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How to nearly (but not quite) get into ST1 ophthalmology training – some reflections

Ophthalmology is often considered to be an elite, highly competitive specialty, with little room for failure. Candidates and trainees tend to cultivate a certain urbane and confident style, and the bottleneck at ST1 can feel rather intense. The majority of...

The College of Optometrists welcomes seven new Life Fellows, two new Honorary Fellows and a Fellow by Portfolio

The College awarded new Fellowships at the annual Diploma Ceremonies in Westminster in November 2024. The College of Optometrists has recognised the outstanding achievements and contributions of 10 individuals working in eye health by awarding new Life and Honorary Fellowships...

What not to miss in neuro-ophthalmology Part 1

Neuro-ophthalmology is a complex and difficult subspecialty in ophthalmology. It has several connections to neurology, neuro-surgery, rheumatology as well as many other medical specialties. Working in an multidisciplinary team (MDT) environment is key to success in this subspecialty as mistakes...

What not to miss in neuro-ophthalmology Part 2

As mentioned previously there are several conditions in neuro-ophthalmology that should not be missed by the general ophthalmologist as well as ophthalmology trainees. We discussed in the first part some of these conditions including third cranial nerve palsies, giant cell...

Traumatic optic neuropathy

In neuro-ophthalmology we get asked a lot about management of patients who suffered significant trauma and presented with loss of vision secondary to presumed traumatic optic neuropathy (TON). TON happens usually in the context of significant craniofacial trauma. The incidence...

The results of the last survey Oct22

I thank everyone for their time in responding to this edition’s survey questions. The first question relates to an issue I have previously discussed around consent for second eye cataract surgery. I touch on this point again for two reasons....

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...

Trans-sinus endoscopic removal of retrobulbar air gun pellet within the orbital apex

Injuries to the eye have been widely reported in medical literature due to a variety of mechanisms causing significant morbidity and occasional unexpected mortality for the patient [1]. It is often wrongly assumed that air gun pellets lack this potential....

Deciphering dark retinal patches

We present a case of bilateral extensive dark without pressure (DWP) located outside the retinal vascular arcades in a young female. This retinal finding is benign but, in some instances, darkened retinal patches could be associated with potential sight-threatening conditions....

Shedding light on Wolfram syndrome: The unveiling of a delayed diagnosis

Wolfram syndrome 1 (WS1) was first described by Wolfram and Wagener in 1938 and it’s a rare neurodegenerative, progressive disorder, also known as DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness) [1]. We present an atypical case of WS...

Transferring imaging from primary to secondary care (part 2)

Transferring clinical imaging from high street optometrists to secondary care is an increasingly requested option, especially in the context of the COVID-19 pandemic. A wide variety of solutions exist to allow this, each with their own merits and shortcomings. In...

Vitreomacular traction: natural course vs. vitrectomy vs. ocriplasmin

Over time, the vitreous gel completely separates from the retina in a process known as a posterior vitreous detachment (PVD). In some instances, however, the vitreous does not detach entirely and remains adherent to the macula. The term vitreomacular traction...