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Immunoglobulin G4-related ophthalmic disease – what is it? (Part 2)

Part 2: Clinical presentation and treatment (see part 1 here) Introduction IgG4-related disease (IgG4-RD) is understood to have a vast clinicopathological spectrum; nearly every organ has had reported involvement. Similarly, IgG4-related ophthalmic disease (IgG4-ROD) is known to affect nearly every...

Designing ophthalmology services - Part 1: How do we address the queues in a clinic?

This first of a three-part series shows how systems engineering can be used to correctly diagnose and address the causes of delays in a clinic. The second article, which will be featured in the April/May 2020 issue, describes how to...

My message to future ophthalmology teaching fellows: Organising an effective ophthalmology placement

Globally, teaching ophthalmology during the undergraduate period presents challenges. The time allocated for it is minimal with substandard exposure [1,2]. Additionally, the number of universities mandating formal ophthalmology education has significantly declined [3]. Research supports the observation that doctors in...

Mastering clinical skills in ophthalmology

To young junior doctors, and some senior doctors who may not have had much exposure to ophthalmology, the specialty can seem very foreign. Not only are the conditions and examination findings specific to the eyes, but the skill set required...

Practice tips: Directions in cataract surgery services and preventing postcataract endophthalmitis

Future directions in the delivery of high quality cataract surgery services and approved intracameral prophylactic approaches to lowering the risk of postcataract infective endophthalmitis were debated by consultant ophthalmic surgeons in a recent London seminar, held at the Royal Society...

It’s All in Your Head: Stories from the Frontline of Psychosomatic Illness

Have you ever reviewed a patient with unexplained symptoms? It’s All in Your Head by Consultant Neurologist Dr Suzanne O’Sullivan is a non-fiction book about patients with psychosomatic disorders. In each of the nine book chapters, she presents an anonymised...

Case report of Leber hereditary optic neuropathy (LHON)

This case report presents a 74-year-old male patient who developed LHON, with a previous diagnosis of bilateral macular holes. LHON occurs predominantly in healthy young men and onset in older age ranges increases the likelihood that the patient will have...

Maintenance therapy for CMV endotheliitis

Cytomegalovirus (CMV) has been associated with corneal endotheliitis, leading to endothelial cell loss and corneal decompensation. CMV corneal endotheliitis recurrence can affect between 5-60% of eyes after cessation of anti-CMV therapy. Each recurrence of endotheliitis has a detrimental effect on...

An unusual case of partial oculomotor nerve palsy

The authors present an unusual case of intra-axial oculomotor nerve involvement due to midbrain infarction. The 65-year-old male patient presented with unilateral complete blepharoptosis and slight limitation of upgaze. Neurological examination revealed a complete ptosis of the left eyelid, slight...

A case report of visual loss as a consequence of coeliac disease

The authors present a case of permanent visual loss secondary to occipital lobe calcification in coeliac disease, the first reported such case. The 58-year-old man had been diagnosed with coeliac disease 20 years prior to his visual investigations and had...

Fungi in chronic anterior blepharitis

In this prospective, non-randomised cross-sectional study the authors demonstrate the presence of fungi in patients with chronic anterior blepharitis of at least two years duration. Eyelash samples were obtained by epilation with sterile forceps and evaluated with PAS staining, fungal...

A population based follow-up study on pseudoexfoliation and cataract surgery

n association between pseudoexfoliation (PEX) and cataracts has been shown in many previous studies. Recently, the Australian Blue Mountains Eye Study, using the Wisconsin Cataract Typing and Grading System, observed an increased prevalence of nuclear cataract in eyes with PEX....