Interesting Eye Case……..

Eye Case

This is a really interesting case……

Patient presented with the below lesions noticed on their regular examination. She was a little vague on her previous ocular history, but she had had previous cataract surgery which ‘required a number of goes!’

Not sure if it is obvious from the photos, but the pupil in that eye is tear-shaped. I had no idea at all what this was.

What do you think this is?

The Eye Health Centre - Interesting Eye Case........ The Eye Health Centre - Interesting Eye Case........










Ok, story is this lady had had complicated eye surgery (there was pupil damage and a vague history of a ‘number of procedures carried out at the hospital’). Turns out this is a scleral fixated IOL and the lesions are simply calcification around the attachment points protruding through the sclera. Given the lady has no symptoms, John is planning on observing her going forward. I’ve included an example of one of the modern day scleral fixated lenses – not sure which version this lady has in, but it is the same general principle.

The Eye Health Centre - Interesting Eye Case........

The Role of Optometry in MBGS an Corneal Cross Linking Webinar

Hello all

The Eye Health Centre Team believe in the importance of continual education and ensuring they are offering their patients the newest technologies.  This Webinar with two of the most reputable Optometrists in Australia Jason Holland and Phuc Ngo worked with Glaukos to present this webinar to Optometrists internationally.

Enjoy and send any questions to myself at

The Role of Optometry in MBGS an Corneal Cross Linking

The Eye Health Centre - The Role of Optometry in MBGS an Corneal Cross Linking Webinar




Case Study



Patient presented to Optometrist with glare issues and vision fluctuating morning to night. Had RK 20 years previously.




Diagnosis: Cataracts were diagnosed.

Treatment: Underwent bilateral cross linking to stabilise corneas before cataract extraction and IC8 implants.

Eye Case of the Week

Eye Case of the Week



What is the cause of the corneal lesion in these two different patients?



Two different herpes simplex keratitis patients in the same week!

Both presented with a classic epithelial herpetic dendrite

#1: First presentation, two weeks history of a sore left eye. Seen GP, treated with antibiotic eye drops and no improvement.

#2: The patient decided to stop oral valtrex but continue steroid eye drops.



Aciclovir 3% 5x/day (Brand name: Zovirax or Acivision). Zovirax is in short supply but Acivision is readily available.

Plus, prophylactic antibiotic coverage, Chlorsig qid.

Alternatively, you could liaise their GP or an Ophthalmologist for a prescription for oral anti virals such as Valtrex 500mg tid for one week.

The Eye Health Centre - Eye Case of the Week

The Eye Health Centre - Eye Case of the Week

Eye Case of the Week

Case of the Week 

Photo 1

Patient presented to us with crusty and telangiectasia along the lid margin. Patient also having Blepharitis along the lid margin as well as Rosacea as well as red nose tip and minor blood vessels along the patients cheek.

The Eye Health Centre - Eye Case of the Week











Photo 2
Infiltrate, with localised Corneal Oedema and cells underneath the infiltrate.  There is a clear separation/margin between the infiltrate and limbal vessels.

The Eye Health Centre - Eye Case of the Week











Diagnosis and Management:

Marginal Keratitis

Treat the infiltrate first with Chlorsiq QID and FML QID. Lid hygiene with Lid & Lash or Occusoft wipes to treat the Blepharatis.

Long-term management: Daily hot compress and lid hygiene (Lid and Lash wipes or Occusoft cleaner). Also look at treating rosacea as well long term.


Eye Case of the Week

Eye emergency of the week
Case #6

Patient presented to practice with light sensitivity and decreased vision (very irritated).  Patient advised they had been scratched.
What are the scratches from?
How to treat?

The Eye Health Centre - Eye Case of the Week











Answer – No (Eye)DEA 

Dog Scratch, put on bandage CL & Ocuflox (QID).  Reviewed in 3 days.  All healed, vision back to normal.  CL out…patient advised he dog only has 3 claws not 6!


Eye Case of the Week


32 year old male presents with a right sore and irritated eye upon blinking. He reports the symptoms after using a grinding machine at work ~1 week ago.

What is the cause?

The Eye Health Centre - Eye Case of the Week











Answer: Rust ring due to a metallic foreign body

Ferrous particles in situ for even a few hours can cause rust staining of the bed of the abrasion.

Removal of a rust ring is performed by:
1. Instil 1 drop of topical anaesthetic (e.g Alcaine, Oxybuprocaine eyedrops)
2. Determine the position and depth of rust ring with a slit lamp.
3. Use a sterile 25 gauge needle or a sterile burr to removal the rust ring.
4. Prescribe topical antibiotic for prophylactic cover and lubricants to promote corneal healing.

If a corneal foreign body is not removed, there is a significant risk of secondary infection and corneal ulceration.

Case of the Week

The Eye Health Centre - Case of the Week

Patient presented with a 3 day history of a red, gritty and watery eye.

It started in one eye (and was definitely worse in that eye), but has progressed to the other.

Vision was slightly reduced.

Suspect: Adenovirus

Treatment: Povodine-Iodine wash; Maxidex QID (+ CPL QID) + Non-preserved lubricants

Warned highly contagious so needs to wash towels/pillow-cases etc

Eye Case of the Week


The Eye Health Centre - Eye Case of the Week

Question: A 75 year old wakes up with blurred vision, what is the cause?


Posterior capsular opacification (PCO)

Most common post-operative cataract complication. It is caused by the proliferation of lens epithelial cells that have remained within the capsular bag following cataract extraction.

Patterns of opacifications:
• Vacuolated, pearl-type – commonly known as ‘Elschnig pearls’
• Fibrosis type
• Soemmering ring – a whitish annular or doughnut- shaped in the periphery of the capsular bag following older methods of cataract surgery, but is clinically uncommon now.

Management: Referral to an Ophthalmologist for capsulotomy with YAG laser.

Eye Case of the Week


A patient with a medical history of type 2 diabetes, high cholesterol, high blood pressure, hypothyroidism and lung cancer presents with unilateral blurred vision. What could be the cause?


Unaided Visual Acuity:   R CF (PHNI)       L 6/24 PH 6/12

Pupils:                            no RAPD

IOPs:                              R & L 14mmHg



Gross Cystoid Macular Oedema (CMO) and subretinal fluid due to Central Retinal Vein Occlusion (CRVO), most likely ischemic nature due to the poor VA.



Referral to retinal specialist same day for further examination and treatment.


Commenced loading does of Eylea every month for three months then extend by every fortnight intervals at each review (e.g. 4 weeks, 6 weeks then 8 weeks) until treatment dosing is 6 monthly then cease.

Eye Case of the Week


This patient presents with transient blurred vision, foreign body sensation and watery eyes. Why?


Cogan’s Map-Dot-Fingerprint dystrophy (Epithelial Basement Membrane DystrophyEBMD)

Epithelial dystrophy: Basement membrane is thickened and extend into the epithelium (forming map and fingerprint)


  • Fingerprint lines (fine, relucent, hairlike lines)
  • Map lines (thicker than fingerprint lines, more irregular, surrounded by faint haze; resemble irregular coastlines/geographic borders)
  • Dots or microcysts (intraepithelial spaces containing debris of epithelial cell that have collapsed and degenerated before reaching epithelial surface)
  • Bleb or cobblestone-like pattern
  • Often have recurrent epithelial erosions
  • May cause irregular astigmatism


  • Educate and warn about recurrent corneal erosion – treat with lubricants
  • Recurrent corneal erosions with epithelial defect – treat with chlorsig drops/ointment QID prophylactic
  • Address blepharitis and dry eye if needed
  • Surgical
    • Epithelial debridement
    • Anterior stromal puncture
    • PTK


The Eye Health Centre Important Information – COVID-19

Dear Patients and Referral Partners

It is important that we communicate with you that The Eye Health Centre is a Specialist Medical Practice & therefore your Vision is our priority.  We remain open for your scheduled appointments and surgeries adhering to all our Government Health Guidelines.

Please refrain from attending your appointment if you have:

  1. Tested positive for Covid-19
  2. Been in contact with anyone who has been in contact with Covid-19
  3. Been overseas recently
  4. Been in contact with anyone who has been overseas recently
  5. Have a sore throat, cough, fever or flu like symptoms

When you visit our practice please adhere to the instructions as per the signage provided.

If you cannot attend or have any questions please call us and let us know 07 3831 8606, ask about our Telehealth consultations with our Doctors.

Keep healthy and lets together stop the spread.

Education Event for Optometrists

The Eye Health Centre provides exceptional clinical education to our local optometrists.

Dr Andrew Apel and Dr John Hogden represented The Eye Health Centre at The Queensland Eye Hospital Education Day, on 23rd February at the Hilton Hotel Brisbane City.

Dr John Hogden, enjoyed presenting to our local Optometrists in his special interest of Cornea’s, by discussing the topic –  Changing trends in Refractive Surgery.  Dr Andrew Apel said it was an honour to lead the panel discussion regarding Cataract Lens Refractive Surgery.

The feedback from the Optometrists who attended this event was very positive and they found the event to be very beneficial to their extended education.The Eye Health Centre - Education Event for Optometrists

Thank you to all who attended & The Queensland Eye Hospital for inviting us to participate.

New Practice Open Aspley

The Eye Health Centre Aspley

Book now!

We are excited to announce that Dr John Hogden has opened his own rooms, conveniently located at 7/1344 Gympie Road Aspley.  Dr John Hogden is an Ophthalmologist with subspecialty training in corneal, external eye disease, cataract, anterior segment and refractive surgery.

Call now for an appointment or with any questions.

Click on the image for more information



Dr Andrew Apel International Speaking Event Niseko Society of Neuromuscular Sciences

The Eye Health Centre - Dr Andrew Apel International Speaking Event Niseko Society of Neuromuscular Sciences

Dr Apel Lecturing in Niseko.

Dr Andrew Apel, Ophthalmologist, has recently visited Niseko to present a lecture on “Cataract and Refractive Surgery…A Converging Art.”

The lifestyle impacts of cataracts and the benefit of cataract surgery is well understood. The development of modern cataract surgery has resulted in highly predictable visual outcomes, expanding the corrective scope of the procedure beyond simple cataracts to refractive ametropia and presbyopia.
In the last century, milestones in surgical technique have resulted in a safe and minimally invasive procedure for patients. Simultaneous innovations have occurred in ocular biometry and IOL calculations allowing for highly repeatable ocular measurements and more accurate IOL selection.
Intraocular lens manufacturers continue to improve on IOL designs with an ever-expanding scope of optical corrections in biocompatible and surgeon friendly materials. In particular, modern multi-focal IOL designs allow for unrivalled visual independence for presbyopic patients.

Merry Christmas & Happy New Year

Merry Chritmas and Happy New Year!

Merry Christmas & Happy New Year!

The Eye Health Centre 2019

2019 has been a wonderful year at The Eye Health Centre. Our team has provided the gift of sight to many happy patients & made many friends along the way.

Dr Apel has been busy lecturing both locally & Internationally, educating other medical professionals in his specialty. Dr Apel has not continues to treat his patients, he also further educates Optometrists, Doctors and new training Ophthalmologists in order for them to also provide their patients with the best possible outcomes.

Our team of Clinical Optometrists have also been very busy and accomplished by supporting our patients in pre and post care.

We have helped many patients with different conditions be much more comfortable by treating their eye conditions i.e. Dry Eye, Keratoconus, Cataracts, Pterygiums, Vision Enhancement Treatments, Corneal Transplants, Ocular Surface Conditions, Aviation Ophthalmology and Ocular Emergencies just to name a few.

Throughout 2019 our team have also supported extraordinary projects including – our very own Optometrist, Phuc Ngo visiting Cambodia with The Australian Health Humanitarian Aid organisation treating hundreds of patients by improving their vision with Cataract Surgery. Dr Apel and team donated glasses to Kenya in order to help disadvantaged be able to see and have better quality of life. Our list goes on and on in how we assist in improving our patients quality of life.

Exciting News 2020

The Eye Health Centre is looking forward to a very exciting 2020. In January 2020, The Eye Health centre Aspley will be opening run by, Dr John Hogden. Along with Dr Hogden will come of great staff, including Clinical Optometrists and Administration support. We welcome Dr Hogden & Team.

We are all very much looking forward to meeting new patients visiting our Aspley Rooms, I am sure you will be extremely well looked after.

Many Thanks for your support through 2019, wishing you a very Merry Christmas, a Healthy, Safe and Prosperous New Year.

The Eye Health Centre Team

Dr Apel Lecturing at the RANZCO Congress, 8-12 November 2019

Dr Andrew Apel, our Ophthalmologist here at Eye Health Centre Brisbane was invited to lecture alongside Dr Mat Green on the topic of Bacterial Keratitis at the 2019 RANZCO Congress held at the International Convention Centre Sydney from 9th November – 11th November.

Dr Apel and Dr Green educated the delegates with their shared knowledge and experience on the subject and was applauded on their delivery and presentation of the subject matter.

Dr Apel is renowned for his desire to share and educate within the Ophthalmic industry.



Our Optometrist James giving back sight in Papua New Guinea

When our very own Optometrist, James Fuss, volunteered his services in Papua New Guinea he was able to give sight back to many including a local father called Nico in Ora Bay.

When James met first met Nico, he was squinting and had very low visual quality.

It seemed Nico was in pain, but James soon came to realise that the squinting was Nico’s way of trying to overcome the haze that veiled his eyes, he was desperately trying to focus his vision.

At 30 years of age, Nico’s whole world is blurry. He has a wife, a six year-old son and a job at New Britain Palm Oil that is limited to very simple tasks.

As James begins to assess Nico’s eyes, he finds that Nico had a cataract removed from his right eye a few years ago, but no new lens was inserted into the eye. In his left eye, he is blind from a previous condition.

The good news is, Nico’s eyesight can easily be improved with a pair of very strong glasses.

James fits Nico’s face with a trial frame and begins test his refraction. As a +8 lens slips over Nico’s eye, he stops squinting and his face immediately begins to relax; he can see!

Nico says to James, “this is the one!”

A pair of +8.75 glasses is found for Nico and fitted on to his face. He is smiling and pointing to landmarks in the distance. He begins to share how happy he is – a whole new world has opened up around him.

Nico shakes James’ hand, and thanks him for the glasses.

The patient who walked in squinting an hour ago, walked out with a smile on his face and his eyes wide open – Nico had transformed.

You can help people like Nico by donating both prescription and reading glasses to YWAM Medical Ships’ optometry team. Your simple pair of pre-loved glasses can change lives, just like Nico’s!

Dr Apel attending the European Society of Cataract & Refractive Surgery Congress

Our leader Dr Andrew Apel thoroughly enjoyed learning about the latest methods of Corneal Cataract and Refractive Surgery in Paris for the European Society of Cataract & Refractive Surgeon Congress – Paris, France September 14-18 2019.