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Photophobia: an unusual symptom of a pituitary macroadenoma

Introduction Photophobia, defined as ‘an abnormal intolerance to light’, is commonly associated with a range of both ocular and neurological pathologies such as dry eye, blepharospasm, corneal pathologies, cataracts, uveitis, retinal dystrophies, optic neuritis, migraine, meningitis, and traumatic brain injury...

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....

Vision on the line: Managing orbital trauma in a 30-year-old surgeon after a football injury

Blunt orbital trauma is a common consequence of sports injuries. Although retrobulbar haemorrhage is frequently associated with orbital compartment syndrome (OCS), the severity of clinical signs can outweigh imaging findings. Early recognition and intervention, such as lateral canthotomy and cantholysis...

Transferring imaging from primary to secondary care (part 1)

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. For...

“We try our best”, but we should still be open and transparent

In a recent discussion with colleagues, someone recognised that many, when asked what they do, say, “I am a doctor”. Rather than “I work as a doctor”. This sense of belonging, pride and duty comes with responsibility. Becoming a surgeon,...

Innovation update: key advances in eyecare transformation in the last year

Vishal Shah and his co-authors reflect on examples of innovation in eyecare delivery published in the last year and the implications for the future of eyecare services. The “new normal” is an overused phrase to describe extraordinary measures that have...

Human factors in the operating room

The importance of minimising human error in surgery is well established. This was initially sparked by lessons learned from the aviation industry in the 1970s after several fatal flight accidents [1]. This became a catalyst for a movement on training...

On becoming a man

It was at the height of the gender debate, with Donald Trump banning transsexuals from serving in the US army and parts of the first world indulging in controversies on whether separate transgender toilets are needed, that a 40-year-old lady,...

Simulation in ophthalmology: a pedagogic viewpoint

The advent of simulation technology has enhanced modern medical training. The first utilisation of simulation was in 1929 where Edward Link used this concept to develop a mechanical flight simulator [1]. Industries such as aviation, nuclear power and the military...

Ocular mucous membrane pemphigoid: the importance of early detection and treatment

Mucous membrane pemphigoid (MMP) is an autoimmune blistering disorder that is characterised by subepithelial bullae. The ocular manifestation of MMP, ocular mucous membrane pemphigoid (OMMP), is a sight-threatening condition characterised by conjunctival cicatricial changes associated with corneal vascularisation and scarring....

Fusarium keratitis in a patient with alcohol dependence

Treatment of fungal keratitis secondary to the Fusarium species remains a challenge. Although relatively more common in warmer climates, this corneal infection is rare in the UK. Most cases have been reported in farmers and are often preceded by trauma....

Obtaining US clinical experience in ophthalmology as a UK medical student or junior doctor

Medical students or junior doctors in the UK may be interested in gaining US clinical experience for many reasons. Unfortunately, many trainees do not know how to arrange these and there is a common misconception that it is difficult to...