n The Teaching Hospitals NHS Trust

Leeds Teaching Hospitals Eye Clinic Intra-vitreal Injections at the Macular Treatment Centre

Information for patients A number of retinal diseases are currently treated by injection of a drug into the vitreous gel in the middle of the eye. Most commonly, this approach is used to treat “wet” age-related macular degeneration and swelling of the retina (macular oedema) due to diabetes damage and blocked blood vessels. The eye department carries out several thousand of these injections each year. This booklet will give you some more information so that you know what to expect before, during and after your injection treatment.

How to find us The Macular Treatment Centre is currently located in the Eye Clinic on W Ward at Hospital. The address for the hospital is York Road, Leeds, LS14 6UH. The Eye Clinic is at the back of the hospital as you enter from York Road. You can get to the eye clinic either through the Main Entrance, following the signs along the corridor, or the back of the clinic where there is a drop-off zone (see the map on page 12). 2 • Arriving by bus Metro provides the following bus services to Seacroft Hospital: 56, 64, 64A, 166, 402, 405, 770, 840, 843, 845. For more bus timetable information, please telephone: 0113 245 7676.

• Arriving by car Parking for patients and visitors is available in the main car park located by the entrance to the hospital. There is also an overflow car park at the back of the hospital serving the RMU, Renal and Prosthetics, Orthotics and Wheelchairs Departments. Payment for parking is by pay and display.

Although most of the injections are given in the Macular Treatment Centre at Seacroft Hospital, there are additional injection clinics at St James’s University Hospital and Wharfedale Hospital, Otley. Please check your appointment letter carefully for the correct location. Please see the maps on pages 13 and 14 for directions if you need to attend these locations. 3 Your clinic visit Each visit to the eye clinic for an injection will comprise several different steps. Although, every effort will be made to complete the assessment and the injection as quickly as possible, you should allow two hours for your clinic visit. Please register at the eye clinic reception when you arrive. You will then be directed to a nurse to check your vision and use drops to enlarge your pupils so that the back of the eye can be examined. The drops often make your vision blurred and your eyes can be more sensitive to bright light for a few hours. You might want to bring some dark glasses for the journey home. While the drops are working, a photographer will take a scan of the back of your eyes. A doctor or another specialist practitioner will then examine your eyes. The results of this examination, the eye scan and the vision test will be used to plan your treatment.

4 Before an injection is given, you will be asked to confirm your identity and the eye that is being treated. Anaesthetic and antiseptic drops will be put into the eye to help make the injection as painless and safe as possible. A spring device is used to help keep the eye open and the injection itself is given through the white of the eye (sclera) into the vitreous gel.

You may feel some discomfort but this does not usually last long. You are normally ready to go home a few minutes after the injection has been given.

5 Follow-up Most of the drugs need to be given regularly in order to be most effective. This might be as often as every month or as little as once a year or more. Your doctor or specialist should be able to tell you all of your treatment options. The most commonly used drugs are given as an initial course of three injections at monthly intervals, followed either by treatment every two months or as often as is necessary. With regular treatment, the majority of patients can expect to keep fairly stable vision. Some may also experience an improvement in their vision. The amount of improvement often depends on the condition that is being treated and the level of vision at the start of treatment. If there has been a poor response to treatment or the sight continues to deteriorate despite treatment, your doctor or specialist may decide that further treatment is not appropriate.

6 Are there any side-effects? Injections into the eye are very safe procedures but there are possible side-effects with any treatment. Common side-effects include discomfort or mild pain during and after the injection, a gritty feeling as if there is something in the eye and blurred vision. These usually settle within a day or two. Other common side-effects include bubbles of air in the eye, floaters and bruising of the white of the eye. Rare but more serious side-effects include:

• An infection inside the eye (endophthalmitis)

• Increased pressure in the eye

• Bleeding inside the eye

• Detached retina

• Cataract

• Inflammation inside the eye

• A rip or tear of the pigmented layer inside the eye. 7 Certain drugs are best avoided in women who may become pregnant or who are breast feeding. If you do become pregnant whilst undergoing intra-vitreal injections please inform your doctor immediately. With some drugs, there may also be a small, increased risk of heart attack or stroke, although some doctors dispute this. However, please inform your clinic doctor or specialist, if you have suffered from one of these in the past.

What to do if there is a problem? After an injection, it is very common to have some discomfort and blurring of vision for the rest of the day. These problems usually get better by the following morning and rarely last for more than 48 hours.

8 If you notice increasing pain or a significant worsening of your eyesight, it is important that you get your eyes examined quickly. These are worrying symptoms and may indicate an infection within the eye. With timely treatment most infections have a good outcome. The treatment usually consists of an injection of antibiotics. Time is of vital importance. Please contact the clinic team as outlined below:

Eye Clinic Emergency Service at St. James’s Hospital • Opening hours: Monday - Friday, 8.30 am to 5.00 pm Telephone: 0113 206 4566 At other times, please go to the Main A&E department at St. James’s Hospital.

9 Other Help • Low Vision Aid clinics are provided within both Seacroft and St. James’s Hospitals. If you are finding reading or other activities difficult, please ask your doctor or specialist about these clinics. Magnifiers will often help and these can be loaned to you

• The Eye Clinic Liaison Officers can often provide practical advice, discuss sight impairment certification and arrange for a rehabilitation officer to visit you at home and offer further help. Telephone: 0113 206 3832 or 0113 206 4923

• The Macular Society provides information about common macular diseases, support and practical advice for those with visual impairment. Telephone: 0300 3030 111 or go to www.macularsociety.org

10 Changing your appointment: If you cannot make an appointment or need to change your appointment please call us on one of the following telephone numbers:

• The administration team at Seacroft: 0113 206 3147

• Patient Advocacy and Liaison Service (PALS): 0113 206 7168 or 0113 206 6261

11 Seacroft Healthcare Campus York Road, Leeds - LS14 6UH

USEFUL INFORMATION

RING ROAD Main Hospital Switchboard 0113 2648164 Bus Timetable Information 0113 2457676

BARWICK RD. SOUTH PARKWAY FIND US AT:

RING ROAD http://www.leedsth.nhs.uk/seacroft-hospital

FOUNDRY LN.

YORK ROAD A64

WYKEBECK VALLEY RD. CROSSGATES RD. PARKING INFORMATION Entrance to Hospital RD.

STATION

SEACROFT RD. CROSSGATES Pay & Display machines, by card & contactless payment only HOSPITAL STATION

AUSTHORPE LN. YORK ROAD A64 RING ROAD A6120

HOLLYSHAW LN. KNIGHTSWAY PUBLIC TOILETS SELBY ROAD A63 GREEN LANE Public & Disabled Toilets are situated in Building H

SELBY ROAD A6120 SELBY ROAD A63

BEVERAGE & FOOD FACILITIES

JUNCTION The R.V.S. Coffee Shop is open Monday to Friday 46

M1

KEY TO WARDS & DEPARTMENTS

ORTHODONTICS & BREAST SCREENING UNIT LEEDS FERTILITY D SEACROFT EYE CLINIC F A C SEACROFT SATELLITE DIALYSIS UNIT N WARD OUTPATIENTS, E HISTOPATHOLOGY & G X-RAY & ULTRASOUND B COFFEE SHOP (R.V.S. ) PROSTHETICS, ORTHOTICS & WHEELCHAIRS ANDROLOGY UNIT SEACROFT DIALYSIS UNIT H DIABETIC EYE SCREENING SPECIALTY OUTPATIENTS GENERAL OUTPATIENTS PUBLIC / DISABLED TOILETS

Exit From Hospital Site VH Histopathology Andrology Unit - Patient Parking Only PD Patient Drop Off Point

OD Main Outpatients Drop Off Point C PD V S D

B One Way System in The Newsam Centre Operation From This Point

Main Entrance S S VH E F A V H S S G 45010792

TO YORK Entrance to Hospital S OD S S

S S

YORK ROAD A64 TO LEEDS 45010819

NO SMOKING IN BUILDINGS Location of the Beverages / Food OR GROUNDS Pay & Display Machines Bus Stop - For times of next Blue Badge Parking S Staff Parking bus text stop number to 63876

Main Entrance into Building V Visitor Parking Two way Patient access

Every care and attention has been taken to ensure the accuracy of information given. The Leeds Teaching Hospitals NHS Trust accepts no responsibility for any inconvenience caused as a result of alterations or inaccuracies. Revised - 23 July 2018 12 St. James's University Hospital Beckett Street, Leeds - LS9 7TF

A58 POTTERNEWTON RD USEFUL INFORMATION

TOWN Main Hospital Switchboard 0113 2433144

ROUNDHAY RD A61 CHAPEL A58 Bus Timetable Information 0113 2457676

SHEEPSCAR ST. NTH

HAREHILLS RD. FIND US AT:

BARRACK RD http://www.leedsth.nhs.uk/st-james-university-hospital BAYSWATER RD.

ASHLEY RD. PARKING INFORMATION St. JAMES'S HOSPITAL STANLEY RD. Pay & Display machines take 10p 20p 50p £1 coins only ASHLEY RD.

HUDSON RD. LA £5 £10 £20 notes (Change given for notes only) ROSEVILLE RD.

DOLLY LANE Entrance to Hospital No credit card payments.

LINCOLN RD. PUBLIC TOILETS Entrance to Hospital

LINCOLN GRN. RD. Public & Disabled Toilets are situated in the Main Reception Areas

BECKETT ST. NORTH ST.

MABGATE BEVERAGE & FOOD FACILITIES REGENT ST LUPTON AVENUE TORRE ROAD INNER RING ROAD A64(M) Bexley Wing Chancellors Wing Gledhow Wing

TO YORK Delimarche Delimarche Costa Coffee YORK ROAD A64 Restaurant Retail Outlet Dining Room Retail Outlet Boots Pharmacy Henry Smith Boots Pharmacy Mondo Subs Retail Outlets CITY CENTRE Marks & Spencer

KEY TO WARDS & DEPARTMENTS X-RAY, CT, VASCULAR 1 THACKRAY MEDICAL MUSEUM 33 44 cont.... LINCOLN WING 11 & MRI RADIOLOGY BREAST SCREENING PRIVATE PATIENTS SUITE 12 COMMUNITY PAEDIATRICS TRUST HEADQUARTERS RADIOTHERAPY RENAL PD 34 COLORECTAL UNIT OCCUPATIONAL HEALTH X-RAY & ULTRASOUND GI PHYSIOLOGY IBD 18 CHAPEL 35 DAVID BEEVERS DAY UNIT 45 EDUCATION,TRAINING & DEVELOPMENT 2 MULTI SPECIALITY OUTPATIENTS WARDS J42 to J50 & J54 19 ADULT OPHTHALMOLOGY 42 CHAPEL OF REST 48 MULTI STOREY CAR PARK 5 WARD J53 OUTPATIENTS 1 & 2 29 UNION HOUSE COFFEE SURGICAL PRE-ASSESSMENT 44 BEXLEY WING 50 BECKETT WING WARDS J30, J31 & J32 ADMISSIONS LOUNGE 30 CHANCELLOR'S WING MAIN RECEPTION IMMUNOLOGY DAY UNIT 7 GLEDHOW WING MAIN RECEPTION WARDS J80 to J98 BRACHYTHERAPY MANNY CUSSINS DIABETES CENTRE MAIN RECEPTION WARDS J22 to J29 ENDOSCOPY FALLS ASSESSMENT UNIT WARDS J1 to J21 ACUTE MEDICAL ASSESSMENT AREA DAY CASE UNIT ANTI COAGULATION OUTPATIENTS ANTE NATAL CLINIC EMERGENCY DEPARTMENT (A&E) BEREAVEMENT SERVICES MULTI FAITH CENTRE 54 FIELDING HOUSE - CLINICAL PSYCHOLOGY THE LEEDS BREAST UNIT DELIVERY SUITE WARD J3 NUCLEAR MEDICINE OPHTHALMOLOGY OUTPATIENTS MATERNITY ASSESSMENT CENTRE OUTPATIENTS 55 ROBERT OGDEN BUILDING OPHTHALMOLOGY PRE-ASSESSMENT RESPIRATORY CARE UNIT PET, CT & MRI SCANNER SLEEP SERVICES THERAPY SERVICES / FOOT HEALTH PATIENT HOTEL 59 PAUL SYKES UROLOGY BUILDING X-RAY & ULTRASOUND SURGICAL ASSESSMENT UNIT

49 54 45 55

Gledhow Road 7 S 12 S 11 S 59 Entrance to Car Park 35 33 5 S 48 18 19 V 42 2 Beckett Street V 1 30 29 45010299 44 V

Leeds City Council 45010298 V Car Park

45010297 50 45013988

NO SMOKING IN BUILDINGS OR GROUNDS Bus Stop - For times of next 45010296 Blue Badge Parking S Staff Parking bus text stop number to 63876

Beckett Street Main Entrance into Building V Visitor Parking Beverages / Food

Every care and attention has been taken to ensure the accuracy of information given. The Leeds Teaching Hospitals NHS Trust accepts no responsibility for any inconvenience caused as a result of alterations or inaccuracies. Revised - 13 March 2018 13 Wharfedale Hospital Newall Carr Road, Otley, LS21 2LY

USEFUL INFORMATION RD Main Hospital Switchboard 01943 465522 CARR Bus Timetable Information 0113 2457676

NEWALL

Entrance to Hospital FIND US AT:

WESTON LANE http://www.leedsth.nhs.uk/wharfedale-hospital

FARNLEY LANE PARKING INFORMATION

BRIDGE STREET Pay on Foot machines take 5p 10p 20p 50p £1 £2 coins only (No change machines on site)

CROSS GREEN Cards & Contactless Payments A659

KIRKGATE A660 WESTGATE PUBLIC TOILETS Public & Disabled Toilets are situated on the Ground &

GAY LANE First Floors by the North & South Entrances / staircases PIPER LANE LEEDS RD BEVERAGE & FOOD FACILITIES BRADFORD RD A660 A6038 A660 Food & beverages are available from the Coffee Shop. 08:00 - 04:00 Monday to Friday Vending machines are available in the Main Reception 07-00 to 23-00 hours, 7 days a week

KEY TO WARDS & DEPARTMENTS

Level LG AUDIOLOGY Level G ANTI-COAGULANT UNIT Level 1 Ward W1 - DAY SURGERY UNIT Level 2 BILBERRY UNIT LYMPHOEDEMA UNIT CARDIOLOGY DAY TREATMENT UNIT HEATHER UNIT PHYSIOTHERAPY / GYM CHEVIN WING ENDOSCOPY PRE-ASSESSMENT UNIT PHLEBOTOMY / PATHOLOGY THEATRES PRE-ADMISSIONS UNIT MAIN RECEPTION MINOR INJURIES UNIT NORTH & SOUTH ENTRANCES OUTPATIENTS RADIOLOGY RESTAURANT

North Entrance S

South Entrance x21 V + S 45025984 V S S

V

NO EXIT

FORMER HOSPITAL GROUNDS (NO ADMITTANCE)

Hospital Newall Carr Road NO SMOKING IN BUILDINGS Entrance OR GROUNDS

NO ENTRY Disabled Parking Location of the Pay on Foot Machines Ambulance Parking + Bus Stop - For times of next S Staff Parking bus text stop number to 63876

45010477 V Visitor Parking - 24 Hours Beverages / Food

Every care and attention has been taken to ensure the accuracy of information given. The Leeds Teaching Hospitals NHS Trust accepts no responsibility for any inconvenience caused as a result of alterations or inaccuracies. Revised - 30 October 2019 14 A space for your notes and questions:

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© The Leeds Teaching Hospitals NHS Trust • 2nd edition (Ver 1) LN004543 Publication date Developed by: Samantha Bird and Sophie Vickers, 02/2020 Retina Specialist Practitioners Review date Produced by: Medical Illustration Services • MID code: 20190308_006/JG 02/2022