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My journey as advanced ophthalmic emergency nurse practitioner

Grace Eni explores her own achievements as an advanced nurse practitioner, emphasising the influential range and significance of this role in ophthalmic care. A pioneering position and job title in the UK and possibly globally, advanced nurse practitioner roles were...

A missed intraocular telescope – an opportunity to re-focus the evidence

Intraocular telescopes allow magnification of the image so that it would be projected into a larger area of the macula, this makes the central defect caused by dry age-related macular degeneration (AMD) smaller. The most common approach is a Galilean...

Ophthalmology in ancient india, Sushruta’s time and the modern era

While reading an article related to the history of Indian ophthalmology, I came across this description of a surgical procedure: “The doctor warmed the patient’s eye with the breath of his mouth. He rubbed the closed eye of the patient...

Effecting change

I took a picture of my new identity badge and sent it to everyone I knew. In fact, I put it up on Facebook as well. The two key words were ‘Consultant Ophthalmologist’ and let us ignore for now that...

From novice to overnight on-calls: developing an ophthalmology bootcamp to ease the learning curve for new trainees

Introduction My first ophthalmology on-call was nine years ago and it was a fairly traumatic experience. I was an FY2 in a Welsh district general hospital and I was on my own – at least, that’s how it felt to...

Lacrimal gland carcinoma

This is a major review of the management of lacrimal gland carcinoma, focusing mainly on adenoid cystic carcinoma. Relevant literature published in English since 1970 was included amounting to some 40 articles after filtering. Overall mortality for all lacrimal gland...

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...

How many injections in nAMD: ranibizumab vs. aflibercept

Intravitreal anti-VEGF injections make up a large proportion of the workload in ophthalmology clinics. Since the introduction of aflibercept with eight weekly injections there has been an option to use a treatment which may require less treatment, with potential cost...

Is an increased homocysteine level associated with greater risk of AMD?

Basic research studies have implicated homocysteine in causing vascular endothelial dysfunction and inflammation, and this has been borne out in large observational studies which suggested that elevated homocysteine is associated with increased risk of cardiovascular disease. In order to determine...

Ranibizumab for the treatment of age-related macular degeneration

This multicentre randomised prospective open label study compared 0.5 versus 2mg of ranibizumab in patients with submacular retinal pigment epithelial (RPE) detachment due to age-related macular degeneration. Four treatment regimens were used for the two strengths either monthly for 12...

Detection of antiranibizumab antibodies in exudative AMD

In this study the authors aimed to detect immune response to ranibizumab treatment in wet age-related macular degeneration (AMD). An ELISA was employed to quantify the anti-ranibizumab titre which was compared against the control anti-abciximab titre. Titres of anti-ranibizumab antibodies...

Role of fundus autofluorescence patterns and baseline atrophy area on geographic atrophy progression

Central geographic atrophy (GA) is one of the morphological sub types of late-stage macular degeneration. The natural course of the disease is characterised by expanding areas of macular atrophy, which cause absolute scotoma. Fundus autofluorescence (FAF) is derived from lipofuscin...