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Quiz Apr/May 2023

History A 76-year-old female presented at her local district general hospital with right decreased visual acuity, glare, and foreign body sensation, in addition to longer-term dry eyes. She was otherwise well. Her past medical history included hypertension. On examination: vision...

The management of possibly progressive pterygium

A 43-year-old Sudanese male patient is referred by his GP with a fleshy lesion encroaching the nasal cornea for the last six months. History Make note of: risk factors, i.e. UV exposure and ocular irritation - history of living in...

Corneal cross-linking for treatment of corneal ulcers

This was an observational cohort study looking at the usefulness of photo activated chromophore for infectious keratitis-corneal collagen cross-linking (PACK-CXL) in reducing the time to heal in suppurative corneal ulcers. This study, conducted in a tertiary care centre in South...

Dramatic myopic shift due to epithelial basement membrane dystrophy

Epithelial basement membrane dystrophy (EBMD), also known as map-dot-fingerprint dystrophy, is a common anterior corneal disorder affecting approximately 2% of the population [1]. It is characterised by the abnormal maintenance of the basement membrane, resulting in protrusions into the epithelium....

Ripasudil after Descemet stripping in Fuch’s endothelial dystrophy

This study prospectively evaluated the use of ripasudil, a rho kinase inhibitor, in patients undergoing Descemet’s stripping only (DSO) without an endothelial graft for Fuch’s endothelial dystrophy (FED). Patients with dense central guttae limited to the central 5mm of the...

Step-by-step guide to mastering skills with the Goldmann applanation tonometer

Ophthalmology is a highly specialised field that requires proficiency in various diagnostic skills for numerous conditions. Entrants into ophthalmology at ST1 often possess minimal to no ophthalmic experience beyond what they learned in medical school. Consequently, they may face significant...

Bandage contact lens cultures after corneal collagen cross-linking

Corneal collagen cross-linking (CCL) is a treatment modality that has been shown to stop the progression of keratoconus. There have also been reports that CCL acts as an antimicrobiologic agent in treating resistant microbial keratitis. This study aimed to investigate...

Surgically induced astigmatism after cataract surgery

In this study, the authors analysed a dataset of 122 eyes of 122 patients with pre- and postoperative measurements of corneal astigmatism with IOL Master 700. A standardised 2.5mm superior corneal incision was utilised. The corneal power vector component in...

Corneal dystrophies simplified

Based on biomicroscopic and histopathologic features, corneal dystrophies can be broadly classified into epithelial, Bowman’s layer / anterior stromal, stromal, and endothelial dystrophies. Corneal dystrophies are a group of inherited, bilateral, gradually progressing, non- inflammatory conditions caused by accumulation of...

Boston type I keratoprosthesis for limbal stem cell deficiency

Boston type I keratoprosthesis (KPro) long-term outcomes were compared in patients with and without limbal stem cell deficiency (LSCD) in this retrospective study. In the 11 year period 68 procedures were performed in individuals with LSCD, and 105 procedures in...

Long-term effect of YAG LPI on corneal endothelium in PACS

This is a single-centre randomised controlled trial of 875 patients with bilateral primary angle closure suspect (PACS) who received YAG laser iridotomy (LPI) prophylactic treatment in one eye randomly and the fellow eye served as control over 72 months. Central...

Microbial keratitis in corneal grafts

The authors report a retrospective case series of 59 episodes of microbial keratitis identified in 41 eyes of 41 patients (39 penetrating keratoplasty (PKPs) and two deep anterior lamellar keratoplasty (DALKs)), from a total of 759 consecutive corneal grafts identified...