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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...

Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

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...

Idiopathic intracranial hypertension (IIH)

IIH is a medical condition where the intracranial pressure (ICP) is raised without an obvious cause. The cerebrospinal fluid (CSF) is produced in by the choroid plexus in the lateral ventricles and the roof of the third and fourth ventricles,...

What's trending Jun/Jul 2018

A round-up of the eye-related hot topics that have been trending on social media over the last few weeks. #BusyPhillips #photokeratitis #sunglasses Last time, we were in the throes of the Beast from the East. Here in the UK, it’s...

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...

Neurofibromatosis with multiple bilateral choroidal nevi and literature review

The aim is to present a case of neurofibromatosis type-1 (NF-1), also known as von Recklinghausen disease, who presented with bilateral multiple choroidal nodular nevi following chemotherapy and mastectomy for breast cancer. Neurofibromatosis type-1 presents as a wide range of...

Hype or helpful: ChatGPT

It would have been hard to miss all the attention chatbots have received over the last few months. Whilst ChatGPT is easily the most well-known example of the large language models that have become so widespread of late, artificial intelligence...

In vivo confocal microscopy, principles and use in keratitis Part 1: Principles

In 1968 Maurice introduced the concept of high powered specular microscopy, it was in that very year that the first scanning confocal microscope was proposed. Marvin Minsky developed the first confocal microscope in 1955 named the ‘double focusing scanning microscope’....

A Multidisciplinary Approach to Neovascular Glaucoma in a Patient with Waldenström’s macroglobulinemia

An 84-year-old Caucasian male attended eye casualty with a four month history of reduced vision, a dull ache and photophobia in both eyes. He had also reported dizziness, weakness and intermittent epistaxis in the nine months prior to presentation. There...

My top five: Emerging alternatives to manage and treat nAMD

Wet (exudative or neovascular) age-related macular degeneration (AMD) is characterised by choroidal neovascularisation, in which new blood vessels from the choroid invade through Bruch’s membrane. These blood vessels proliferate beneath or through the retinal pigment epithelium (RPE), causing patients to...

Leadership and management in optometry: why is it important?

The General Medical Council recognises that leadership and management is essential for every doctor, and provides guidance detailing management and leadership responsibilities [1]. Indeed, management and leadership is part of the core training for all medical trainees. However, to date,...