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Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

Discussing treatment modalities for bilateral wet AMD

A 65-year-old lady with bilateral wet AMD and vision of 6/24 comes with an internet search about current therapies. How do you explain the various treatment modalities available? There are two NICE approved treatments for wet age-related macular degeneration (AMD)....

Ocular electrophysiology

A 34-year-old woman, who is a CEO in a multinational firm, has been losing vision over the last 12 months. She has seen her opticians, who initially tried different glasses but could not improve things. Clinical examination is unremarkable. How...

What's trending Oct/Nov 2021

A round-up of the eye-related hot topics that have been trending on social media over the last few weeks. #cataracts #holography #simulation Cataracts are the major cause of blindness globally and innovating novel management strategies remains as important as ever...

Traumatic injuries from foam Nerf bullets

Background Three patients are presented in this case report: an adult and two children which were subjected to ocular injuries from Nerf gun bullets. Generally, Nerf guns are considered safer than airsoft guns. While there are many papers on airsoft...

Progressive myelination of the retinal nerve fibre layer: Acquired or incidental?

*Co-first authors.Myelinated retinal nerve fibres are retinal nerve fibres encased by a myelin sheath, located anterior to the lamina cribrosa [1]. First described by Virchow in 1856, a myelinated retinal nerve fibre layer (RNFL) appears as a whitish, feathery patch...

IN FOCUS - Prevention and treatment of blindness worldwide: the story of ‘VISION 2020: The Right to Sight’

The story of blindness and efforts to prevent and treat it cannot be told without going back to the earliest recorded history of blindness. Trachoma was described in ancient Egypt, cataract surgery in India about the fifth century BC and...

The power of the full blood count

Vishal Shah walks us through his thought process whilst highlighting the importance of routine investigations when dealing with unusual retinovascular presentations. Retinal changes can arise in anaemia, leukaemia, lymphoma, myeloproliferative and myelodysplastic syndrome. They are often the first manifestation of...

A focus on Pakistan’s growing eye care needs: over 43 million patients treated for curable blindness free of charge

With 90% of the world’s visually impaired living in developing countries, Pakistan is no exception to this on-going global healthcare challenge. Despite massive leaps over the last few decades in targeting this issue, the World Health Organisation (WHO) reports that...

Foundation Post in Ophthalmology

If you are in your final year of medicine at university, firstly congratulations on making it so far and secondly, you may be wondering how and which jobs to rank highly. If you have found yourself reading this article, then...

My top five: Emerging alternatives to manage and treat nAMD

Wet (exudative or neovascular) age-related macular degeneration (AMD) is characterised by choroidal neovascularisation, in which new blood vessels from the choroid invade through Bruch’s membrane. These blood vessels proliferate beneath or through the retinal pigment epithelium (RPE), causing patients to...

Minimally Invasive Glaucoma Surgery: What options are there and when might they be considered?

In recent years there has been a rapid expansion in a group of operations termed ‘minimally invasive’ or ‘micro invasive’ glaucoma surgery (MIGS). These options generally offer less significant IOP reduction, but with a more favourable safety profile when compared...