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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...

Strabismus in thyroid eye disease

Pathogenesis Thyroid eye disease (TED) is an auto-immune condition, in the initial phase there is lymphocytic infiltration and oedema of the extraocular muscles with deposition of glycosaminoglycans and hyaluronic acid and adipogenesis, which can lead to an increase in the...

Cataract surgery in uveitis patients

Cataract formation is a common complication of uveitis, causing up to 40% of vision loss in these patients. Cataract results from inflammation +/- corticosteroid therapy and is usually posterior subcapsular, but a small proportion have a rapid increase in nuclear...

Cataract surgery supervision

Senior trainees supervising other more junior trainees’ cataract surgery is a skill which needs to be taught and developed with care. It is beneficial for senior trainees as it provides an opportunity to develop supervision techniques prior to consultancy and...

Biometry and IOL choice errors

In the next instalment of this series I focus on problems associated with biometry and intraocular lens (IOL) selection for cataract surgery. I have taken previous medicolegal cases I have dealt with and tried to extract some learning points and...

A patient report of pseudoxanthoma elasticum, angioid streaks and choroidal neovascularisation

Angioid streaks (AS) on their own do not cause many problems, with the majority of patients remaining asymptomatic [1]. However, once choroidal neovascularisation (CNV) occurs, the visual prognosis of the patient rapidly declines [2]. Treatment is imperative to try and...

Situation analysis of diabetic retinopathy services in eleven countries

A five-year project funded by The Queen Elizabeth Diamond Jubilee Trust is facilitating development of diabetic retinopathy services (DRS) to reduce unnecessary blindness in 10 Commonwealth countries through the establishment of a capacity-building network, the DR-NET part of the Commonwealth...

Addressing childhood blindness in sub-Saharan Africa

In this article, the authors explore paediatric ophthalmology subspecialist fellowship training in African nations south of the Sahara. Until recently, most African ophthalmologists who wished to pursue a subspecialty ophthalmology training fellowship had to go abroad. There is a huge...

Orbital cellulitis - an overview of the diagnosis and management

Periorbital (preseptal) and orbital cellulitis are infections of the subcutaneous tissues of the eye. They are differentiated by the location of the infection. Periorbital cellulitis refers to infection of the eyelid and subcutaneous tissues anterior to the orbital septum, whereas...

Principles of contact lens fitting in keratoconus

Keratoconus is an ectatic condition of the cornea characterised by progressive conical distortion with irregular astigmatism, myopia and apical protrusion. Most cases progress slowly resulting in varying degrees of myopic astigmatism. Management of keratoconus includes spectacles, soft contact lenses, a...

Preoperative povidone iodine: weighing the risks

Following on from our recent online survey, the authors examine the potential risks and benefits of diluting the concentration preoperative povidone iodine. Povidone iodine (PI) is an iodophore that has an established use as a broad-spectrum antiseptic, mainly for the...

Does vitrectomy increase the risk of glaucoma? A retrospective review from a UK hospital

The authors investigate what proportion of patients undergoing pars plana vitrectomy subsequently developed ocular hypertension or a diagnosis of glaucoma. A systematic review carried out in 2017 including seven studies found that there is evidence that pars plana vitrectomy (PPV)...