The London Clinic have issued strict protocols around this virus, with similar actions to those detailed above.

We hope that you find this information helpful in your decision-making and we will update this blog as needed. As ever, please don’t hesitate to contact us if you need any further information.

Feb
17

Meditation and Glaucoma

I attended the Moorfields International Glaucoma Symposium recently in London. Many interesting talks were delivered on a number of glaucoma topics at this two day conference.

Although there was much that was interesting, the most original and novel lecture was on the benefits of meditation on glaucoma – this attracted a lot of interest. A team from India looked at the benefits of mindfulness meditation in a group of glaucoma patients. In this well designed, scientific study, the researchers studied 90 glaucoma patients who were taking glaucoma drops. They were randomly divided into half – one group received a 3 week course of meditation instruction by a yoga instructor for one hour every morning. The second group did not meditate. Both groups continued their glaucoma drops. After 3 weeks, 75% of the meditation group demonstrated a 25% drop in their eye pressure. Those who did not meditate showed no difference in their pressures. Interestingly, the meditation group also had lower levels of markers of stress and inflammation in their blood after three weeks (cortisol). Meditation also increased the levels of “good” or beneficial markers involved in regeneration and repair (brain derived neurotrophic factor). No changes were observed in the non- meditating group.

This landmark study suggests that one can use meditation in order to lower stress hormones in glaucoma patients, with a measurable benefit on the eye pressure. There are likely to be other longer term benefits on the progress of the disease, but these need to be studied further. As one might expect, the researchers also found that meditation also improved the patient’s sense of general well-being. As a glaucoma specialist I also see one other attraction of meditation which is this: I spend a lot of my time counselling and managing the side effects of our glaucoma treatments – namely the side effects of drops, and the admittedly rare risks of interventions such as laser and surgery. Meditation really has no side effects or drawbacks as far as I can envisage, other than perhaps the time commitment required to do it. But this may not be so onerous, as it is suggested that you can get a useful effect with as little as 15 minutes, three times per week. You can also get mindfulness apps on your phone that can help (Calm and Headspace are two of the most well known, although I haven’t tried them!).

I am happy to recommend meditation to my patients and I think we will see further research interest in this area over the next few years. I would be very interested to hear from any of my patients who have tried this.

Jan
13

2019 in numbers

New year and time to look at our private practice stats again. These are only for the private practice and don’t include Mark’s NHS work at Moorfields Eye Hospital and The Royal London Hospital – otherwise the totals for surgery and consultations would be much higher!

Number of consultations (new patient and follow up): 2100

New patients: Over 370

Cataract surgery: 180

Laser procedures: Over 80

Intravitreal injections: 25

Number of combined lecture/wine tasting evenings we’ve run at the Royal Society of Medicine for London’s leading optometrists and opticians: 3

Number of houseplants Mark has managed to kill in his consulting rooms: 1 (he maintains it’s because he’s focusing on his patients…..!)

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