Macular emergencies

Taking charge of your angiographic needs or intraocular injections

In other parts of our site, you can find information regarding the various procedures we carry out and how our diagnostic equipment works and what you can expect when you undergo the examination. Here we wish to give you some insight our procedures and philosophy regarding our care for patients that require a speedy and/or frequent visits and treatments.

Patients with a macular problem, particularly one that causes distortion of vision, the appearance of a central haze, shadow, or spot usually require some diagnostic testing shortly after the symptoms are noticed and the patient is seen by a primary vision caretaker or GP. (The vision change is more clearly visible or noticed when the good idea is closed. It may have been there for a while, but if you never seen this before, you should see a vision caretaker as soon as possible). A vision caretaker will confirm that your macula is involved and will most likely schedule an angiogram of your eye(s) at a center where this procedure can be carried out. Confirmation with an angiogram is often needed prior to appropriate therapy to insure that the insurance companies cover the cost of the medications used. After confirming a diagnosis such as wet age related macular degeneration (AMD), cystoid macular edema (CME) due to diabetes mellitus (DME) or following a retinal vein occlusion (RVO- BRVO or CRVO),  you will be scheduled for an intraocular injection of a medication capable of altering the course of the disease and preventing (in most cases) further loss of vision. Between your initial visit to your primary caretaker and treatment there is often a significant delay (14 days is not unusual).

Our office is equipped with a Heidelberg Spectralis machine, which allows us to perform highly detailed exams of the retina by fluorescein or icg (indocyanine) angiography as well as other associated exams such as OCT, autofluorescence or microperimetry. We prefer to carry out these exams on tuesdays and wednesdays but they can be carried out on other days in case of acute need, particularly if you have had an eye angiogram in the past without any adverse reaction (allergy). The exact time and date will be given to you after you contact our center.

Intraocular injections are carried out in a dedicated clean room (according to the Swiss norms from SwissMedic for an operating room in a private practice), located at the back of our office. We can most often carry these out shortly after confirming the diagnosis and on the same day. This minimizes the time lost in repeat visits to the doctor, which is often the case in patients suffering from macular diseases. We have at our direct disposal medications such as the anti-VEGFs: lucentis, eylea, avastin; intraocular corticosteroids: iluvien ( fluocinolone), triessence (triamcinolone), ozurdex (dexamethasone); enzymatic vitreolysis (treatment for symptomatic vitreomacular traction VMT): Jetrea (ocriplasmin).

We are acutely aware of the time you have to spend with ophthalmologists, often on a monthly basis. We also know that this is often only one of many appointments you have to juggle with health care professionals. We also are aware that, in order to get to these appointments you are often dependent on the goodwill of friends, children and family. For this reason, we try to minimize the time you spend in our office. To do this, we attempt to combine the ocular examinations, diagnostics, and the therapy as much as possible in the same visit, and at one location. Nevertheless, it will take you one to three hours to get through all these exams and treatments at each visit.

Give us your opinion; thanks to your help we will improve our care even more. We look forward to seeing you or one of your close friends or relatives in the near future.