Heartbeat: New technology revolutionises eye care at SWB

February 17, 2022

In the modern world, we are always updating and revising technology but once in a while, something revolutionary is introduced and in this case, it is the new In-vivo confocal microscopy (IVCM) at BMEC.

This is an invaluable addition to the cornea service for what is otherwise the second largest ophthalmology unit in England after Moorfields Eye Hospital in London.

“IVCM is a specialised and useful investigation modality used in ophthalmology,” said Dr Matthew Azzopardi, Junior Academic Research Fellow at Birmingham and Midland Eye Centre.

“In combination with polymerase chain reaction (PCR) swabs and culture, it is the current clinical standard for diagnosis of Acanthamoeba Keratitis (AK). This is a rare and sight threatening cornea infection which can lead to blindness if left untreated. Unfortunately, the diagnosis of AK is often delayed due to lack of a gold standard diagnostic technique and due to the difficulty of clinical diagnosis as its initial presentation can mimic other types of infection. It is a type of single cell protozoan organism which can be found in the natural environment including water and soil, with contact lens wearers being most at-risk.

“In addition, IVCM is used to aid the diagnosis of other cornea conditions including cornea inflammatory eye disease, cornea neuropathy, and other infections such as cytomegalovirus (CMV).”

Before the Trust had this technology, BMEC could not offer this service which meant many of our patients would be referred to other places across the country such as London, Southampton and Wolverhampton for IVCM which had a significant impact in the care given by SWB as it caused disruption to the patient journey and delayed treatment.

When asked about the impact ICVM has had, Dr Alberto Recchioni, Research Imaging Optometrist said: “Feedback from our patients has been excellent with one patient saying that the process of going through the IVCM diagnosis was thorough and they felt at ease and glad that they didn’t have to travel elsewhere. Patients also reported that they were pleased that the source of infection could now be visualised directly and the images shown to them immediately.”

He added: “Feedback from my clinical colleagues has also been positive with many saying that their confidence has increased in regards to making the diagnosis of AK when used in conjunction with other diagnostic techniques such as PCR.

“Clinicians and ophthalmologist are now able to directly refer patients from BMEC to the academic unit at Sheldon Block for direct imaging of the cornea with IVCM.”

The Trust is hopeful that moving forward we can use IVCM as an invaluable diagnostic aid as well as research tool. Currently, further work is being done to look at the sensitivity and specificity of IVCM for a variety of eye conditions, especially when used in conjunction with other tools such as PCR and cultures.