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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...

Ultrasound biomicroscopy (part 2): primary angle closure

Patients with primary angle closure or primary angle closure glaucoma [PAC(G)] comprise a significant subgroup affecting around 10% of glaucoma patients amongst Caucasians. Assessment of the patient with angle closure, or narrow angles, requires gonioscopy. However, whilst identifying the presence...

How to diagnose and treat Acanthamoeba keratitis

Corneal ulceration caused by Acanthamoeba is on the rise, and recent publications indicate an outbreak in the UK over the last few years [1]. Since Acanthamoeba keratitis often presents with atypical features, diagnosis from slit-lamp examination alone can often be...

Management of squint with near-distance angle disparity

These are a group of strabismus disorders where the angle of misalignment is different between near and distance. The focus of this article will be on the patients where the angle for near exceeds the distance angle by more than...

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...

The results of the last survey Feb 2020

I appreciate that I keep on reiterating it, but again we see so much practice variance. Who is right and who is wrong? Is there a right or wrong approach? And does it matter? I think it probably does matter....

The results of the last survey Jun24

When I was in my training and even in my early years as a consultant, I did not fully understand the difference between different lenses. When asked my preference of hydrophilic versus hydrophobic intraocular lenses (IOLs) I really did not...

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...

Recurrent corneal erosions secondary to isotretinoin use

Isotretinoin (13–cis-retinoic acid) is the first line treatment for moderate to severe nodulocystic or papulopustular acne [1,2]. Although it is a safe medication, it has several adverse side-effects, including ophthalmic manifestations, as shown in Table 1 [3]. These side-effects need...