Specialist Services

Specs of Kensington recommend a regular eye examination, usually every one or two years, as a vital part of your eye care and your general heath care for all the family to allow for early detection, prevention and treatment of any eye care problems. It may be that we can help you further with other tailored clinical services. Please see below our specialist services and don’t hesitate to give us a call to discuss your needs.

Optomap Wide-field scanning

Protect your vision.

Bringing the most advanced technology to our patients, we recommend optomap® ultra-wide digital retinal imaging as part of your comprehensive eye exam today.

The optomap ultra-wide digital retinal imaging system helps you and your optometrist make informed decisions about your eye health and overall well-being. Combining your optometrist’s expertise and optomap technology, optomap brings your eye exam to life.

What is your retina?

The retina is a delicate lining at the back of the eye similar to film in a camera. Light strikes the retina through the lens in your eye and produces a picture which is then sent to the brain, enabling you to see.

Why is a healthy retina important?

An unhealthy retina cannot send clear signals to your brain which can result in impaired vision or blindness. Most retinal conditions and other diseases can be treated successfully with early detection.

Although you may see clearly, a comprehensive eye exam is essential to check the health of your retinas. The retina has no nerve endings so you may not feel any pain and therefore be unaware of a potential problem.

Early detection is vital.

What can happen to the retina?

Your retina is the only place in the body where blood vessels can be seen directly. This means, in addition to eye conditions, signs of other diseases (for example, stroke, heart disease, hypertension and diabetes) can be seen in the retina. Early detection is essential so treatments can be administered.

Diabetic Retinopathy (DR).

Diabetes affects the eyes and the kidneys and is a leading cause of blindness. Retinopathy occurs when diabetes damages the tiny blood vessels inside the retina.

Age-related Macular Degeneration (AMD).

The centre of the retina (the macula) can become diseased as we get older. This results in alterations to our fine central vision making daily activities such as driving and reading difficult.

Glaucoma (Increased Eye Pressure).

Glaucoma causes damage to the optic nerve and almost always develops without symptoms.

Hypertension (High Blood Pressure).

Increased pressure can result in changes to blood vessels in the eye, increasing the risk of cardiovascular disease (stroke or heart disease).

How does your optometrist normally examine the retina?

Examining the retina is challenging. Your optometrist looks through your pupil to examine the back of your eye. Traditional viewing methods can be effective, but difficult to perform and are carried out manually without any digital record.

How does the optomap help?

The optomap ultra-wide digital retinal imaging system captures more than 80% of your retina in one panoramic image. Traditional methods typically reveal only 10-15% of your retina at one time.

The unique optomap ultra-wide view enhances your optometrist’s ability to detect even the earliest signs of disease that appear on your retina. Seeing most of the retina at once allows your optometrist more time to review your images and educate you about your eye health. Numerous clinical studies have demonstrated the power of optomap as a diagnostic tool ¹.

1. Data on file

An important method for evaluating eye health.

Do all optometrists have an optomap ultra-wide digital retinal imaging system?

Not yet, optomap is a standard of care for evaluating eye health at this practice and millions of people worldwide have benefited from optomap.

How often should I have an optomap?

Your optometrist will advise you based on your individual circumstances, but the general recommendation is that you have an optomap every time you have an eye exam. This will ensure you have a digital record of your retinal health on file which can be compared for changes over time.

Should my children have an optomap too?

Many vision problems begin at an early age, so it’s important for children to receive proper eye care from the time they are infants.

Will I need to be dilated and does it hurt?

An optomap takes only seconds to perform, is not painful, and typically does not require dilation. However, your optometrist may decide dilation is still needed.

OCT - Ocular Coherence Tomography

Ocular Coherence Tomography – is an advanced 3 Dimensional eye scan for people of all ages. Similar to ultrasound, OCT uses light rather than sound waves to illustrate the different layers that make up the back of your eye in 3D.

We also capture a digital photograph of the surface of your eye to cross-reference areas of concern.

OCT – Optical Coherence Tomography

Dry Eye Clinic

Treatment of dry eye depends on the cause and if there is any associated blepharitis or meibomian gland dysfunction. By performing certain tests your Optometrist can determine the cause and recommend the appropriate treatment.

The following recommendations can help alleviate symptoms and applies to all types of dry eye:

1. A humidifier puts more moisture in the air. With more moisture in the air, your tears evaporate more slowly, keeping your eyes more comfortable. Both central heating in the winter and air conditioning in the summer decrease the humidity in the air.

2. Excessive air movement dries out your eyes. Avoid having excessive air movement by decreasing the speed of ceiling fans and/or oscillating fans.

3. Large amounts of dust or other particulate matter in the air may worsen the symptoms of dry eye. In those situations, an air filter may be helpful.

4. If you notice your eyes are dry mainly while you are reading or watching TV, taking frequent breaks to allow your eyes to rest and become moist and comfortable again, is helpful. Closing your eyes for 10 seconds every five to 10 minutes will increase your comfort, as will blinking more frequently.

Research has also shown that nutrition can be factor in dry eye. Incorporating certain elements in your diet, such as flax seed and fish oil, has been shown to improve dry eye. Omega-3 fatty acids (containing eicosapentaenoic acid [DHA and EPA]) are thought to decrease inflammation, stimulate aqueous tear production, and augment the tear film oil layer by enhancing the flow of oil out of the meibomian glands.

Other types of treatment your Optometrist may recommend include:

  • Lubricating eye drops
  • Warm compresses
  • Lid massage/hygiene
  • The EyeBag
  • Prescription medications
  • Food supplements
  • Punctal plugs
Treatment for Dry Eye

Overnight vision correction - Orthokeratology

Imagine waking up each morning with prefect vision and not having to wear contact lenses or glasses through the day.  Overnight vision correction (OVC) lenses correct your vision whilst you sleep so you remove them each morning to leave you with crisp unaided vision through the day. These lenses are custom made lenses which gently reshape your eyes while you sleep. They are suitable if you are moderately short sighted (myopic) up to -5 and even if you have mild astigmatism up to -1.5. The effect is reversible and the risks are no greater than with daytime contact lenses. Check out the i-GO or Eyedream website and watch the video on YouTube to find out how it works. You can also read about us in the travel section of the Evening Standard and the testimonial of Jo Fernandez, Evening Standard Travel Journalist.

How it works in terms of fitting appointments and what it costs:

At Specs of Kensington we are dedicated to giving you the best eye care possible and that applies to our approach to looking after your eyes if you choose to have OVC. The ongoing cost of wearing OVC is about the same as wearing the best quality Daily Disposable Contact Lenses.

To start with, you will come in for a consultation to discuss your suitability for OVC. If it‘s been more than 6 months since your last full eye examination or you don‘t have an up-to-date written prescription, then we‘ll need to do an eye examination for you too. The cost of this initial consultation is just £50 (or £95 if you need the eye examination as well).

If you prove to be a suitable candidate for OVC and you decide you‘d like to go ahead to try lenses out, then you will pay a fee of £300 and we will order your first pair of lenses. The fees you have paid will cover you not only for the initial visit and this first pair of lenses, but also for all the appointments within the following 4 weeks. (Teach and issue appointment, next morning follow-up, 1 week follow-up and 1 month follow-up, plus any extra appointments that might be needed within this time.)

If you don’t proceed beyond the first month, you return the lenses to us and we will refund you £100 – this being the deposit you paid towards lens costs & you will simply have paid our professional fees.

That‘s it – no long term commitments until you see if OVC is right for you – peace of mind that your suitability for OVC is well established before you proceed to use OVC as your longer term vision correction of choice.

If, after the first month, you wish to carry on wearing OVC, you will put in place a DD which starts from £49.00 per month. This monthly payment covers you for all your ongoing contact lens check-ups as an OVC wearer, both routine and unscheduled, as well as routine eye examinations, as needed. It also covers the cost of a new pair of lenses every six months, which is the time frame on which they should be routinely replaced, as well as your contact lens care products. The only extra cost you might incur would be if you need any extra lenses because of loss or breakage.

Call us today to book an appointment for your initial evaluation. You‘ll need at least an hour for this and if you need an eye examination as well, please allow an hour and a half.

Myopia control

What is Myopia?

Myopia is also known as short-sightedness. Near objects are clear but objects viewed in the distance are blurry. This is usually because the eye has grown too long to focus correctly. Myopia is increasing worldwide at a rate which can’t be explained by genetics alone. In 2010 28% of the global population was myopic. By 2050 this is predicted to be 50%.

Why does Myopia Matter?

For most short-sighted people the main problem is inconvenience. Being dependent on spectacles or contact lenses can limit activities and be frustrating. However, highly myopic eyes are at a greater risk of developing some serious eye conditions. A person who has a myopic prescription of -6.00 has a 16x risk of developing retinal detachment and a 40x risk of getting myopic maculopathy. If the myopia is in the region of -3.25 the risk drops to 10x in each case. If we can stop myopia developing beyond -1.25 those risks drop to just 2x in each case.

You are more likely to develop short-sightedness if your parents are short-sighted. If one parent is short-sighted their child is 3x more likely to become myopic. If both parents are myopic then their child is 7x more likely to also be short-sighted.

The younger the child is when they are first found to be short-sighted, the higher the myopia is likely to be come.

The link below helps understand how myopia generally progresses.

Myopia Prevention

Research has shown that more time spent outdoors as a child helps prevent myopia. The exact reasons why this is the case are not yet fully understood and much work continues in this area to property understand the protective mechanisms outside life provides, whether it be sunlight, UV exposure, vitamin D levels or more limited exposure to screen technology. It doesn’t matter if the time outdoors is spent sitting around or playing sports, it’s just that time outside seems to be a positive in slowing myopic change.
Time spent outdoors cannot however reverse myopia once it has developed.

Myopia Control

There is currently no cure for short-sightedness. Laser surgery in adulthood doesn’t change the length of the eye, just the front surface curvature, so doesn’t change the risk of conditions associated with myopia. Various methods of complex spectacle correction such as bifocals or multifocal lenses have been shown to slow myopic progression rates to some degree but contact lenses are most likely to provide the best slowing of myopic eye elongation. Under correction of myopia has been shown to actually promote eye growth.

The aim of myopia control is to slow the progression of myopia as much as possible. It is highly unlikely that we can stop myopic change altogether. The response to myopia control treatments varies significantly between individuals but we hope to try and reduce myopic change by around 50% . So, if a child is predicted to be say -6.00 by adult hood our hope would be to stop this becoming more than about -3.00. There are, however, no guarantees that this can be achieved.

Research into myopia has shown that the light going to the periphery of the retina is responsible for eye growth or the lack of it. As normal contact lenses don’t change the way the light hits the peripheral retina these aren’t effective at controlling the growth of length of the eye. Specialised myopia control contact lenses, whether they be daily disposable soft contact lenses or Orthokeratology overnight rigid gas permeable lenses, are designed to blur the light hitting the peripheral retina.

At Specs of Kensington we offer 2 types of lenses for myopia control:

Orthokeratology (Ortho-k or Overnight Vision Correction) for Myopia Control.

Extensive research worldwide has shown orthokeratology has one of the greatest effect on the slowing of myopia progression. It is thought that the effect on myopia control may be greatest with orthokeratology because the reshaping of the front of the eye is combined with the refocusing of the light that reaches the peripheral retina. The effect is not guaranteed, as results vary for individual children, but it has never been shown to make children more short-sighted.

Ortho-K lenses are rigid gas permeable contact lenses, made of very high oxygen permeable materials of a type which have been shown to be generally safe over many years of wear. All lens wear is done overnight so the lenses are not worn out of the house, which means less worry about lost lenses or spectacles. Also, daytime is free of specs and or contact lens wear so children can take part in all activities and sports without having to worry about their vision or lens loss.

Who Is Suitable for Ortho-K?

We use a variety of Ortho K lenses and may be able to fit people with up to the following degrees of short-sightedness and astigmatism:

  • A spherical spectacle prescription of up to -8.00 D
  • Astigmatism of up to -2.50D

Orthokeratology lenses are worn overnight to gently reshape the front of the eye so that the lenses can be removed in the morning and give crisp, natural vision all day.

Ortho-K at Specs of Kensington

As well as being experts in all types of contact lens fitting, our Optometrists have attended extensive training programmes in Ortho-k fitting. We will be pleased to advise on suitability and our Ortho-K fitting programmes include the necessary ongoing professional care.

MiSight Daily Disposable soft contact lenses.

MiSight lenses are a newer approach to myopia control. First developed in 2009 and launched in Hong Kong, early results were promising and now longitudinal studies are showing good results. (Myopia in Eastern populations is at higher levels than in the West – 47% in 2010 – projected to rise to 65% by 2050).

After 3 years children wearing MiSight lenses had 59% less myopia on average than the control group and 52% less growth in the axial length of the eye.

Our goal to try and achieve the best results, is to treat early. Myopia at any level, once established, will not reduce. Once the eye has grown, it cannot ‘ungrow’.

Contact Lens wear in general.

You should be aware that anyone who wears contact lenses, of any type, is at a slightly greater risk of eye infection. Nevertheless, the advantages of contact lens use, irrespective of any myopia control considerations, has been shown to be significant for young people in terms of self-image and convenience, for instance when playing sport. Modern contact lens materials and modalities of wear have significantly reduced the complication rates and risks of lens wear.

Ortho-K Versus MiSight

Ortho-K

Pros

Longer establish proof of efficacy

Freedom from contact lens wear in the day

Appropriate with low levels of astigmatism

Cons

Time to gain lens tolerance

Overnight wear may raise the risk of eye infection compared to daily wear.

MiSight

Pros

Easy adaptation

Cons

Peripheral vision ghosting

Not suitable for those with significant astigmatism

Myopia Control

References:

  1. Chamberlain P, at al. Clinical evaluation of a dual focus myopia control 1 day soft Contact lens. 3 years results. BCLA meeting June 2017.

Vision & sports

Whether you are a golfer, cyclist, angler, runner or even a kite surfer, we have a frame and lens combination to suit your requirements. Especially selected with functionality, style, quality and value for money in mind. Our professional dispensing opticians are experts in the products that we offer, so if you have a particular leisure or sport activity you enjoy, speak to one of our staff and they will be able to suggest a range of frames and lenses that will be the perfect fit for your sport.

You can also book an eye test to see whether your prescription has changed.

Vision and Learning

Helping children with specific learning difficulties.

Should my child have further assessment?

The first step with any child is to have a full eye examination which is free of charge to you, being covered by the NHS. This will check if there is any need for spectacles or ocular health issue that could explain any visual difficulties.

A child with difficulties who is found to have no significant refractive error (spectacle prescription), or who presents with classic symptoms of specific learning difficulties such as “words jumping on the page” will then be recommended for further assessment. This appointment is not covered by the NHS at present, and private fees will apply.

What should we expect?

The assessment is designed to detect any visual factors which may be contributing to a child‘s difficulties. These may or may not be related to any diagnosed Specific Learning disability.

During this test your optometrist will concentrate on the co-ordination of the two eyes (binocular vision). Muscle weaknesses or strain found by these tests certainly explain difficulty sustaining focus when reading. They will also check your child‘s ability to focus on near objects in order to make text clear. Should any of these tests find areas of weakness then simple eye exercises will be issued for your child to perform at home.

Finally your child will be assessed for “Meares-Irlen Syndrome” which is a sensitivity for colour where using a prescribed coloured overlay may increase the speed of reading. A recent study found that about 20% of subjects found a decrease in symptoms of eyestrain and headache when using a coloured overlay. Should your child demonstrate an improvement whilst using their selected individual overlay then a specific coloured A5 sheet will be issued. The child should never be forced to use the overlay as voluntary use of the overlay is evidence itself that it may be helping.

Follow up

Following your child‘s examination, an in depth report will be provided for your reference and with your consent, another fully documented report will be sent to your child‘s appropriate teacher so they are fully aware of our findings and recommendations.

Most children are recommended to return 6-8 weeks after their initial assessment where the results of exercises will be investigated and the effect of using the overlays discussed.

Please note

You should be aware that recent studies into improvements in reading performance achieved when using coloured overlays have shown that this may be due to Placebo effect.

We are not able to diagnose a specific learning disability. Our job is to try and find any visual factors which may be contributing to a child‘s difficulties. Our role is to work as part of a multi-disciplinary team with your child‘s teachers and educational psychologists.

There are many other vision training / tests available but currently there is lack of scientific evidence to support them. You should discuss any concerns you have with your child’s teachers to consider other possible areas of support. For instance Phonics instruction may provide improvements in reading.

Glaucoma Screening Services

What is glaucoma?

Glaucoma is the name for a group of eye conditions in which the optic nerve is damaged at the point where it leaves the eye. This causes a loss of peripheral vision which is why it can go undetected until the later stages. If it remains undetected for a long period of time then it may result in “tunnel vision” and blindness. The optic nerve carries information from the light sensitive layer in your eye, the retina, to the brain where it is perceived as a picture.

Your eye needs a certain amount of fluid pressure inside it, to keep the eyeball in shape so that it can work properly. In some people, the damage is caused by raised pressure. Others may have an eye pressure within normal limits but damage occurs because there is a weakness in the optic nerve. In most cases both factors are involved, but to a varying extent.

Raised ocular pressure is NOT the same as high blood pressure and detection of the early stages of glaucoma is often difficult because it is so gradual.

There are 4 different types of glaucoma:

Chronic Glaucoma: This is the most common type of glaucoma. The eye pressure rises very slowly and there is no pain to show there is a problem, but the field of vision gradually become impaired.
Acute Glaucoma: This is less common in western countries. This type of glaucoma occurs when there is a sudden blockage to the flow of aqueous fluid to the eye. This can be quite painful and will cause permanent damage to your sight if not treated properly.
Secondary Glaucoma: This type of glaucoma occurs as a result of a rise in eye pressure caused by another eye condition.
Developmental Glaucoma: This is a rare but sometimes serious condition which occurs in babies and is caused by a malformation in the eye.

How common is glaucoma?

In the UK some form of glaucoma affects about 2 in 100 people over the age of 40.

Are some people particularly at risk of chronic glaucoma?

Yes. There are several factors which increase the risk:
Age: Chronic glaucoma becomes much more common with increasing age. It is uncommon below the age of 40 but affects one percent of people over this age and five percent over 65.
Race: If you are of African origin you are more at risk of chronic glaucoma.
Family: If you have a close relative who has chronic glaucoma then you should have regular eye examinations. You should advise other members of your family to do the same. This is especially true if you are over 40. Those with a family history of glaucoma are 10 times more likely to develop it.
Short sight: People with a high degree of short sight are more prone to chronic glaucoma.
Diabetes: It is believed that diabetics have an increased risk of developing chronic glaucoma.

Can glaucoma be treated?

If detected early enough, glaucoma can usually be treated to control the pressure and prevent futher damage to the eye. In most cases, eye drops to reduce the pressure will be prescribed, although in some cases a minor operation is needed. Treatment is unable to restore vision that has been already been lost but aims to preserve the remaining sight. This makes detecting it early even more important.

Regular eye examinations where the ocular health, eye pressure and field of vision are checked are essential. New examination techniques, such as OCT, are helping to diagnose glaucoma ever earlier. If you are worried about glaucoma, or would like any more information then just contact the practise and we will be happy to talk to you.

Glaucoma

Medical Contact Lenses

Contact lenses are often used as therapeutic devices in medicine and our Moorfields Eye Hospital trained optometrists have all the skills needed to hlep you, if this is what is required. For instance we are experts at fitting specialised contact lenses for keratoconus, and we are happy to fit bandage lenses for relief of symptoms in cases of severe dry eye conditions or after ocular trauma, generally working hand in hand with your Consultant Ophthalmologist.

Pachymetry

Recent discoveries about the cornea, the clear part of the eye‘s protective covering, are showing that corneal thickness is an important factor in accurately diagnosing eye pressure. When we measure the intra-ocular pressure we don‘t always get a truly accurate reading. The intra-ocular pressure reading depends on the thickness of the cornea, thicker corneas cause falsely higher eye pressure readings and thinner corneas cause falsely lower eye pressure readings.

Your corneal thickness therefore affects your risk for glaucoma, and knowing what your corneal thickness is can make your diagnosis more accurate. With an ultrasonic device called a Pachymeter we can measure your corneal thickness. It is also known that people with a thin central corneal less than 0.555mm are significantly more at risk of developing Primary Open Angle Glaucoma.

Corneal topography

This is a process for mapping the surface curvature of the cornea, similar to making a contour map of the land. The cornea is the clear part on the surface of the eye that a contact lens fits over. About 70% of the eyes focusing power is done by the cornea so its shape can determine the visual ability of the eye. A perfect eye has an evenly rounded shape, but sometimes the cornea is too flat making it long-sighted, too steep making it short-sighted or unevenly curved causing astigmatism (rugby ball shaped).

The pupose of corneal topography is to produce a detailed description of the corneal shape and power. We can use the computerized imaging technology to produce a 3 dimensional map. This is a fantastic tool for giving a base-line of the shape of the cornea and monitoring the health for any changes that may be caused by contact lenses.

Laser Surgery

Modern Laser surgical techniques to correct refractive errors, such as myopia, have evolved significantly over the past 20 years and there are now various procedures which deliver increasingly predictable end results. There are also other types of eye surgery designed to reduce dependency on spectacles or contact lenses, such as lens replacement surgery (similar to a cataract extraction operation). The type of operation which might be best for you is very dependent on the type of visual error you have and factors such as whether you need reading glasses as well as distance correction and so on.

We are delighted to discuss with you what the various options are, and which, if any, might be the most appropriate to try and solve your particular visual difficulties, together with the relative risks and benefits of different techniques. Just arrange to come to see us and mention at the time of booking your appointment that you would particularly like to talk about refractive surgery options.

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