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Third nerve palsy

Case scenarios A 71-year-old female presented to a nearby eye emergency unit with two days history of partial ptosis in her left eye with diplopia. She saw her GP earlier that day and he asked her to go to the...

Acanthaemoeba keratitis

In the second of this series I describe a case of Acanthaemoeba keratitis (AK) that was misdiagnosed for a prolonged period which resulted in a devastating outcome. This is one of half a dozen similar medico-legal cases I have dealt...

Hydroxychloroquine toxicity

Being the subject of litigation is stressful and upsetting. Having to look back over your previous decisions and justify the care you delivered in good faith can be difficult. Sadly, we all live with the Sword of Damocles above us...

Ophthalmology survey results June/July 2019

Firstly may I thank all of you who took the time to answer the survey. I hope you will agree that the findings are very interesting. From a medicolegal perspective we always consider the Bolam test which can be summarised...

Ophthalmology survey results August/September 2019

I am delighted to see another great response to the practice variance survey. I am extremely grateful to all of you who took part and would encourage those of you who didn’t to try this survey. It literally takes mere...

The results of the last survey Apr 2020

As ever, I would like to thank all those who participated in the last edition’s survey. A lot of data was generated and I do not intend to go through each individual finding. What is staggering again is the degree...

The results of the last survey Apr21

There was a really fascinating response to the last edition’s practice variance survey. Strictly speaking, I cheated and this was not really about practice variation, but more about your impressions about what represents negligent practice. For the first time ever,...

The results of the last survey Feb22

This edition’s survey took a slightly different tack and tried to look at the problems we face in litigation. Litigation is unpleasant. It is horrible being involved in it and the process of litigation can be extremely stressful. From the...

The results of the last survey Jun23

*Please be aware that this data does not form part of a peer reviewed research study. The information therein should not be relied upon for clinical purposes but instead used as a guide for clinical practice and reflection. I continue...

Disseminated cutaneous zoster – a masquerade

Reactivation of varicella zoster infection in the elderly commonly presents to ophthalmologists as herpes zoster ophthalmicus (HZO), affecting the Va trigeminal dermatome. In patients with impaired immunity, zoster infection occurs with increased severity and may be complicated by visceral and...

Fundus photography in Malawi – setting up a screening programmefor diabetic retinopathy

We present the case of a 53-year-old lady who presented to the diabetes outpatient clinic at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. She was diagnosed with type 2 diabetes mellitus six years ago, for which she takes metformin orally. She...

Acute retinal necrosis presumably caused by Epstein-Barr virus infection

Acute retinal necrosis (ARN) is an uncommon, but serious and potentially blinding condition. ARN is characterised by panuveitis, occlusive vasculopathy and progressive peripheral necrotising retinitis. The diagnosis is clinical but confirmation is sought via aqueous and vitreous sampling. Varicella zoster...