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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...

Four pillars: Education

This series explores the four pillars of advanced clinical practice and here, Catherine Garrott explores the pillar of education. Advanced clinical practice applies to all allied healthcare professionals (AHP) in ophthalmology, such as nurses, orthoptists and optometrists. As our roles...

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...

Is patient masking leading to an increase in post-op infection after eyelid surgery?

Due to the COVID-19 pandemic, the use of facemasks or face coverings in the clinical setting has become necessary. It is important to recognise that facemasks can be a source of infection after eye surgery and consider ways to minimise...

What's trending Dec/Jan 2021

A round-up of the eye-related hot topics that have been trending on social media over the last few weeks. #threeblindmice US company Nanoscope Therapeutics has developed a new treatment which is hoped will restore vision in those affected by retinal...

Diagnosis and management of IV cranial nerve palsy

Aetiology: Trochlear nerve palsy can be divided into acute or congenital. Congenital trochlear nerve palsy is usually noted in childhood with development of abnormal head posture. Various pathologies can lead to acute IV nerve palsy, most commonly trauma. Other causes...

Toxic nutritional optic neuropathy (TON)

Toxic optic neuropathy are a group of conditions manifested by reduction of visual functions secondary to damage to the anterior visual pathways from exposure to a toxin. The implicated toxin could be work-based, food or drink related, or iatrogenic medication....

Internuclear ophthalmoplegia: a case study

A 44-year-old patient presents with binocular, mostly horizontal diplopia when fixating on moving objects. This has been ongoing for approximately five years. He is known to have multiple sclerosis and had an episode of optic neuritis six years prior in...

The results of the last survey Feb22

This edition’s survey took a slightly different tack and tried to look at the problems we face in litigation. Litigation is unpleasant. It is horrible being involved in it and the process of litigation can be extremely stressful. From the...

Disseminated cutaneous zoster – a masquerade

Reactivation of varicella zoster infection in the elderly commonly presents to ophthalmologists as herpes zoster ophthalmicus (HZO), affecting the Va trigeminal dermatome. In patients with impaired immunity, zoster infection occurs with increased severity and may be complicated by visceral and...

Macular imagery: observing the visual sensations pre- and post-Jetrea injections

A 63-year-old woman, a professional painter, was diagnosed with vitreomacular traction (VMT) in 2017. She had a history of metamorphopsia, drop in visual acuity (VA) in the left eye (6/6 in the RE; 6/18 in the LE), foveal vitreomacular traction...

A rare neonatal presentation of bilateral dacryocele and choanal atresia

Following a routine pregnancy, a newly delivered baby boy, born at term, was found to have increased work of breathing, stridor and a left medial canthal swelling. The baby required 100% oxygen via a face mask to maintain oxygen saturations....