Specialty Trainee
Principles of contact lens fitting in keratoconus
Keratoconus is an ectatic condition of the cornea characterised by progressive conical distortion with irregular astigmatism, myopia and apical protrusion. Most cases progress slowly resulting in varying degrees of myopic astigmatism. Management of keratoconus includes spectacles, soft contact lenses, a...
Preventing refractive surprises by real time biometry during cataract surgery
A few months ago a retired lady presented for second eye cataract surgery. I noted on the pre-op ward round that the outcome of her first eye’s surgery looked like a refractive surprise as her spherical equivalent in that eye...
On the wrong track
A 65-year-old very high myope lady presented with sudden blurred vision down to count fingers to her right eye after a short and sharp pain. She also described seeing a black swirly line and as all these symptoms were exactly...
Anisometropia following cataract surgery and its non-surgical treatment
The desired result of cataract surgery is improved visual acuity without the use of spectacles. In practice most patients following initial cataract extraction are likely to be symptomatic of anisometropia giving rise to prismatic effects (anisophoria) and unequal retinal image...
“I can’t see nothing out of that eye, you ....!”
This is exactly the call you don’t want to receive at 11 at night. The A&E colleague phoned to inform me about a young man who was kicked several times in the face and could not see out of one...
External dacryocystorhinostomy in the management of childhood epiphora
Congenital nasolacrimal duct obstruction is thought to be caused by a membranous obstruction at the distal end of the nasolacrimal duct (NLD). Rarely, associated midline deformities in soft tissue and bony structures of the face are present in patients with...
A European ophthalmology perspective
Europe: from the Greek eurus: broad, wide, and ops: eye, face, sight. Thus Europe = the far-sighted (lady). For my first contribution to this column – as the successor of Jonathan Park, whose witty observations and entertaining style many of...
Ocular mucous membrane pemphigoid: the importance of early detection and treatment
Mucous membrane pemphigoid (MMP) is an autoimmune blistering disorder that is characterised by subepithelial bullae. The ocular manifestation of MMP, ocular mucous membrane pemphigoid (OMMP), is a sight-threatening condition characterised by conjunctival cicatricial changes associated with corneal vascularisation and scarring....
Friendly felines and a spot diagnosis
A nine-year-old girl presented to me in eye casualty with a three-week history of blurred vision in her left eye. Otherwise she was apparently well, with no past ophthalmic, medical, drug or relevant family history. Visual acuity was 6/4 right...
Fusarium keratitis in a patient with alcohol dependence
Treatment of fungal keratitis secondary to the Fusarium species remains a challenge. Although relatively more common in warmer climates, this corneal infection is rare in the UK. Most cases have been reported in farmers and are often preceded by trauma....
Strange Sequelae Succeeding ‘Surfer’s Eye’
Ophthalmologists in the UK are relatively infrequently faced with a patient requesting surgery for a pterygium. This condition is more common where ultraviolet exposure is greater, especially if coupled with activities associated with ocular surface irritation. For this reason, a...
A Multidisciplinary Approach to Neovascular Glaucoma in a Patient with Waldenström’s macroglobulinemia
An 84-year-old Caucasian male attended eye casualty with a four month history of reduced vision, a dull ache and photophobia in both eyes. He had also reported dizziness, weakness and intermittent epistaxis in the nine months prior to presentation. There...
