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Management of a giant pigment epithelium detachment with transition from half- to full-dose aflibercept

This case report describes the management of a giant pigment epithelial detachment (PED) in neovascular age-related macular degeneration (nAMD) using half-dose aflibercept. An 80-year-old woman presented with a huge PED (maximum height 1338µm) and multiple risk factors for retinal pigment...

From trainee to teacher: Top tips for teaching fellow applications

Getting into ophthalmology training has become increasingly competitive in recent years. In 2025, the competition ratio rose to over 21:1, compared to 3:1 in 2019 [1,2]. Similar trends are seen across other specialties, with over 30,000 doctors applying for just...

21st Century retinal laser treatment in the anti-VEGF era

In today’s world, macular laser treatment has a vital role in the treatment of diabetic macular oedema (DMO). DMO is one of the most common causes of visual impairment. Despite expensive intravitreal treatment courses of anti-VEGF, many will agree that...

Conservative management of concomitant strabismus

The aim of management for all patients with strabismus should centre around four goals: to prevent amblyopia, to alleviate symptoms, to restore binocular single vision (BSV) and to improve ocular alignment. The conservative management options available for strabismus include observation,...

Binocular single vision (BSV)

Introduction In this article I will try to summarise some of the definitions, tests and assessments performed in the strabismus clinic to assess patient binocular potential. This is a key feature of strabismus assessment, especially in adults, and it will...

Ophthalmic viscoelastic devices: Useful insights for a novice cataract surgeon

Ophthalmic viscoelastic devices (OVDs) are essential in many different stages of cataract surgery. This article discusses the categories of OVDs and their respective properties, and highlights their uses in different scenarios faced in cataract surgery. Ophthalmic viscoelastic devices are gel-like...

Aqueous misdirection: a case series of unexpected surgical complications

Aqueous misdirection (AM), also known as malignant glaucoma, is a form of secondary glaucoma that typically presents with shallowing of the anterior chamber (AC), raised intraocular pressure (IOP), and reduced visual acuity (VA) in the presence of patent peripheral iridotomies...

Lessons from an unusual case of syphilis

The rise of syphilis transmission rates over the past two decades has been one of public health’s great puzzles. In the UK, the situation has reached epidemic levels, with a 126% increase between 2013 and 2018 [1]. We present a...