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Surgical strategies to manage incomitant strabismus in adults

Incomitant vertical and / or horizontal strabismus is a challenging presentation. Patients are usually symptomatic as the onset is either sudden so they haven’t developed any coping mechanisms or very complex so that any coping mechanisms will not cover all...

Commonest mistakes during the refraction certificate exam

Ophthalmology specialty trainees are required to pass the refraction certificate exam within the first two years of training. If one passes this exam before entering a training programme, this can add two points to the portfolio during applications. In this...

Just sign here: the intricacies of consent in the post-Montgomery era

The consent process is a vital part of the patient pathway and is far more than just getting the patient to sign on the dotted line. In my work in litigation I often see issues around informed consent resulting in...

High-stakes scenarios in retinal vein occlusion: A survey of medico-legal implications

Central retinal vein occlusion (CRVO) is the second most common retinal vascular disease after diabetic retinopathy, and its clinical complexity often intersects with medico-legal scrutiny [1]. Missteps in timely diagnosis, inadequate follow-up or poor documentation can lead to patient harm...

Patient changes eye colour permanently and has brighter and whiter looking eyes

In this new series, Simerdip Kaur takes a look at the latest ophthalmology-related news stories and asks which are scientific reality and which are ‘fake news’. Headline: Patient changes eye colour permanently and has brighter and whiter looking eyes If...

Acute dellen formation post trauma

Corneal dellen are saucer-like thinnings, usually of the peripheral cornea [1]. Dellen formation is thought to be related to localised tear film instability [2], specifically the absence of the mucin component of the tear film. Without the mucin layer, dry...

An unusual case of acute retinal necrosis

Case report A 40-year-old Caucasian male presented with a four-day history of redness and progressive painless reduction of vision in the left eye. His visual acuities were 6/4 in the right and 6/36 in the left. The left eye showed...

A step-by-step approach to the diagnosis and management of Sands of Sahara Syndrome

Sands of Sahara syndrome (diffuse lamellar keratitis) is a rare postoperative complication of Laser in situ keratomileusis (LASIK). Its estimated prevalence is reported to be 2-4% among LASIK cases [1], despite that, it is more likely to be encountered by...

Lockdown and eye health – a case of accommodative spasm

A 25-year-old male presented to the eye casualty with a one-day history of sudden onset worsening vision. More specifically, he noted his vision was more blurred than usual and this was more exaggerated for near-work than for distance-work. He was...

Microcatheter in the vertebral artery as a cause of branched retinal artery occlusion?

A 19-year-old male presented to eye casualty with a seven-day history of a ‘blurred patch’ in the left eye. The patient denied any other visual symptoms including flashes or floaters and there had been no change in visual symptoms in...

A case of Miller Fisher Syndrome and bilateral asymmetric globe retraction

Miller Fisher syndrome (MFS) is a rare, acquired nerve disease that is considered to be a variant of Guillain-Barré syndrome. It was first recognised by James Collier in 1932 as a clinical triad of ataxia, areflexia and ophthalmoplegia. Later, it...

A case of ‘60-day glaucoma’

Neovascular glaucoma (NVG) has been called ‘90-’ or ‘100-day glaucoma’ in the past due to its typical development three months after the onset of central retinal vein occlusion (CRVO). In reality, NVG can occur anywhere between two weeks and two...