Text size: Aa Aa Aa

Retina Care

The practice of Hadi Zambarakji

News & Thoughts

Thoughts from RetinaCare


Retinacare’s quarterly newsletter keeps you up-to-date with the latest in retinal care developments. The most recent issue is below, you can browse the archive by clicking the links to the right or subscribe by emailing info@retinacare.org.uk.



Newsletter January 2021

Issue 7.1

How the covid-19 pandemic has changed the way we work

I hope you are all keeping well and that your loved ones are safe and have not been affected directly by the pandemic. These are truly unprecedented times, and particularly challenging to all of us.


So what are we doing differently at Retinacare?

For a start we have seen an increase in the number of patients with retinal disease in particular retinal detachment, macular hole and epiretinal membrane. There is also some suggestion that non-attendance to scheduled appointments after the implementation of national lockdowns might have resulted in a disproportionately higher number of patients with macular haemorrhages secondary to macular degeneration. Fortunately, the local NHS trusts have kept going the local injection services for age-related macular degeneration and diabetic macular oedema which is so important to prevent vision loss from the most common but treatable macular diseases. In the NHS however, we have seen a number of advanced retinal detachments with proliferative vitreoretinopathy, either because of non-attendance (patients were shieling) or because the early signs of PVD and retinal break had not been spotted.

For patients who are shielding, I have been able to do video consultations in the private sector using a link though the “top doctors” website which works very well https://www.topdoctors.co.uk/doctor/hadi-zambarakji. For some patients, a telephone consultation is sufficient of course, but most have adapted to using face time or zoom so one way or another it is always possible to communicate with the patients reasonably well.

Most of you have provided a primary care service, which is so important and for which I know patients are extremely grateful. I have been very impressed with the quality of referrals of new patients with anterior segment images and OCT images, which is indeed so helpful so as to identify those that need to be seen promptly from the less urgent referrals.

In the private sector, at one point we had to prioritise patients who needed cataract surgery as the private hospitals had been providing some NHS services and would only allow surgery for patients who met certain priority levels. Everything changes daily of course, and at the moment this does not seem to be an issue. However, we are unable to do surgery under general anaesthesia at The Holly or The Spire London East Hospitals because of the concern for the possible need to recover a patient in intensive care. For 99% of patients who need cataract surgery however, surgery is done under local anaesthesia with or without mild sedation so this is not really a concern. I have however done any surgery that requires general anaesthesia for more complex procedures at the Hospital of St. John’s and St. Elizabeth in St John’s Wood which is a very useful back up.


Ophthalmic manifestations of Covid-19

A small number of articles have addressed the association between covid-19 and conjunctivitis but the true association remains unclear. Viral particles however, have been detected in conjunctival secretions of SARS-CoV-2 patients who present with conjunctivitis, which is likely to be another mode of transmission. To prevent ocular transmission, the importance of eye protection cannot be emphasized enough for all of us that manage eye disease and to the healthcare workforce in general.

In terms of the posterior segment findings, retinal vascular changes (mainly dot blot haemorrhages) have been reported in severely ill patients with covid-19 and are thought to be secondary to clinical comorbidities instead of a direct damage by SARS-CoV-2.

On this note, I would like to wish you all a safe and healthy New Year and I hope that by the time I write another newsletter, we would have all been vaccinated. Unfortunately, covid-19 is here to stay for a while and will change the way we do things long-term. For one we will most probably be wearing masks for some considerable time, but this is only a minor consequence if the dangers of covid-19 can be controlled with the current vaccination program.

With very best wishes to all



No comments yet

Leave a comment


Search the RetinaCare website



Register as Sight Impared

Fill out the form here.



Newsletter Archive

Retinacare Newsletter Issue 7.1 (January 2021)


Retinacare Newsletter Issue 6.2 (December 2018)


Retinacare Newsletter Issue 6.1 (November 2018)


Retinacare Newsletter Issue 5.1 (Spring 2016)


Retinacare Newsletter Issue 4.1 (Spring 2015)


Retinacare Newsletter Issue 3.1 (Summer 2014)


Retinacare Newsletter Issue 2.1 (Summer 2013)


Retinacare Newsletter Issue 1.3 (Winter 2012)


Retinacare Newsletter Issue 1.2 (Autumn 2012)


Retinacare Newsletter Issue 1.1 (Summer 2012)


If you are subscribed and don’t wish to receive any further newsletters, please email: info@retinacare.org.uk



News & GP Articles

Scleral buckle in primary retinal detachment. How do I do it...
A scleral buckle webinar; August 2020


Patient education video: “My vision is distorted”
A live Q & A with Mr Hadi Zambarakji; January 2019


Patient education video: Lens implants as part of cataract surgery
A live Q & A with Mr Hadi Zambarakji; May 2018


Management of advanced diabetic eye disease:
Diabetic Eye Journal; March 2014


Delivering drugs to the retina:
Newsletter for GPs Holly House Hospital; Winter 2014 (page 8)


Diabetic macular oedema:
Practice matters issue 14; December 2013


Guide to Vitrectomy for Floaters


Guide to 23 gauge vitrectomy surgery


Driving with poor eyesight: a safety guide for drivers who need to wear glasses or contact lenses


Useful links

Certificate of Vision Impairment (CVI) Registration:

Download pdf form here


The Royal College of Ophthalmologists:

This should probably the first site accessed by anyone in the UK who would like to obtain information about eye care. The College provides valuable support for professionals and patients.



The National Institute for Health and Care Excellence (NICE):

NICE Supports healthcare professionals and others to make sure that the care they provide is of the best possible quality. NICE provide independent, authoritative and evidence-based guidance on the most effective ways to prevent, diagnose and treat disease and ill health, reducing inequalities and variation.




BEAVRS is the acronym for the British and Eire Association of Vitreoretinal Surgeons. The aim of the Association is to promote high quality patient care by supporting and representing British and Irish Vitreo-Retinal Surgeons through education, research, audit and revalidation.



This should probably the first site accessed by anyone in the UK who would like to obtain information about eye care. The College provides valuable support for professionals and patients.



The Macular Society:

This society has been supporting people with macular conditions, including age-related macular degeneration (AMD), for 25 years. The society offers information and support while funding research to find a cure. All services are free so that no one has to face a macular condition alone. This is the best site in the UK if you are a patient with macular degeneration and would like to know more and seek where can you get support.



Royal National Institute of Blind People (RNIB):

The RNIB is the leading charity offering information, support and advice to almost two million people with sight loss. The RNIB provide practical ways to help patients live with sight loss, and give advice to help travel, shop and manage money and finances independently. The RNIB also give advice on technology for blind and partially sighted people.


The British Medical Association (BMA):

The BMA stand up for doctors both individually and collectively on a wide variety of employment issues and, since the inception of the NHS, have been formally recognised for collective bargaining purposes within national negotiating machinery and by individual employers at local level.



The “access to work program”:

This government program helps pay for practical support so anyone with a disability can do their job (in the case of my patient, this is usually a visual disability). This is free of charge to anyone in the UK.



The implantable intraocular telescope for patients with advanced age-related macular degeneration:

The CentraSight treatment programme uses a tiny telescope, which is implanted inside the eye to improve vision and quality of life for individuals affected by end-stage age-related macular degeneration. The above link allows the patient to find the necessary information about this program. Mr. Hadi Zambarakji is currently in the process of developing a patient pathway and will be offering with CentraSight this new technology to his patients.


Website design and build by GroganShaellDesign