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Ophthalmology | Counties Manukau

Public Service, Ophthalmology

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Manukau SuperClinic™

Description

What is Ophthalmology?
Ophthalmology is the branch of specialist medicine that is focused on the health of eyes and their surrounding tissues, including muscles, bones, eyelids, and tear production/drainage systems. Your eye is the organ of vision and consists of the cornea (the outer clear layer), the sclera (the white of the eye), the iris (the coloured part), the lens (lies behind the iris) and the retina (the light-sensitive lining at the back of the eye). Your eyes ‘see’ by focusing light that enters the eye onto the retina which sends the image to the brain by the optic nerve.

Ophthalmologists
are doctors who are trained in the study of eyes. Most will be trained in eye surgery, and may have particular areas of interest or expertise.
 
Optometrists are university trained professionals who diagnose eye disease, assess visual function, and prescribe spectacles and contact lenses as appropriate. Optometrists with TPA (therapeutic) endorsement may also prescribe a range of topical medicines (drops and ointment) for use in the eye.
Current Optometrists are:
  • Vicky Wang
  • Rebecca Findlay
  • Debra So
  • Deepa Kumar
  • Vandana Kumar
  • Sandhya Mathews

Orthoptists are specially trained Allied Health professionals who work closely with ophthalmologists and optometrists. Orthoptists examine, diagnose and manage conditions related to eye movement problems and defects with how the eyes work together as a pair (binocular vision). As a result, they assess a large variety of disorders and patients of all ages from neonates to the elderly. They are experts in investigating any abnormal eye movements (ocular motility disorders), misalignment of the eyes (strabismus/squint), reduced vision during childhood visual development (amblyopia) and double vision (diplopia). 

Current orthoptists are:

  • Miriam Langeslag-Smith
  • Grace Yung

Consultants

Ages

Child / Tamariki, Youth / Rangatahi, Adult / Pakeke, Older adult / Kaumātua

How do I access this service?

Referral

Referrals to the service are received from:

  • GPs
  • Optometist
  • Plunket
  • B4 Schools Screening Programme
  • ADHB following acute assessment
  • Private ophthalmologists
  • Internal referrals
  • Other DHBs

Referral Expectations

The preferred method of referrals is by e-referral

Fees and Charges Description

There are no charges for services to public patients if you are lawfully in New Zealand and meet one of the Eligibility Directions specified criteria set by the Ministry of Health.  If you do not meet the criteria, you will be required to pay for the full costs of any medical treatment you receive during your stay.

To check whether you meet the specified eligibility criteria, visit the Ministry of Health website.

For any applicable charges, please phone the Accounts Receivable Office on (09) 276 0060.

Hours

Manukau SuperClinic™

Mon – Fri 8:00 AM – 4:30 PM

Common Conditions / Procedures / Treatments

Cataracts

Cataracts are the most common age-related occurrence in eyes. The lens becomes thicker and stiffer and appears yellow and cloudy. Eventually it may turn white, changing the colour of the pupil. A cataract may cause your vision to become fuzzy in a progressive fashion and may also be the cause of disabling glare. Once a cataract affects vision too much, a cataract removal operation is generally advised. This decision is usually made in consultation with an eye specialist. The operation is almost always done under local anaesthetic. Once the cataract has been removed an artificial lens is put in to replace it. It is relatively short in duration and an overnight stay in hospital is not required. Post-operative care consists of eye drops and a check at 1-2 days then after 2-4 weeks.

Cataracts are the most common age-related occurrence in eyes. The lens becomes thicker and stiffer and appears yellow and cloudy. Eventually it may turn white, changing the colour of the pupil. A cataract may cause your vision to become fuzzy in a progressive fashion and may also be the cause of disabling glare.
Once a cataract affects vision too much, a cataract removal operation is generally advised.  This decision is usually made in consultation with an eye specialist. The operation is almost always done under local anaesthetic. Once the cataract has been removed an artificial lens is put in to replace it. It is relatively short in duration and an overnight stay in hospital is not required.  Post-operative care consists of eye drops and a check at 1-2 days then after 2-4 weeks.
Diabetic Retinopathy

This is a complication of diabetes and is caused by small blood vessel damage within the retina of the eye. It commonly affects both eyes and may cause permanent loss of vision. Macular oedema is sometimes also present with diabetic retinopathy. Macular oedema is when fluid leaks into the retina and causes swelling and blurred vision. This may occur at any stage of diabetic retinopathy, but is more common as the disease progresses. There are often no symptoms in the early stages but as the condition progresses vision may begin to become impaired. Often visual loss may be sudden and without warning. This is why it is imperative that at-risk diabetics have frequent eye checks. Poorly controlled diabetes and pregnancy in diabetes are risk factors for developing this condition. Often, first-stage diabetic retinopathy requires no active treatment on the eye but requires stabilisation of diabetes and regular eye examinations. With progressive retinopathy, a laser treatment called the PRP laser can be used. This works by shrinking enlarged blood vessels to prevent further bleeding into the retina. Severe bleeding may require a surgical procedure called a vitrectomy, where blood is surgically removed from the eye. Treatment of macular oedema, if present, is by focal laser and/or intra-ocular injection. Vision is stabilised by reducing the degree of fluid leakage into the retina. Often more than one treatment is required. Diabetes Retinal Screening Programme (DRS) We offer free retinal screening for people with diabetes that reside in the Counties Manukau region. How Can I Get My Free Retinal Photo-Screen Examination? Ask for information about diabetes care from practitioners such as your GP, nurse, midwife, optometrists, ophthalmologists, diabetes specialists or diabetic screening and monitoring services available in your area. Your GP/Practice Nurse can arrange a referral to the diabetic screening and monitoring services in your area. Health Professionals: If you would like retinal screening information pamphlets, please click on the links below: CMH Retinal Screening Single page.pdf.pdf.pdf.pdf (PDF, 900.9 KB) CMH Retinal Screening Trifold.pdf.pdf.pdf.pdf (PDF, 975.9 KB)

This is a complication of diabetes and is caused by small blood vessel damage within the retina of the eye.  It commonly affects both eyes and may cause permanent loss of vision.  Macular oedema is sometimes also present with diabetic retinopathy.  Macular oedema is when fluid leaks into the retina and causes swelling and blurred vision.  This may occur at any stage of diabetic retinopathy, but is more common as the disease progresses. There are often no symptoms in the early stages but as the condition progresses vision may begin to become impaired.  Often visual loss may be sudden and without warning. This is why it is imperative that at-risk diabetics have frequent eye checks. Poorly controlled diabetes and pregnancy in diabetes are risk factors for developing this condition.
Often, first-stage diabetic retinopathy requires no active treatment on the eye but requires stabilisation of diabetes and regular eye examinations. With progressive retinopathy, a laser treatment called the PRP laser can be used. This works by shrinking enlarged blood vessels to prevent further bleeding into the retina. Severe bleeding may require a surgical procedure called a vitrectomy, where blood is surgically removed from the eye.

Treatment of macular oedema, if present, is by focal laser and/or intra-ocular injection. Vision is stabilised by reducing the degree of fluid leakage into the retina.  Often more than one treatment is required.

Diabetes Retinal Screening Programme (DRS) 
We offer free retinal screening for people with diabetes that reside in the Counties Manukau region. 

How Can I Get My Free Retinal Photo-Screen Examination? 
Ask for information about diabetes care from practitioners such as your GP, nurse, midwife, optometrists, ophthalmologists, diabetes specialists or diabetic screening and monitoring services available in your area. 
  • Your GP/Practice Nurse can arrange a referral to the diabetic screening and monitoring services in your area.


Health Professionals:

If you would like retinal screening information pamphlets, please click on the links below:

Glaucoma

Glaucoma is a group of diseases that can damage the eye’s optic nerve and may result in vision loss and blindness. Multiple factors are often important in causing glaucoma, but it is most commonly related to in an increase in pressure in the eye. Symptoms are generally absent until the condition has progressed to an advanced stage. Very occasionally, a rarer form of glaucoma can develop suddenly and symptoms may then include: headaches and aches around the affected eye, seeing halos around lights, sensitivity to light, blurred vision, nausea and vomiting. You may be more likely to develop glaucoma if you: have someone else in your family with glaucoma already have high pressure in your eye have experienced injury to your eye have or have had certain other eye problems have migraine or circulation problems. Glaucoma is more common in people over 50 years of age and more common in women than men. Diagnosis usually comes after consultation with an eye doctor. Signs of glaucoma may also be picked up at an optometrist’s eye examination. The following tests are used to diagnose and monitor glaucoma: Tonometry – measures eye pressure. It is often the first screening test for glaucoma. The eyes are numbed with eye drops and then examined. Dilated eye exam - this is done with an ophthalmoscope (which is a medical instrument that allows the doctor to look through the pupil to the back of the eye).The retina and optic nerve are then examined for any sign of damage. Visual acuity test – test to check distance vision using an eye chart. Visual field test – test to measure side (peripheral) vision. Pachymetry – test to measure the thickness of the cornea. Many other new techniques are emerging to help identify the likelihood of glaucoma and help determine its rate of worsening. Although glaucoma cannot be cured, early treatment can prevent further worsening of the condition and vision loss. Regular eye examinations will need to be continued life-long. Eye drops to decrease eye pressure are the most common early treatment. Surgery may be required, especially if medications are not taking adequate effect. Laser trabeculoplasty, in which a surgeon uses a laser to help the fluid drain from the eye, may be considered in some cases, but has limited effectiveness. More commonly, a trabeculectomy may be performed when other methods have failed to adequately control pressure. This is a medium length operation that makes a new opening for fluid to drain from the eye. For more information, visit the Glaucoma New Zealand website.

Glaucoma is a group of diseases that can damage the eye’s optic nerve and may result in vision loss and blindness. Multiple factors are often important in causing glaucoma, but it is most commonly related to in an increase in pressure in the eye.

Symptoms are generally absent until the condition has progressed to an advanced stage.  Very occasionally, a rarer form of glaucoma can develop suddenly and symptoms may then include: headaches and aches around the affected eye, seeing halos around lights, sensitivity to light, blurred vision, nausea and vomiting.
 
You may be more likely to develop glaucoma if you:
  • have someone else in your family with glaucoma
  • already have high pressure in your eye
  • have experienced injury to your eye
  • have or have had certain other eye problems
  • have migraine or circulation problems.
 
Glaucoma is more common in people over 50 years of age and more common in women than men. Diagnosis usually comes after consultation with an eye doctor. Signs of glaucoma may also be picked up at an optometrist’s eye examination.
 
The following tests are used to diagnose and monitor glaucoma:
  • Tonometry – measures eye pressure.  It is often the first screening test for glaucoma. The eyes are numbed with eye drops and then examined. 
  • Dilated eye exam - this is done with an ophthalmoscope (which is a medical instrument that allows the doctor to look through the pupil to the back of the eye).The retina and optic nerve are then examined for any sign of damage. 
  • Visual acuity test – test to check distance vision using an eye chart.
  • Visual field test – test to measure side (peripheral) vision. 
  • Pachymetry – test to measure the thickness of the cornea.
 
Many other new techniques are emerging to help identify the likelihood of glaucoma and help determine its rate of worsening. Although glaucoma cannot be cured, early treatment can prevent further worsening of the condition and vision loss. Regular eye examinations will need to be continued life-long. 
 
Eye drops to decrease eye pressure are the most common early treatment.  Surgery may be required, especially if medications are not taking adequate effect. Laser trabeculoplasty, in which a surgeon uses a laser to help the fluid drain from the eye, may be considered in some cases, but has limited effectiveness.  More commonly, a trabeculectomy may be performed when other methods have failed to adequately control pressure. This is a medium length operation that makes a new opening for fluid to drain from the eye.

For more information, visit the Glaucoma New Zealand website.
Refractive Error: short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism

These conditions cause distance blur. In myopia, the eye has a resting focus at a near distance so that people will be able to see objects clearly at some point close to them, whilst the distance is blurry. Hyperopia also causes distance blur but often does not become noticeable until the eye loses its ability to change focus, frequently in middle age. The loss of focus for near distance (presbyopia or “aged sight”) is also related to a decreased ability to change focus but only affects reading. Astigmatism causes an image to be blurry at all distances, but does not affect clarity of images unless it is severe. An optometrist or ophthalmologist can test for these conditions. Treatment is usually glasses or contact lenses which are only obtainable through an optometrist or dispensing optician. Laser surgery and other corrective surgical techniques can also be used to change the focus of the eye to give clarity of sight in suitable patients.

These conditions cause distance blur. In myopia, the eye has a resting focus at a near distance so that people will be able to see objects clearly at some point close to them, whilst the distance is blurry. Hyperopia also causes distance blur but often does not become noticeable until the eye loses its ability to change focus, frequently in middle age. The loss of focus for near distance (presbyopia or “aged sight”) is also related to a decreased ability to change focus but only affects reading. Astigmatism causes an image to be blurry at all distances, but does not affect clarity of images unless it is severe.

An optometrist or ophthalmologist can test for these conditions. Treatment is usually glasses or contact lenses which are only obtainable through an optometrist or dispensing optician. Laser surgery and other corrective surgical techniques can also be used to change the focus of the eye to give clarity of sight in suitable patients.

Retinal Detachment

This is when the retina detaches, meaning it is lifted or separated from its normal position within the eye. An acute retinal detachment requires urgent assessment and appropriate treatment. Unless prompt and effective treatment is given, some forms of retinal detachment may lead to irreversible blindness. Signs and symptoms include: a sudden or gradual increase in floaters, deterioration in vision, cobwebs or specks with the visual field, light flashes in the eye or the appearance of curtains over the visual field. You are more likely to have a retinal detachment if you are very short-sighted or have had an injury or previous surgery to the eye. For minor detachments, a laser or freeze treatment (cryopexy) are used. Both therapies re-attach the retina. For major detachment, surgery will be necessary. A band is often put around the back of the eye to prevent further detachment. Surgical treatment is usually a vitrectomy, where the jelly (vitreous) is removed from the eye. This often involves a hospital stay. It can take several months post-surgery to see the final visual result.

This is when the retina detaches, meaning it is lifted or separated from its normal position within the eye. An acute retinal detachment requires urgent assessment and appropriate treatment. Unless prompt and effective treatment is given, some forms of retinal detachment may lead to irreversible blindness.
Signs and symptoms include: a sudden or gradual increase in floaters, deterioration in vision, cobwebs or specks with the visual field, light flashes in the eye or the appearance of curtains over the visual field. You are more likely to have a retinal detachment if you are very short-sighted or have had an injury or previous surgery to the eye.
For minor detachments, a laser or freeze treatment (cryopexy) are used.  Both therapies re-attach the retina. For major detachment, surgery will be necessary. A band is often put around the back of the eye to prevent further detachment.  Surgical treatment is usually a vitrectomy, where the jelly (vitreous) is removed from the eye. This often involves a hospital stay.  It can take several months post-surgery to see the final visual result.
Squints (strabismus)

A weakness in one or more of the muscles of the eye will cause the eye to turn or move away from the normal focusing position. This is commonly known as a squint. A squint can be corrected by surgery, or by using glasses. Rarely, children may grow out of a squint. Surgical correction of squint usually involves a general anaesthetic. In the procedure, the muscles involved are repositioned to correct the alignment. It is important to recognise and treat a squint as, if left uncorrected, it can result in permanent impairment of vision.

A weakness in one or more of the muscles of the eye will cause the eye to turn or move away from the normal focusing position.  This is commonly known as a squint. A squint can be corrected by surgery, or by using glasses.  Rarely, children may grow out of a squint. Surgical correction of squint usually involves a general anaesthetic. In the procedure, the muscles involved are repositioned to correct the alignment.  It is important to recognise and treat a squint as, if left uncorrected, it can result in permanent impairment of vision.

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Manukau SuperClinic™

South Auckland

901 Great South Road
Wiri
Auckland 2104

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Street Address

901 Great South Road
Wiri
Auckland 2104

Postal Address

Private Bag 93311
Ōtāhuhu

This page was last updated at 2:39PM on November 22, 2023. This information is reviewed and edited by Ophthalmology | Counties Manukau.