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Vitreomacular traction and full thickness macular hole

Clinical scenario: A 64-year-old lady presented to the clinic with a few weeks history of sudden onset of metamorphopsia, central blur and reduced vision in her right eye. The ocular examination and ocular coherence tomography confirmed right eye focal vitreomacular...

The management of chronic central serous chorioretinopathy

Central serous chorioretinopathy (CSCR) is a common retinal disease characterised by one or more serous neurosensory detachments. Patients present with acute onset blurring of vision, metamorphopsia and / or central scotomas. The condition is six times more common in men...

The management of possibly progressive pterygium

A 43-year-old Sudanese male patient is referred by his GP with a fleshy lesion encroaching the nasal cornea for the last six months. History Make note of: risk factors, i.e. UV exposure and ocular irritation - history of living in...

Ocular electrophysiology

A 34-year-old woman, who is a CEO in a multinational firm, has been losing vision over the last 12 months. She has seen her opticians, who initially tried different glasses but could not improve things. Clinical examination is unremarkable. How...

Time is vision in central retinal artery occlusion

Central retinal artery occlusion (CRAO) is a rare but devastating vascular episode that can have severe impact on vision. Treatment is very time-limited and needs to be initiated very quickly to salvage any vision. The majority of patients present to...

Poppers retinopathy: What is it and how do we treat it?

Poppers retinopathy is a relatively unknown phenomenon which afflicts users of poppers but should be considered as a differential in sudden-onset or sub-acute visual acuity loss – particularly in patients with a history of recreational drug use. Raising awareness of...

Unilateral central scotoma following dengue fever

Case report A 16-year-old Caucasian male was referred to the eye casualty at Nottingham University Hospitals NHS Trust by the infectious diseases unit in September 2013. He gave a history of photophobia, pain on eye movements and central blurred vision...

Progressive myelination of the retinal nerve fibre layer: Acquired or incidental?

*Co-first authors.Myelinated retinal nerve fibres are retinal nerve fibres encased by a myelin sheath, located anterior to the lamina cribrosa [1]. First described by Virchow in 1856, a myelinated retinal nerve fibre layer (RNFL) appears as a whitish, feathery patch...

The approach to trabeculectomy postoperative complications

Performing a trabeculectomy is like giving birth to a baby. It may be traumatic and there is scope for devastating error but once the operation is completed only then does the real work begin. The bleb must be nurtured into...

The power of the full blood count

Vishal Shah walks us through his thought process whilst highlighting the importance of routine investigations when dealing with unusual retinovascular presentations. Retinal changes can arise in anaemia, leukaemia, lymphoma, myeloproliferative and myelodysplastic syndrome. They are often the first manifestation of...

Adaptive optics imaging: resolving single cells in the living eye

The human retina is unique in the central nervous system (CNS) in that it can be directly visualised non-invasively. Technological advances of several imaging modalities, including optical coherence tomography (OCT), multichannel scanning laser ophthalmoscopy (SLO) and fundus photography, have afforded...

Letter from America: Orbit and oculoplastic fellowship, University of California, San Diego

I was the fortunate recipient of the 2012 Keeler Scholarship, granting me the incredible opportunity to undertake a fellowship at the University of California, San Diego (UCSD) in orbital, oculoplastic and reconstructive surgery. My fellowship mentors were the renowned Professor...