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NICE approves treatment for cause of sudden sight loss

The National Institute for Health and Care Excellence (NICE) has approved a treatment for Leber Hereditary Optic Neuropathy (LHON), called Idebenone (Raxone), in those aged 12 and above who are affected by the condition. LHON is a rare mitochondrial genetic...

The final step

Not long after securing my fellowship in London I was successful at interview for a consultant post at Singleton Hospital, Swansea. The interview took place before I had actually started in London and besides the basic things that are asked...

No such thing as a free lunch

Rudyard Kipling was a very wise chap. He was in San Francisco towards the end of the 19th century and noticed that in some bars and saloons the house was giving away free lunches for every patron who first purchased...

How to win presentation medals

Having been to many tens of thousands of ophthalmology registrar presentation competitions and seen the types of presentations that consistently impress the judges, as well as the ones that fail to make the grade, I feel it is my humble...

The butterfly effect

One of the most fascinating aspects of being a consultant is seeing the workings of the machine that is medical training from the other side. For two years now I have taken part in the specialty recruitment interviews and it...

The writing on the wall

The Prophet Daniel tells a famous tale of how the tyrannical king of Babylon held a feast for all his top lords and ladies, and as the feasting grew to fever pitch a mysterious hand appeared from nowhere that started...

Feb/Mar 2017 Quiz

History A 40-year-old male patient presented with a right lower eyelid swelling with gradual enlargement for two months. On examination there was a large lesion apparently involving lid margin, part of palpebral conjunctiva and skin. No other local or systemic...

Oct/Nov 2016 Quiz

History A 67-year-old female patient had chronic left canaliculitis becoming painful and more recently complicated by left lower blepharitis. Examination revealed a small fleshy lump on the medial aspect of the left lower eyelid. There was also swelling of the...

Apr/May 2018 Quiz

History A 57-year-old lady presents with a right subconjunctival lesion which has been increasing in size for three months (Figure 1). She has never had vision problems other than presbyopia. Past medical history: hypertension and asthma. On examination, she had...

Apr/May 2014 Quiz 2

History A 29-year-old woman presented to the emergency department with a two week history of floaters and patchy peripheral visual field loss in the left eye (LE). She had no relevant medical history and she was not on any current...

Feb/Mar 2014 Quiz 2

History A 65-year-old lady presented with a ten year history of nonspecific visual disturbance and mild symptoms of dry eyes. Questioning revealed progressive nyctalopia. Previous medical history of note included Crohn’s disease requiring two bowel resections including small intestine. Figure...

Dec/Jan 2019 Quiz

History A 72-year-old male presented to his GP with a large ulcerated lesion on his right lower eyelid present for six months and enlarging in size. He had an urgent referral to a tertiary centre for specialised examination. The lesion...