The Visual Impairment Centre of the Faculty Hospital Motol is located in pavilion 16 and it is the only health establishment in the Czech Republic that specialises on the complex care of visually impaired patients of all age groups. The centre has been looking after patients for sixty years and currently has a team of experienced specialists from the following fields: ophthalmology, medical genetics, clinical psychology, eyesight training, specialised pedagogy, social and professional consultancy. From 2001 the Visual Impairment Centre has been managed by DrJitka Řehořová and in 2002 it became a part of the eye clinic for children and adults that is part of Charles University’s 2 nd Faculty of Medicine.
If I find out that I don’t see well I visit my GP and he sends me to an eye specialist. How do I get to you?
Patients are sent to us by other eye specialists and it is not so much for the purpose of examination but because of the eyesight loss compensation. We are trying to find a special optic or electronic aid that would make things easier for them. We are annually visited by 700 to 800 patients. Every eye specialist who has been visited by a patient for sometimes even several years, has to examine the patient, evaluated seriousness of his eye loss then make a diagnose and prognosis. He has to advise a patient what to do in future and direct him to an appropriate establishment where specialists will take care of him and help him.
How many similar specialised establishments are there in the Czech Republic?
We are the only establishment that provides complex care. We have social workers, psychologists and eye therapists – there are special pedagogues, doctors and nurses.
On top of that there is one specialised ophthalmologist in every Czech regional city who works under the auspices of Czech Ophthalmology Association and who usually comes to us for training. We taught them to prescribe special optical aids and that’s what they do in their regions. This is however not the main responsibility of these specialised ophthalmologists. It is more the case that they have surgery hours in certain days of the week and the job is mainly our responsibility.
What do you do with patients who come to you? What kind of handicaps do they come with? I mean more serious handicaps that can’t be solved with glasses.
Small children usually have some kind of an inborn illness. In this case it is important to identify it as soon as possible and to start with therapy, rehabilitation and possibly surgery. Adults come either with further developed handicaps that started in their childhood or with some problems that appeared later in their life. Regarding the age group above sixty they usually have an age conditioned macular degeneration (a progressive illness that affects a central part of retina and causes gradual loss of central vision). This illness is in this age group dominant and its numbers increase with prolonging age expectancy.
I remember that in the past we hardly ever came across final stages of macular degeneration but with prolonging age expectancy their occurrence swiftly increases.
What are the basic options of treatment?
Regarding inborn illnesses we try to monitor, ease and facilitate the best possible quality of life. Regarding inborn defects that need an operation, such as cataracts, we try to do that as soon as possible. We also try to operate on glaucoma as soon as possible and monitor development, even though the outcome might be bad.
In adult age we operate on senile cataracts but have to consider age conditioned macular degeneration which sometimes deteriorates after the cataract operation and in the end the patient’s eye vision becomes even worse. Regarding the age conditioned macular degeneration we also have to distinguish the simple form which is not that dangerous because it proceeds more slowly than the more dangerous form that happens with fast progress. The latter one should be diagnosed and an attempt to stop it should be made as soon as possible. There is however not a hundred percent successful treatment yet.
Can we say that children stand a bigger chance then adults to partially regain their sight after an operation?
No, I think that it’s the other way round. And it also depends on the kind of operation. When the cataract (vision obstacle) is operated on, the sooner it is done the sooner a patient gets a replacement. Either a lens is operated on inside the eye or contact lenses are used or glasses. The sooner a patient gets a replacement the better chance is there for restoration of eyesight. The later we operate the bigger risk of purblidness, which is an illness that is more difficult to cure.