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Qualifications and Memberships
Professional Training
Prior to appointment, as Consultant Ophthalmic Surgeon, Mr Tanner carried out three years of advanced sub-specialist training at Moorfields Eye Hospital, London and St Thomas' Hospital, London. During this period he gained expertise in the surgical and medical management of retinal disorders including macular surgery. He regularly gives regional and national lectures and has recently co-authored a post-graduate textbook and atlas “Diseases
of the Ocular Fundus”. This textbook was awarded first prize as "Best Authored Textbook in 2005" by the Royal Society of Medicine and Royal Society of Authors.
His research interests and publications include phacoemulsification cataract surgery and many aspects of vitreo-retinal surgery including macular hole repair and high-resolution retinal imaging.
Higher Qualifications
- Medical Sciences with Biochemistry
- MB BS (Lond.) University of London, 1990
- ECFMG (USA) Certification, 1990
- FRCOphth. Fellowship of Royal College of Ophthalmologists, 1994
- CCST Certificate of Completion of Specialist Training, 1999
Membership of Professional Societies
- European Society of Retina Specialists - Euretina
- Fellow of Royal College of Ophthalmologists
- American Academy of Ophthalmology
- British Medical Association
- European Society of Cataract and Refractive Surgery
- UKISCRS
- British and Eire Association of Vitreoretinal Surgeons
- Medical Defence Union
- European Vitreo-Retinal Society
Presentations
Scientific presentations:
- Houston, we have a problem! What to do when the vitreous does not lift off.
I Papandreou, V Tanner
British and Eire Association Vitreo-Retinal Surgeons, Annual Meeting, Durham 2017
- Myopic Foveoschisis
I Papandreou, V Tanner
British and Eire Association Vitreo-Retinal Surgeons, Annual Meeting, Durham 2017
- The relationship between vitrectomy surgery and zonular dehiscence
J Doyle, V Tanner et al
ARVO - ASIA, Australia, 2017
23 gauge vitrectomy outcomes for proliferative diabetic retinopathy
H Jenkins, V Tanner. Poster Presentation Euretina annual meeting, France, 2015
23 gauge vitrectomy outcomes for proliferative diabetic retinopathy
H Jenkins, V Tanner. Presentation BEAVRS annual meeting, 2015
- Vitrectomy for retained metallic foreign body
H Jenkins, V Tanner. Presentation Southern British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting 2015
- Intralenticular injection of Ozurdex ! - Cataract Surgery
L Thai, V Tanner. Presentation Southern British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting 2015
- Contributory surgeon,
National Ophthalmic Database, Retinal detachment surgery outcomes,
BEAVRS meeting, Edinburgh 2014
- Contributory surgeon,
National ocriplasmin (Jetrea) survey
BEAVRS meeting, Edinburgh 2014
- Complex Diabetic Vitrectomy
H Jenkins, V Tanner
British and Eire Vitreo-Retinal Surgeons Meeting, 2014
- BEAVRS results: the first 2000 cases - complexity adjusted results.
Contributory Surgeon to presentation at EURETINA annual meeting.
London. 2014
- Diabetic Vitrectomy - 5 year review of outcomes
H Jenkins, V Tanner Southern
British and Eire Vitreo-Retinal Surgeons Meeting, 2014
- Early experience with Ocriplasmin
(Jetrea) H Jenkins, V Tanner Southern
British and Eire Vitreo-Retinal Surgeons Meeting, 2014
- Safety day case vitreo-retinal surgery
T Cochrane, V Tanner. Presentation Southern British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting 2013
- Next day review following Vitreo-Retinal Surgery
T Cochrane, V Tanner. Presentation, British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting 2013
- Outcomes of Epiretinal Membrane Surgery over an 8 year period
R Nath, V Tanner. Presentation
Southern British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting Henley on Thames 2012
- Eccentric Macular Holes following Macular Surgery.
K Xue, V Tanner. Presentation
Southern British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting Henley on Thames 2012
- Artisan lens implant in aphakic vitrectomised eyes : in-vivo lens mobility study
D Sanchez Chicharro, V Tanner Poster presentation. European Society of Cataract and Refractive Surgeons. Prague. Feb 2012
and paper presentation at Southern British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting 2012.
- Macular oedema in retinal vein occlusion, the role of Ozurdex Steroid implants
D Chicharro, V Tanner
Southern BEAVRS meeting, 2011
- Analysis and background of coding practice for Vitreo-Retinal Surgical intervention.
M Groppe, V Tanner
British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting 2010.
- Retinal detachment - Quality of information available on the internet.
M Groppe, V Tanner
British and Eire Association of Vitreo-Retinal Surgeons, Amsterdam, 2009
- Epidemiology of VR surgery in the UK: Update on regional and seasonal variation.
A El-Amir, V Tanner
British and Eire Association of Vitreo-Retinal Surgeons, Amsterdam, 2009
- Recent advances in VR practice. Southern BEAVRS meeting.
Brighton. 2009
- Optical Coherence Tomography of the effects of stromal hydration on clear corneal incision architecture
United Kingdom & Ireland Society of Cataract and Refractive Surgeons, Brighton, 2008.
- Update - Twenty year trends in volume and geography of VR surgery
British and Eire Association of VR surgeons. Reading 2008
- Sutureless 23g Vitrectomy techniques. Initial experience
British and Eire Association of VR surgeons. Reading 2008
- Routine day case VR surgery – safety audit
British and Eire Association of VR surgeons. 2007
- Ultrasound Biomicrospy of hydrated corneal wounds in routine cataract surgery
European Society of Cataract and Refractive Surgery, Berlin 2008 UKISCRS, 2008
- Twenty year trends in volume and geography of VR surgery
British and Eire Association of VR surgeons. 2007
- Outcome following Macular hole surgery using ILM peel and C2F6 gas
et al V Tanner.
Royal College of Ophthalmologists. Annual Congress. 2006
- Outcome following Macular hole surgery using ILM peel and C2F6 gas
V Tanner et al.
British and Eire Association of Vitreoretinal Surgeons. 2005
- One year experience with day case vitreo-retinal surgery.
V Tanner et al.
British and Eire Association of Vitreoretinal Surgeons. 2005
- Diseases of the Ocular Fundus
Post Graduate textbook 2005
Jack J. Kanski, Stanislaw MilewskiMD, Bertil Damato and Vaughan Tanner.
Elsevier
- Is Day Case Vitreoretinal Surgery Safe?
Desai A, Tanner V et al
Poster presentation. Annual Congress of Ophthalmologists. Birmingham.2005.
- Globe perforation and repair
Desai A, Tanner V
Video presentation. Annual meeting American Society of Cataract and Refractive Surgery. Washington.
USA. 2005
- Techniques in the use of heavy silicone oil.
Desai A, Tanner V.
British and Eire Association of Vitreoretinal Surgeons. Manchester. 2004
- Day case Vitreoretinal Surgery
M Parulear, V Tanner
Southern Association of Vitreoretinal Surgeons. March 2004
- "Heavy" silicone oil for inferior retinal detachments
A Desai, V Tanner
Southern Association of Vitreoretinal Surgeons. March 2004
- Use of "Heavy Silicone oil"
A Desai, V Tanner
London Vitreoretinal Society, Moorfields Eye Hospital. Feb 2004
- Intravitreal Triamcinolone in cystoid macular oedema following cataract surgery
V Tanner
London Vitreoretinal Society. July 2003
- Use of vision Blue in Macular Hole surgery
A Desai, V Tanner
Southampton Vitreoretinal Meeting, March 2003
- Management of inferior retinal breaks during pars plana vitrectomy.
Tanner V, Williamson TH.
British and Eire association of Vitreoretinal Surgeons, Annual meeting.
Newcastle. November 2000.
- The predictive value of vitreous pigment and symptomatology in posterior vitreous detachment.
Tanner V, Harle D, Tan J, Williamson TH, Chignell AH.
Clinical paper. Awarded Fellowship prize for best paper.
British and Eire association of Vitreoretinal Surgeons. Cambridge. October 1999.
- Optical Coherence Tomography in the differential diagnosis of Macular Holes.
Tanner V, Williamson T.H.
Poster presentation. The Oxford Ophthalmic Congress, Oxford. July 1999.
- Watzke-Allen testing of Macular holes confirmed by optical coherence tomography.
Tanner V, Williamson T.H.
Poster presentation. Annual meeting of Association for Research in Vision and Ophthalmology, Fort Lauderdale, U.S.A. May 1999.
- The Watzke-Allen sign Revisited.
Tanner V, Williamson T.H.
Clinical paper. British and Eire association of Vitreoretinal Surgeons. Leeds. October 1998.
- Optical Coherence Tomography and Macular holes.
Tanner V.
Scientific / Clinical paper.
Alumni meeting, Oxford Eye Hospital, Oxford. July 1998.
- Posterior Sub-tenons triamcinolone injection in the treatment of posterior uveitis: a prospective study with 6 month follow up.
Tanner V, Frith P, Kanski J.
Poster presentation. Awarded best poster prize.
Annual Congress of Royal College of Ophthalmologists, Glasgow 1998.
- An electron microscopy study of explanted intraocular lenses from non-infected eyes.
Tanner V, Rosen P, Skinner A, Ferguson DJP, Mc Donald B.
XV Congress, European Society of Cataract and Refractive Surgery, Prague. Czech republic. 1997.
- Electron microscopy of explanted intraocular lenses.
Tanner V, Rosen P, Skinner A, Ferguson DJP, Mc Donald B
Poster presentation, Annual Congress of Royal College of Ophthalmologists. Glasgow, 1998
- Posterior Sub-tenons triamcinolone injection in the treatment of posterior uveitis.
Tanner V, Frith P, Kanski J.
i) Poster presentation. ARVO. U.S.A. April 1997.
ii) Poster presentation. The Oxford Ophthalmic Congress, Oxford. July 1997.
iii) Paper presentation. Alumni meeting, Oxford Eye Hospital, Oxford. July 1997.
- Ultrasound monitoring of retinal cryotherapy.
Tanner V, Nischal K, Kanski J.
Free paper. The Registrars Meeting, Royal Society of Medicine, London. June 1996.
- The use of 10% Phenylephrine is an unnecessary risk prior to routine cataract surgery.
Tanner V, Casswell A G.
Free Paper. The Registrars Meeting, Royal Society of Medicine, London. June 1994.
- Automated chromatic sensitivity testing increases the diagnostic accuracy of Dysthyroid Optic Neuropathy.
Tanner V, Tregear S J, Ripley L G, Vickers S V.
Free Paper. Annual Congress of Royal College of Ophthalmologists, Guernsey. April 1994.
Publications, Scientific Letters, Surgical Videos and others
Publications
-
Real world outcomes of ocriplasmin use by members of the British and Eire Association of Vitreo-Retinal Surgeon
Haynes et al
EYE. 2017 (31), 107-112 Contributing Surgeon
- Femtosecond Laser Cataract Surgery - Better or worse ?
Tanner V
Literature review and GP/Optician update article; 2014
- Macular oedema in retinal vein occlusion, the role of Ozurdex Steroid implants
D Chicharro, V Tanner
Invited Review Article, Eye News, 2011
- Trends in rates of retinal surgery in England from 1968 to 2004: studies of hospital statistics.
El-Amir AN, Keenan TD, Abu-Bakra M, Tanner V, Yeates D, Goldacre MJ.
Br J Ophthalmol. 2009 Dec;93(12):1585-90.
- Optical coherence tomography of the effects of stromal hydration on clear corneal incision architecture.
Calladine D, Tanner V.
J Cataract Refract Surg. 2009 Aug;35(8):1367-71.
- Kanski : Clinical Ophthalmology, A Systematic Approach
Sixth edition.
Post-graduate textbook 2007
Chapter review: Retinal Disease.
Elsevier
- Feasibility
of day-case vitreoretinal surgery.
Desai A, Rubenstein A, Reginald A, Parulekar M, Tanner V
Eye. 2006 Jul 21
- Macular
microholes: pathogenesis and natural history.
Zambarakji HJ, Schlottmann P, Tanner V, Assi A, Gregor ZJ
Br J Ophthalmol. 2005 Feb;89(2):189-93
- Unsutured
posterior chamber lens implantation in eyes requiring lens extraction
at the time of pars plana vitrectomy with silicone oil tamponade
K. S. Balaggan, B. Dong, V. Tanner, W. K. Poon, T. H. Williamson
Journal of cataract and refractive surgery. 2004 30:1:168-174
- Optical
Coherence Tomography imaging of severe commotio retinae and associated
macular hole.
Ismail R, Tanner V, Williamson TH
British Journal of Ophthalmology.2002;86:473-4
- Optical coherence tomography of the vitreo-retinal interface
in macular hole formation.
Tanner V, Chauhan DS, Jackson TL, Williamson TH
British Journal of Ophthalmology.2001;85:1092-7
- Management of inferior retinal breaks during pars plana
vitrectomy.
Tanner V, Williamson TH.
British Journal of Ophthalmology.2001;85:480-2
- Modern advances in macular surgery – Macular Translocation
Tanner V.
Comment article. Current Medical Literature – Ophthalmology.
2001
- Primary rhegmatogenous retinal detachment: Surgical techniques
and outcomes over 20 years
Minihan M, Tanner V, Williamson TH.
British Journal of Ophthalmology. 2001;85:546-8
- Combined Phacoemulsification cataract extraction and pars
plana vitrectomy without intraocular lens implantation.
Jackson T, Larsson J, Tanner V, Williamson TH.
Acta Ophthalmologica scandinavica. 2001;215:271-5
- The predictive value of vitreous pigment and symptomatology
in posterior vitreous detachment.
Tanner V, Harle D, Tan J, Williamson TH, Chignell AH.
Prospective clinical study. British Journal of Ophthalmology.
2000;84:1264-8
- Watzke-Allen slit beam testing of macular holes confirmed
by optical coherence tomography.
Tanner V, Williamson TH.
Prospective clinical study. Archives of Ophthalmology. 2000;118(8):
1059-1063.
- Acute Posterior Vitreous Detachment.
Chignell AH, Harle D, Tanner V, Williamson TH.
Prospective clinical study and national survey. Optometry in practice.
2000;1: 97-102
Clinical supplement to Ophthalmic and physiological optics.
- Modified sutureless sclerotomies in pars plana vitrectomy.
Jackson T, Tanner V, Williamson TH
Case series / correspondence. American Journal of Ophthalmology.
2000; 129:1. 116-117
- An
electron microscopy study of intraocular lenses explanted from
non-infected eyes.
Tanner V, Rosen P, Skinner A, Ferguson DJP, Mc Donald B.
Scientific / Clinical paper. Journal of Cataract and Refractive
Surgery. 1998;24:8.1145-51
- Posterior
Sub-tenons triamcinolone injection in the treatment of posterior
uveitis.
Tanner V, Frith P, Kanski J.
Prospective clinical study. Eye. 1998; 12.4: 679-685.
- Optimisation
of out-patient resources in cataract management.
Prasad S, Tanner V, Patel CK, Rosen PR.
Clinical paper / audit. Eye. 1998; 12.3A: 403-406.
- Phacoemulsification
and combined management of intraocular silicone oil.
Tanner V, Haider A, Rosen P.
Surgical technique paper. Journal of Cataract and Refractive Surgery.
1998; 24:5: 585-591
- Radiation
Keratopathy.
Tanner V, Bron AJ.
Case Report. British Medical Journal. 1998; 7142: 1470
- What
effect does laser photocoagulation have on driving visual fields
in diabetics?
Pearson AR, Tanner V, Keightley SJ, Casswell AG.
Clinical paper. Eye. 1998; 12:1. 64-68.
- A
comparative study of the efficacy of 2.5% phenylephrine and 10%
phenylephrine in mydriasis prior to routine cataract surgery.
Tanner V, Casswell A G.
Prospective clinical study. Eye. 1996; 10: 95-98.
- Automated
achromatic contrast and chromatic discrimination sensitivity testing
in dysthyroid optic neuropathy.
Tanner V, Tregear S J, Ripley L G, Vickers S V.
Clinical paper. Eye. 1995; 9: 354-357.
- Combined
Atracurium and d-Tubocurarine muscle relaxant technique.
Nott M R, Tanner V.
Case series. Anaesthesia. 1993; 48:644.
- Fibronectin
does not enhance the endocytosis of fibrin breakdown peptides.
Tanner V, Knox P.
Laboratory based study. Biochem. Soc. Trans. 1988; 16: 559-560.
Letters:
- The predictive value of vitreous pigment and symptomatolgy in posterior vitreous detachment - Author's reply
Tanner V, Chignell AH.
Accepted. British Journal of Ophthalmology. 2001.
- Phacoemulsification and removal of silicone oil
Tanner V, Haider A, Rosen P.
Ophthalmology. 1999;106:1235-1236
- Posterior Sub-tenons triamcinolone in the treatment of uveitis
Tanner V, Kanski JJ, Frith P.
Eye. 1999;13:5.704
- The influence of lens delivery systems on pan-retinal photocoagulation.
Tanner V, Rosen P.
Eye. 1998; 12.4: 751-752.
- A comparative study of the efficacy of 2.5% phenylephrine and 10% phenylephrine in mydriasis prior to routine cataract surgery - Author’s reply.
Tanner V, Casswell AG.
Eye. 1997; 11:6. 947-948
Published Abstracts:
- Watske-Allen slit beam testing of macular holes confirmed by optical coherence tomography.
Tanner V, Williamson TH.
Invest Ophth Vis Sci. 1999; 40 (4 ): 115
- Posterior sub-tenons triamcinolone in the treatment of posterior uveitis.
Tanner V, Frith PA, Kanski JJ.
Invest Ophth Vis Sci 1997 ; 38 (4 ): 2439
- Early onset keratoconus and atopy. Mutation screening for gene encoding beta-subunit of high affinity Ig E receptor.
Downes SM, Tanner V, Wensley C, Kenyon J, Black G.
Invest Ophth Vis Sci 1996 ; 37 ( 3 ): 4679.
Videos:
- Combined cataract extraction, lens implantation and removal of silicone oil.
Tanner V, Haider A, Rosen P.
Surgical technique video.
Accepted for publication. Video Journal of Cataract and Refractive Surgery. 2001.
- Sutureless 3 port pars-plana vitrectomy
Tanner V, Towler H, Rosen P.
Surgical technique video.
Presented at American Academy of Ophthalmology meeting, San Francisco, U.S.A. 1997.
Presented at Annual Congress of Royal College of Ophthalmologists, Birmingham. 1997.
- Combined cataract extraction, lens implantation and removal of silicone oil
Tanner V, Haider A, Rosen P.
Surgical technique video.
Presented at Annual Congress of Royal College of Ophthalmologists, Birmingham. 1997.
Presented at XV Congress, European Society of Cataract and Refractive Surgery, Prague. Czech republic. 1997
Other:
- The management of acute posterior vitreous detachment
Chignell AH, Harle D, Tanner V, Williamson TH
CD-ROM. Educational update, Optometry in practice. 2001
- The symptomatology of posterior vitreous detachment and secondary retinal
Harle D, Tanner V, Chignell AH.
Report to the College of Optometrists on national questionnaire of optometric referral patterns of patients presenting with symptoms of acute posterior vitreous detachment. May 1999.
- Clinical applications of an automated test of chromatic discrimination sensitivity.
Tregear S J, Ripley L G, Knowles P J, Tanner V, de Alvis D V, Reffin J P, Vickers S V, Casswell A G, Gilday R T
Chapter in Dalton's colour vision legacy - Published Proceedings of The John Dalton Colour Vision Conference.
U.M.I.S.T., Manchester. September 1994.
Invited Speaker
VR in a day - Joint meeting Moorfields Eye Hospital and St Thomas's Hospital, London, 2015 Mr Vaughan Tanner
VR in a Day, London, 2015.
Chair, free paper session, British and Eire Association of Vitreo-Retinal Surgeons, Annual Meeting 2013
Management of dislocated lens Fragments.
Annual Meeting United Kingdom and Ireland Society Cataract and Reafractice Surgeons. 2010.
Advances in Day Case Vitreoretinal Surgery – An Update
Trends in Ophthalmology meeting, London 2010
Current Trends in VR Surgery, New horizons in VR nursing
Reading 2008
Management of dropped lens fragments during phacoemulsification cataract surgery
Vitreoretinal course, St Thomas' Hospital, London. 2007
Management
of dropped lens fragments during phacoemulsification cataract surgery
Vitreoretinal course, Moorfields Eye Hospital, London. February
2006
Macular
Hole pathogenesis
Moorfields and St Thomas' Hospital annual VR update. London 2005
Advances
in phacoemulsification cataract surgery and intra-ocular lenses
Berkshire Optometrists. March 2004
Management
of dropped lens fragments during phacoemulsification cataract surgery
Vitreoretinal course, Moorfields Eye Hospital, London. March 2004
Management
of age related macular degeneration
St Peter's Hospital, Chertsey. March 2004
Advances
in Retinal Surgery
Windsor GP update. Feb 2004
Intravitreal
Triamcinolone
Oxford Eye Hospital. Jan 2004
Chronic
endophthalmitis following cataract surgery: Under-recognised and
under-treated ?
Royal Society of Medicine, London. Jan 2004
Retinal
Surgery
Wokingham regional GP update. June 2003
Retinal
Surgery
Reading regional GP update. May 2003
Management
of acute endophthalmitis following cataract surgery
St Thomas' Hospital, London. Feb 2003
Surgical
Management of Age Related Macular Degeneration
Oxford Eye Hospital. Jan 2003
Management
of Age related Macular Degeneration, Photodynamic Laser Therapy
Berkshire Optometrists. Dec 2002
Challenging Surgical Cases.
Vitreoretinal Surgery update. Alcon Laboratories, London. July 2002
Macular Hole Surgery
Regional Teaching. Oxford Eye Hospital. January 2002
Update on surgery for age-related macular degeneration.
Vitreoretinal Surgery update. Alcon Laboratories, London. June 2001
Seminar on retinal imaging - Optical Coherence tomography
and macular holes
Royal College of Ophthalmologists Annual Congress. May 2001
Retinal detachment pathogenesis
SE Thames regional study day. Kent County Ophthalmic and Aural Hospital,
Maidstone. May, 2001
Management of acute endophthalmitis – role of vitrectomy
SE Thames regional study day. Kent County Ophthalmic and Aural Hospital,
Maidstone. May, 2001
Surgical options in age related macular degeneration
Age related macular degeneration update. St Thomas’ Hospital,
London. January 2001
Retinal breaks - creation and detection
Vitreoretinal update course. St Thomas’ Hospital, London.
January 2001
Acute endophthalmitis – review of management and role
of vitrectomy
Vitreoretinal update course. St Thomas’ Hospital, London.
January 2001
Surgical management of inferior retinal breaks
Vitreoretinal Surgery update. Alcon Laboratories, London. March.
2000
Chorioretinal biopsy
Trends in Ophthalmology. St Thomas’ Hospital, London. November
1999
Retinal degeneration and break development
Vitreoretinal update. Moorfields Eye Hospital, London. November
1999
Perils of prophylaxis for retinal detachment
Vitreoretinal update. Moorfields Eye Hospital, London. November
1999
Laser and surgical treatment options for macular oedema
South East Thames Regional Study Day. St Thomas’ Hospital,
London. March 1999
Macular Hole Surgery and Optical Coherence Tomography
Vitreoretinal Surgery update, Alcon Laboratories, London. January
1999
Klebsiella Endophthalmitis
Trends in Ophthalmology. St Thomas’ Hospital, London. October
1998
Macular Hole Surgery
Trends in Ophthalmology. St Thomas’ Hospital, London. October
1998
Pre-operative planning and examination in Retinal Detachment
Surgery
Vitreoretinal Surgery Course. St Thomas’ Hospital, London.
June 1998
Performance of Conventional Retinal Detachment Surgery
Vitreoretinal Surgery Course. St Thomas’ Hospital, London.
June 1998
The use of colour vision testing in the management of dysthyroid
eye disease
Symposium on dysthyroid eye disease. Mayday Hospital, London. October
1995
Colour vision in dysthyroid eye disease
South East Thames Regional Study Day. Sussex Eye Hospital, Brighton.
November 1995
Disclaimer
The
information provided in this website is intended as a useful aid to general
practitioners, optometrists and patients. It is impossible to diagnose and
treat patients adequately without a thorough eye examination by a qualified
ophthalmologist, optometrist or your general practitioner. Hopefully the
information will be of use prior to and following a consultation which
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