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Preventing refractive surprises by real time biometry during cataract surgery

A few months ago a retired lady presented for second eye cataract surgery. I noted on the pre-op ward round that the outcome of her first eye’s surgery looked like a refractive surprise as her spherical equivalent in that eye...

On the wrong track

A 65-year-old very high myope lady presented with sudden blurred vision down to count fingers to her right eye after a short and sharp pain. She also described seeing a black swirly line and as all these symptoms were exactly...

Atlas Of Orbital Imaging

It was an absolute pleasure to review this beautifully written textbook. Authorship is from a diverse, international group of experienced and respected oculoplastic surgeons with an interest in orbital disease. A significant contribution to most of these chapters has been...

Could the sclera be key to glaucoma?

The glaucomas are a group of conditions characterised by optic neuropathy and associated visual field defects. Of these, chronic open-angle glaucoma (COAG) – diagnosed on the basis of progressive structural changes to the optic nerve head (ONH) and nerve fibre...

Embedding EMR for a complete transformation in user experience

Informatics and IT projects in the NHS have a history of being over budget, delivered late and not fulfilling the design brief. “But it doesn’t have to be that way,” believes Chris Canning, Consultant Ophthalmologist and Chief Clinical Information Officer...

Can thou lyse this? A national study of emergency canthotomy and cantholysis

Eighty-two-year old Janet Smith woke up on the floor. Had she been unconscious? Her head hurt. It was the middle of the night, but in the darkness she suddenly wasn’t sure whether she could see out of her right eye....

Genetic profiling for personalised healthcare solutions in AMD – an update

Age-related macular degeneration (AMD) is a multifactorial condition influenced by genetics and lifestyle factors (Table 1). This article outlines several recent advances in AMD genetics, as well as evolving therapeutic concepts and established practical measures for the treatment and /...

Is optician led service an answer to ever increasing demand on eye emergency clinics?

The demand for eye casualty appointments has been steadily increasing in the UK, leading to pressures on the hospital emergency services. The incidence of presentations to eye casualty services has been estimated at 20-30 per 1000 per year [1]. Evidence...

A short survey of the views of clinicians on the role of procedure-specific consent forms

Informed consent is an ethical and legal right of every patient [1]. It is essential that patients receive clear, concise and accurate information regarding the risks, benefits and alternatives to a potential intervention. In addition to this, the patient must...

Use of a smartphone repair microscope for microsurgical suturing simulation

Suturing ocular tissues under microscopic guidance is a skill that has declined in frequency, with the majority of cataract operations being sutureless. With the recent COVID-19 outbreak, training opportunities in theatre have declined further, given elective surgery cancellations. Subsequently, trainees...

Randomisation, confounding & observational methods in ophthalmic epidemiology

Randomisation and confounding Understanding the relationship between an exposure and an outcome of interest is the central challenge in ophthalmic epidemiology. The exposure may be aetiological, taking the form of a putative risk biological factor, or therapeutic, in the form...

The last three patients: general medicine (Patient Two)

For the second reflection in this series (see Patient One here), Professor Jonathan Rees recounts his experiences of the last patient he saw as a medical registrar, telling the tragic story of a young man’s death and the risks that...