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Pantheo Eye Center

Ophthalmology Clinic
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Pantheo Eye Center

Because sight is precious!

 

The PANTHEO Eye Center was founded in 2004 and has been operating purely as an eye clinic in Limassol since then. The cornerstone of the philosophy at the PANTHEO is the personalized approach towards the patient by a team of ophthalmologists in different sub specialties and the provision of a legeartis care in simple and complicated ophthalmic cases.

 

It is no coincidence that the PANTHEO is a center of referral cases from all over Cyprus. The team of PANTHEO has as its goal the best possible provision of high-quality and integrated services covering the entire spectrum of eye diseases at the level of that equivalent of the major European ophthalmological centers.

Outpatient Department

Our outpatient department is open on a daily basis. Appointments for examinations are available both on a pre-arranged basis and on an emergency basis. On arrival to our clinic you will be escorted from reception by a trained nurse for a pre assessment and detailed history of your problem. A basic ophthalmologic examination involves visual acuity test, intraocular pressure, refraction and fundoscopy. All necessary tests will then be performed in preparation for your medical consultation.

 

Operating Department

PANTHEO Eye Center operating theatre is equipped with state of the art technology. Focused solely on eye treatment and eye surgery for Cyprus, our Operating Department is made of three operating theatres. The procedures performed range across both fields of anterior and posterior segment surgery, covering numerous cases in the districts of Limassol, Paphos, Larnaca and Nicosia.

 

Refractive Surgery

Laser vision correction is an alternative to glasses and contact lenses. The concept behind laser vision correction is simple – to reshape the cornea (the front of the eye) in order to change its focusing power. The technology used is of the latest generation of femtosecond and excimer laser platforms known as Visumax (Zeiss) and Alegretto (WaveLight) and the procedures performed are listed as follows: PRK, LASEK, LASIK (Custom-LASIK, Femto-LASIK, Wavefront Optimised, Wavefront-Quided, Oculink-Topography Customised). There are many benefits to this method, such as the recovery is quick and associated with little pain, vision is corrected almost immediately and adjustments can be made quite readily if required.

 

Corneal and Anterior Segment Surgery

Keratoplasty, a corneal transplantation, is a procedure that takes place when a damaged cornea is replaced by a donor graft. The reasons for undergoing a corneal transplantation may vary, such as an injury or an infection that may have caused corneal scarring; corneal ulcers; keratoconus-a medical condition that makes your cornea bulge out; thinning; clouding or swelling of the cornea; inherited eye diseases such as Fuchs’ dystrophy and others or problems caused by an earlier eye operation.

 

There are three methods of keratoplasty. There is PKP (Penetrating Keratoplasty) where the entire cornea is replaced, DALK (Deep Anterior Lamellar Keratoplasty) where the anterior part of the cornea is replaced and lastly, DSAEK (Descemet’s Stripping Automated Keratoplasty) where the posterior part of the cornea is replaced.

 

Cataract Surgery

A cataract is a clouding of the eye’s natural lens. The only treatment currently available for cataracts that are impacting visions is that of Cataract Surgery or Intra-Ocular Lens (IOL) impantation. The technology used is the femtosecond laser (LenSx-Alcon) and phacoemulsification (Centurion-Alcon) employing minimally invasive small incision techniques. The procedures performed are FALCS (femtosecond-assisted laser cataract surgery), Small Incision Phacoemulsification and Scleral Fixation of IOLs. These methods will allow you to see more clearly again and also reduce your dependency on glasses.

 

Glaucoma Surgery

YAG Laser Iridotomy: in cases of narrow angles and angle closure glaucoma.

MDLT (Micropulse Diode Laser Trabeculoplasty): this laser aims to reduce the intraocular pressure by stimulating the trabeculum (the drainage channel of the eye) to drain more fluid. It has the advantage of the micropulse technique which causes minimal tissue damage.

 

Laser Peripheral Iridoplasty: in cases of plateau iris syndrome when the YAG laser iridotomy is not sufficient to open the drainage angle.

Diode Laser Cyclophotocoagulation: frequently used laser which reduces the production of the fluid circulating in the eye and hence reducing the intraocular pressure.

 

Trabeculectomy: the most commonly performed glaucoma surgery worldwide. The object of this operation is to open a new drainage channel for the fluid of the eye to drain so that the intraocular pressure is controlled

Ahmed Glaucoma Valve: an artificial tube is inserted in the eye to drain the fluid, but it also has a valved mechanism to avoid excessive drainage.

 

Vitreoretinal Surgery

Vitreoretinal Surgery is used for the treatment of conditions behind the lense of the eye, such as the macula, vitreous fluid and the retina. This is called Posterior Segment Surgery or Vitrectomy and it includes Vitrectomy for Trauma; Retinal Detachment Repair; Diabetic Tractional Detachment Repair; Macular Hole Surgery and Epiretinal Membrane Peeling. These are standard procedures performed on a very frequent basis and the most standard routine is the Small Incision Sutureless Vitrectomy.

 

Anti-VEGF Therapy (Intravitreal Injections of Lucentis, Eylea and Avastin) is used for Wet Macular Degeneration and Diabetic Retinopathy as a host of other more rare disorders of the retina.

 

Paediatric and Strabismus Surgery

Eye surgery in children is unique in many ways and requires specialisation. Treatment of Retinopathy of Prematurity (ROP), Amblyopia Screening and Squint Surgery including Adjustable Strabismus Surgery are all part of our Paediatric Teams routine and are usually performed under general anaesthesia.


Oculoplastic Surgery

Management of both cosmetic and functional abnormalities which affect the eyelids, eyebrows, orbital tissues, and tear drainage system.

 

The Oculoplastic Surgeons at the Eye Centre combine in-depth knowledge of the eye with expertise in reconstructive surgery to treat a broad range of conditions such as drooping eyelids (Ptosis), turning out of the eyelids (Ectropion), in-turning of the eyelids (Entropion), misdirection of eyelashes (Trichiasis), excessive eyelid skin, wrinkles, eye muscle spasms (BOTOX Injections) and eyelid injuries.

 

Surgery to the tear drainage system (Dacrocystorhinostomy or DCR for short) is a commonly performed procedure to relieve the symptoms of constant or excessive tearing (otherwise known as Epiphora) and recurrent tear sack infections.

 

Optometry and Contact Lens Fitting

Our optometry department is staffed by an experienced UK trained optometrist. Apart from routine adult refractions, paediatric refractive work is performed and there are pre arranged specialist refractive days dealing with difficult contact lens management problems including keratoconus contact lens fitting.

 

Orthoptic Department

Orthoptics concerns the investigation, diagnosis and treatment of: eye movements; binocular vision defects and problems relating to vision. It includes visual screening and the assessment of babies, small children and children with special needs. Early detection and intervention of strabismus (squint) and amblyopia (lazy eye) is crucial for a good prognosis. Treatment can also be provided to adults with double vision associated with conditions including: Diabetes, Thyroid disease, and neurological disorders such as Multiple sclerosis.

 

Ocular Prosthetic

The Ocular Prosthetic Department provides custom made ocular prostheses, cosmetic scleral shells and facial prostheses to patients who have undergone enucleation or evisceration and to patients with microphthalmia or anophthalmia. Also to patients who have suffered trauma, congenital deformity, or have undergone reconstructive or corrective surgery for malignancy or disease. An impression procedure is carried out to obtain an accurate model of the socket. A wax model of the impression is made and sculptured to obtain optimum contour, eyelid closure, mobility and comfort. The artwork of the iris is hand painted by the Ocularist. The patient is fitted and a full instruction is given on how to remove, refit and care for the ocular prostheses. In the laboratory procedures, the materials used are the most recent medical Polymethylmethylacrylate/ P.M.M.A.

 

Electrodiagnostics

Electrodiagnosis is a method of obtaining information about diseases by recording the electrical activity of eye in response to visual stimulation. The electrical activity is recorded painlessly by attaching sticky electrodes to the skin around the eye. The information is used to accurately diagnose a number of eye conditions and monitor their progress. Our EDTs department provides a full range of tests including VEP, ERG, EOG.

 

DIAGNOSTIC SERVICES

 

  1. Visual acuity check (Snellen, EDTRS)
  2. Refraction (prescription of glasses for distant and near vision)
  3. Tonometry (measurement of intraocular pressure)
  4. Slit lamp examination
  5. Ophthalmoscopy
  6. Contact Lenses fitting for refractive errors and Keratoconus
  7. Orthokeratology
  8. Orthoptic assessment in adults and children
  9. Retinoscopy
  10. Contrast sensitivity test
  11. Endotheliometry (Topcon)
  12. Pachymetry
  13. Biometry –IOL master
  14. Ultrasound (A-scan, B-scan)
  15. Ultrasound Biomicroscopy – UBM (Aviso)
  16. Corneal topography and tomography (Allegro topolyzer)
  17. Eye wavefront analysis (Zywave analyzer)
  18. Visual fields (Humphrey Field Analyzer)
  19. OCT disc and macula (Cirrus-Zeiss)
  20. OCTA-OCT Angiography (Spectralis HRA+OCT imaging platform-Heidelberg Engineering)
  21. Wide field fluorescein angiography (Spectralis HRA, Heidelberg Engineering)
  22. Electrodiagnostics – EDTs (ERG, EOG, VEP) - For more details click here

 

PROCEDURES OFFERED

 

  1. Femtosecond laser assisted cataract surgery –FLACS (LenSx-ALCON)
  2. Phacoemulsification (Centurion Vision System – ALCON)
  3. Vitrectomy- macula hole surgery, Epiretinal membrane peeling
  4. Retinal detachment repair with and without Vitrectomy
  5. Anti-VEGF injections –AVASTIN, LUCENTIS, EYLEA
  6. Femtosecond LASIK (visumax-ZEISS)
  7. Cornea Refractive Surgery –PRK, LASIK (Alegretto WAVELIGHT)
  8. Conreal Cross Linking for keratoconus (PESCHKE-Platinum PXL)
  9. Pterygium and limball transplantation surgery
  10. Corneal transplantation Full thickness transplantation (PKP) and partial thickness transplantation (DESAEK,DEAMEK)
  11. Amniotic Membrane Transplantation
  12. Trabeculectomy
  13. Cyclodiode laser ablation
  14. Ahmed glaucoma valve implant
  15. Lid surgery
  16. Dacryocystorhinostomy –DCR
  17. Other Oculoplastic surgeries
  18. Retinal Photocoagulation (PASCAL Laser system)
  19. YAG-Laser system (ZEISS) - For more details click here
The doctors have put together some information for your reference:

 

What is a cataract and how is it removed.

 

The eye is like a camera.  When you take a picture, the lens in the front of the camera allows light through and focuses that light on the film that covers the back inside wall of the camera.  When the light hits the film, a picture is taken. The eye works in much the same way. The front parts of the eye (the cornea, pupil, and lens) are clear and allow light to pass through.   The light is focused by the cornea and the lens onto a thin layer of tissue called the retina, which covers the back inside wall of the eye. The retina is like the film in a camera.  It is the seeing tissue of the eye.  When the focused light hits the retina, a picture is taken.  Messages about this picture are sent to the brain through the optic nerve.  This is how we see. When the lens of the eye becomes cloudy or opaque it no longer allows light to enter the eye and the vision deteriorates.  An opaque or cloudy lens is called a cataract.  This is what needs to be removed and replaced in order to restore vision.

 

Instructions for Cataract surgery under local anaesthetic.

 

Your cataract will be removed completely painless using the technology of laser (FLACS-Femtosecond Laser Assisted Cataract Surgery with use of LenSx-ALCON) and ultrasound (Phacoemulsification with Centurion-ALCON) to liquefy and aspirate the cataract.  A foldable lens implant is then inserted into the eye and usually sutures are not required.

 

You will be able to go home immediately after the operation is completed. It is very important therefore to follow your postoperative instructions carefully.

 

  • On the day of surgery have a light breakfast and if you have been prescribed drops to use prior to surgery do so as instructed.

 

  • You can come dressed in your normal clothing. There is no need to bring any nightclothes with you.  You will be taken to the operating theatre by the nursing staff when its time for your surgery, this is usually between 1 to 3 hours after your arrival depending on the preparation time necessary and how busy the theatre timetable is on that day.

 

  • In the operating theatre you will receive some local anaesthetic drops 15 to 20 minutes before your surgery. Usually an injectable local anaesthetic is not necessary, if it is this will be explained to you.  During the operation you will be wide-awake and you will be able to hear everything but you will not see or feel any part of the operation.  You will be able to talk to the surgeon at any time and tell him if you have a problem.  At the end of the procedure your eye will be closed with an eye pad and you will go home.

 

  • During your first evening after the surgery feel free to do as you please as long as you keep your eye pad dry and intact. If you develop a headache you can take your normal pain relief that you would use at any other time.

 

  • The following day you will need to attend for a post operative visit as instructed and have your eye pad removed. Your eye will remain open from then on.  You will have good vision from day one but will continue to improve for about one month.  You will then be examined again and told if you need to go to your optician for new glasses.

 

  • Refractive surgery Refractive surgery is the operation using laser technology (excimer laser) to change the refractive status of the eye. It has become one of the most popular procedures in medicine and since 1983 over 20 million such procedures have been performed worldwide.
  • What are the benefits? - Reduce or eliminate dependence on glasses, improve appearance and give the ability to play sports unhindered
  • Is the procedure effective and permanent? - One year after treatment over 95% of people with low to moderate prescriptions are able to pass a driver’s license vision test without corrective lenses.
  • How the excimer laser works? - It uses a cool ultraviolet beam to precisely remove (ablate) very tiny bits of tissue from the surface of the cornea in order to reshape it. When you reshape the cornea in the right way it focuses light into the eye and onto the retina, providing clearer vision than before.

 

The Eye, retina and retinal detachement explained HOW THE EYE WORKS
Before we talk about what can go wrong, it is important to understand how the eye works when it is working properly. The eye is like a camera.  When you take a picture, the lens in the front of the camera allows light through and focuses that light on the film that covers the back inside wall of the camera.  When the light hits the film, a picture is taken.

 

The eye works in much the same way.  The front parts of the eye (the cornea, pupil, and lens) are clear and allow light to pass through.  The light also passes through the large space in the centre of the eye called the vitreous cavity.  The vitreous cavity is filled with a clear, jelly-like substance called the vitreous or vitreous gel.  The light is focused by the cornea and the lens onto a thin layer of tissue called the retina, which covers the back inside wall of the eye.  The retina is like the film in a camera.  It is the seeing tissue of the eye.  When the focused light hits the retina, a picture is taken.  Messages about this picture are sent to the brain through the optic nerve.  This is how we see.

 

The retina has two parts:  the peripheral retina and the macula.  If you imagine the retina as a circle with a bull’s-eye at the center, the macula is like the bull’s-eye, it is very small.  The large area of the retina that surrounds the macula and makes up 95% of the retina is called the peripheral retina. The peripheral retina gives us vision to the side, called ‘peripheral’ vision.  It is this part of the retina that is at work when we see something out of the corner of the eye.  Because the peripheral retina is not able to see detail clearly, we cannot use the peripheral vision to read, thread a needle, drive, or even recognize a face.  If you see someone off to your side, ‘out of the corner of your eye’ you may be able to tell who it is because you recognize the person’s general shape, but you won’t be able to see the expression of the person’s face.

 

In order to see fine detail, you must look straight ahead, using the macula, the ‘bull’s-eye’ center of the retina.  Even though the macula makes up only a small part of the retina, it is one hundred times more sensitive to detail then the peripheral retina.  The macula allows you to see tiny detail, read fine print, recognize faces, thread a needle, read the time, see street signs, and drive a car.

 

What is retinal detachment?

Retinal detachments often develop in eyes with retinas weakened by a hole or tear. This allows fluid to seep underneath, weakening the attachment so that the retina becomes detached – rather like wallpaper peeling off a damp wall. When detached, the retina cannot compose a clear picture from the incoming rays and vision becomes blurred and dim.

 

Retinal Surgery, Important Information and Recovery Visual recovery.

 

The degree of visual recovery depends on the extent of the detachment and its duration.
  • In general a good proportion of the vision lost will be recovered.
  • The vision does not fully recover to its original pre detachment level
  • The vision would be totally lost unless surgery is performed

 

Post-operative medication

 

You will be given instructions for the use of drops on your first post-operative day.  You must use your drops regularly and do not stop them unless you are asked to do so.  If you run out buy a new bottle from the chemist.

 


Cleaning instructions
You must clean you eye for the first ten days using sterilised water only.  You can either purchase this from the chemist or boil water and allow it to cool.   You must not wet your eye using tap water or shower water.

 


Dos and don’ts
If gas has been used in your eye you must not go in an aeroplane and avoid high altitude until it has dissolved.  Ask your surgeon before you fly.

 


From day one after the surgery you can:
  • eat and drink what you like
  • read and watch television as much as you like
  • return to normal activities as long as you keep your eye clean
  • use your old glasses if you find these helpful. If not then don’t use any glasses at all
  • wear dark glasses if you want to and if they make you feel more comfortable but they are not necessary

 

For 15 days you must NOT:

  • lift weights greater than 20Kg
  • get shower water or tap water into your eye
  • go swimming
  • get dirt or dust into your eye

 

It is normal to feel mild discomfort and have mild swelling around your eye for the first few days.

 


Call the doctor and inform him if:
  • you have severe pain
  • your eye becomes very swollen
  • your vision is deteriorating rather than improving
Questions and answers about retinal detachment:

 


Who is at risk of retinal detachment?
Detachment of the retina is more frequent in middle aged, short sighted people. However, it is quite uncommon and only about one person in ten thousand is affected. It is rare in young adults.

 


What are the symptoms?
The most common symptom is a shadow spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark spots called floaters. These symptoms are never painful. Many people experience flashes or floaters and these are not necessarily a cause for alarm. However, if they are getting severe and seem to be getting worse and you are losing vision, then you should seek medical advice. Prompt treatment can often minimise the damage to your eye.

 


What is the treatment?
If you get help early, it may only be necessary to have laser or freezing treatment. This is usually performed under a local anaesthetic. Frequently, however, an operation will be needed to repair a hole or put the retina back in place. This is usually done under a general anaesthetic. In 90 – 95 per cent of cases the retina can be repaired with a single operation. The operation does not usually cause much pain, but your eye will be sore and swollen for a few days afterwards. Typically, you will be hospital for a few hours or an overnight stay, depending on your particular condition. We want to reassure you that the surgeon does not take your eye out of its socket to operate on it.

 


How much vision can I expect after a successful operation?
This depends on how much the retina has detached and for how long. The shadow caused by the detachment will usually disappear when the retina has been put back in place. If your ability to see fine detail has been damaged before the operation, this may not fully recover afterwards.

 


What happens after the operation?
You will be encouraged to get up and carry on as usual on the day after the operation, although sometimes you will be asked to keep your head in a particular position to help the healing process. Your eye specialist will prescribe eye drops and you will need to use these for a few weeks.

 


What happens if the detached retina is not put back in place?
Most people will loose all useful vision if no operation is carried out, or if the treatment is unsuccessful.  However, further treatment is usually possible if it does not succeed the first time. Occasionally, if the detachment involves the lower portion of the retina, some vision may recover by itself.

 


Can retinal detachment be prevented?
If your family has a history of retinal detachment, or your doctor finds a weakness in your retina, then preventive laser or freezing treatment may be needed. However, in most cases it is not possible to take preventive action. Retinal detachment does not happen as a result of straining your eyes, bending or heavy lifting.

 


What about my other eye?
If you have had a retinal detachment in one eye, you are at an increased risk of developing one in the other eye. But there is only about a one in ten chance of this happening.

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