The Bicentennial Eye Clinic at Sydney Eye Hospital

25 Jun 2014

An interview with
Associate Professor Alex Hunyor,
Vitreoretinal Surgeon,
Sydney Eye Hospital.

What is the Bicentennial Eye Clinic all about?

The idea of the clinic came at the time of the Bicentennial of Sydney Hospital in 2011. It was an opportunity for us to create a new space within the Hospital for a couple of highly specialised areas of ophthalmology – the corneal and retinal units.

The Eye Hospital deals with a range of different areas of ophthalmology which have become increasingly specialised in the last 10-20 years. In terms of the number of patients seen, the two busiest subspecialties are cornea and retina. These are also two highly technology-dependent areas of ophthalmology.

The Bicentennial Eye Clinic is a purpose-built facility specifically for those specialties, with brand new ‘state of the art’ equipment. It gives us the ability to do all the consultations, diagnostics and a lot of treatments in that one area. Obviously, there are still things we need to do in the operating theatre but there is a range of treatments which are able to be done in the Clinic.

What will this mean to patients, say compared with the outpatient’s clinic?

It’s part of an overall plan to upgrade the facilities of the Hospital. One of the reasons this is important is that it will allow us to relocate some services from our existing outpatient clinics, and eventually, we’ll be able to progressively refurbish and improve the older outpatients department to the same standard.

For our patients, what it offers is a newer, more comfortable environment for them and one where they can have everything done in one place. Whereas, for example, some of the corneal treatments required that the patient have the procedure done in the operating theatre, now we have the facilities to do them in one of the rooms at the Bicentennial Eye Clinic. The same goes for retinal treatments, particularly the injection clinics.

So with both the Bicentennial Eye Clinic and the main outpatient’s clinic, we are striving to streamline and improve the experience for patients.

There has been a lot of new equipment installed in the new clinic, more than 1 million dollars’ worth…

Yes. The original space was being used for another, non-eye-related purpose and so we redesigned and completely rebuilt the clinic for this purpose. Everything is brand new, including, as you say, over 1 million dollars’ worth of equipment which was generously provided by the Sydney Eye Hospital Foundation.

Are there any ‘stand out’ pieces of equipment that ‘make’ the clinic?

The main features were the purchase of the corneal and retinal diagnostic equipment. They’re the latest technology for diagnosing corneal and retinal problems. We also have an operating microscope and retinal laser machine.

How many doctors work in the clinic?

This clinic initially will have three cornea clinics and four retinal clinics per week, and will also have some other clinics such as injection clinics for macular degeneration. In total there will be at least a dozen doctors working in the clinic. This includes corneal and retinal specialists, as well as trainee fellows and registrars. The corneal and retinal fellows, along with fellows in other subspecialties, are also funded by the Foundation.

How has the Sydney Eye Hospital Foundation made a difference?

The Sydney Eye Hospital Foundation has continued in its tradition of funding major equipment purchases over the past 2 decades. What has happened historically, particularly in the last 10 years, is that the Foundation has allowed the Hospital to remain at the cutting edge of ophthalmology by funding some ‘big ticket’ items of equipment, which have been difficult for the Hospital to afford because they are large single purchases.

There were three contributors in terms of funding of the Bicentennial Eye Clinic. The Sydney Eye Hospital Foundation donated the largest amount of money, $1.2 million, for the clinic’s fit out and all the equipment. Then there was also the Sight for Life Foundation which contributed $200,000 and the remainder of the money came from the Hospital.

Do these new machines have data saving abilities? Will this, in turn, improve admin processes?

All the new equipment inside the Bicentennial Eye Clinic is networked with the area server so all the information we gather from the diagnostic equipment in the clinic is available in the main outpatient’s clinic, and vice versa.

Ultimately the hospital will move to paperless (electronic) medical records, and the data from all the diagnostic equipment will be able to be incorporated into the electronic medical records.

Equipment in the new Bicentennial Eye Clinic

Zeiss Cirrus and Heidelberg Spectralis OCT:

These are the latest model optical coherence tomography scanners for assessment of macular conditions and glaucoma. In addition, the Heidelberg Spectralis has an anterior segment module that permits imaging of the front part of the eye, enabling surgeons to visualise parts of the eye that could not otherwise be seen.

Heidelberg HRA Fundus Imaging:

A retinal imaging system for specialised photography, in particular, autofluorescence imaging and ICG angiography. This gives additional information about the structures at the back of the eye in a wide range of conditions.

Zeiss Cirrus and Heidelberg Spectralis OCT:

These are the latest model optical coherence tomography scanners for assessment of macular conditions and glaucoma. In addition, the Heidelberg Spectralis has an anterior segment module that permits imaging of the front part of the eye, enabling surgeons to visualise parts of the eye that could not otherwise be seen.

Oculus Pentacam:

This is an optical scanner of the corneal surface, enabling surgeons to diagnose keratoconus and other corneal disorders. It is extremely useful to provide care after a patient has undergone corneal transplantation.

Nidek Confoscan:

This is a high-magnification microscope for the live cornea, enabling surgeons to see individual infection-causing microorganisms, and also to assess the health of the deeper layers of the cornea.

Nidek OPD3 Aberrometer:

This instrument measures the finer optical abnormalities of the eye, helping surgeons determine why some patients do not have adequate vision. Leica Operating Microscope: This instrument is used for in-clinic minor corneal procedures, which may avoid sending the patient to the operating theatre.