Ophthalmology
A complicated case of cytomegalovirus viremia: “What would you do doctor?”
Mrs W walked gracefully into my urgent care clinic. It was another busy session and I hoped she did not have anything serious going on which might slow the clinic further. She was an elegant 72-year-old lady who seemed like...
Initiatives in macular service provision
A report from Monitor in October 2015 identifies good practices that will realise most of the potential productivity gain in elective care available to NHS hospitals. These include: stratifying patients by risk and creating low-complexity pathways for lower-risk patients (tailoring...
Pathophysiology of diabetic macular oedema: why combination therapy may be better
The prevalence of diabetes has continued to increase over the years. It is currently estimated that there are 382 million with diabetes worldwide in 2013, and that this figure is expected to rise to 592 million by 2035 [1]. In...
Strategies for managing neovascular AMD and DMO in routine clinical care
Treatment practice in the management of neovascular age-related macular degeneration (AMD) and diabetic macular oedema (DMO) illustrate increasing adoption of patient-tailored treatment approaches based on initial diagnosis and regular monitoring of imaging and visual outcomes in routine clinical care. The...
Genetic profiling for personalised healthcare solutions in AMD – an update
Age-related macular degeneration (AMD) is a multifactorial condition influenced by genetics and lifestyle factors (Table 1). This article outlines several recent advances in AMD genetics, as well as evolving therapeutic concepts and established practical measures for the treatment and /...
Intravitreal injections delivered by ophthalmic clinical nurse specialists
Intravitreal injections of the anti-vascular endothelial growth factor (anti-VEGF) agent ranibizumab, for the treatment of wet age-related macular degeneration (AMD) was approved by National Institute for Health & Care Excellence (NICE) in 2008 [1]. The Manchester Royal Eye Hospital (MREH),...
Anterior segment imaging: a photographer’s view
My name is Rosalyn Painter and I work within the vision science and ophthalmic imaging team at Bristol Eye Hospital, where we cover all aspects of imaging within the hospital, including fluorescein angiograms, fundus photography, optical coherence tomography (OCT), slit-lamp...
What’s next in retinal imaging? Faster, deeper and full-on
Fast-evolving technological leaps are opening the way toward clinically useful ocular coherence angiography, generating 3-dimensional microvasculature maps without intravenous dye injection, as well as whole-eye imaging, handheld patient-operated optical coherence tomography (OCT) devices and, for challenging vitreoretinal procedures, integrated intraoperative...
Myasthenia gravis presenting with isolated ptosis: a poorly studied subgroup
Investigation into the cause of one isolated symptom or sign can be challenging if that particular sign may be caused by a variety of pathological processes, affecting different tissues, and presenting to different specialties. Unilateral ptosis is a case in...
Shifting the paradigm of managing patients in medical retina: how real-world data can help us to improve clinical practice
The ophthalmic subspecialty of ‘medical retina’ has undergone dramatic changes in recent years. With the introduction of ranibizumab (Lucentis, Novartis), a specialty formerly dominated by laser-based therapies has been transformed to become, in large part, pharmacotherapy-based. To date, these pharmacotherapies...
Retinopathy of prematurity treatment in the South West of England: long-term outcomes 1997-2008
Retinopathy of prematurity (ROP) is a condition that affects the developing retinal vascular system of pre-term babies. If left untreated, ROP can lead to severe visual impairment. The severe visual impairment caused by untreated ROP can be prevented by screening...
Management of proliferative diabetic retinopathy
Diabetic retinopathy is a major cause of blindness in the working-age population. Due to the worsening global epidemic of diabetes, the incidence of morbidity caused by the disease is set to increase [1]. The prevalence of diabetes in the UK...
