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Oct/Nov 2017 Quiz

History A 73-year-old man presented with a rapidly growing left lower eyelid lump with recent bleeding. On examination there was a raised, ulcerated, firm mass occupying two thirds of his lower eyelid. The lesion bled easily and appeared connected to...

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...

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,...

A case of late spontaneous subluxation of in-the-bag intraocular implant

An 82-year-old frail lady was referred by her optometrist with a finding of subluxated implant in the right eye. She had uneventful phacoemulcification with in-the-bag intraocular implant 17 years earlier. There is no history of having had pseudoexfoliation (PXF) or...

Triamcinolone (TA) deposits following subcutaneous injection to treat chalazion

Chalazia are chronic lipogranulomatous inflammations of the eyelid secondary to a blocked meibomian gland. Whilst most resolve spontaneously, certain chalazia warrant treatment. Options include incision and curettage (I&C), lesion excision, intralesional steroid injections, and botox injections [1]. I&C is usually...

Meltdown, Spectre, Flying Hospitals and Spy Cams

iPhone slowdown In early 2018 users discovered that Apple was slowing down older iPhones intentionally. The reported reason was to prolong the usable battery life. These changes were made without the knowledge or consent of owners. Unsurprisingly, a community backlash...

COVID-19 and Ophthalmology: RCOphth, ICEH and COECSA joint webinar

The Royal College of Ophthalmology of Eastern, Central and Southern Africa (COECSA) and the Royal College of Ophthalmologists (the Royal College) have had a successful VISION 2020 LINK partnership for over 12 years. The partnership was established by the VISION...

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...

Systemic sarcoidosis presenting with acute myopia and angle closure

Case report A 40-year-old Asian man presented to the Emergency Department with a one day history of sudden onset visual disturbance in his right eye. He complained of image distortion and noted that objects now appeared smaller. He also described...

OCT biomarkers in asymmetric anti-VEGF response in bilateral diabetic macular oedema

This study aimed to identify optical coherence tomography (OCT) biomarkers for predicting response to anti-VEGF treatment in diabetic macular oedema (DMO). Bilateral DMO patients with asymmetric response to a loading dose of anti-VEGF (ranibizumab / aflibercept) treatment were retrospectively studied....

My Top Five: Preparing for the Duke Elder examination: My tips for success

The Duke Elder Examination is a prestigious ophthalmology exam, open to all medical undergraduates. It is a prize examination, consisting of 90 multiple-choice questions in two hours, testing students on ophthalmology content beyond the undergraduate curriculum. With notoriously tough questions,...

How the development of Glaucoma Guidelines, Glaucoma Toolkit and GLASS training and the Glaucoma nurse training can effect change in Nigeria

In July 2024, a combined training, led by Fatima Kyari, was run in Abuja, Nigeria to facilitate a multifaceted upskilling in glaucoma management. The first week comprised of inviting 36 doctors practising glaucoma from around Nigeria’s 36 states, including the...