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Quiz Feb/Mar 2020

History A 92-year-old female patient was referred for a three-month history of a left conjunctival growth with ocular irritation. Her past medical history included: hypertension, back pain and osteoarthritis, all of which were controlled by medication. On examination: vision in...

Lessons from an unusual case of syphilis

The rise of syphilis transmission rates over the past two decades has been one of public health’s great puzzles. In the UK, the situation has reached epidemic levels, with a 126% increase between 2013 and 2018 [1]. We present a...

Intravitreal dexamethasone in diabetic macular oedema (DMO) - enhancing the response to anti-VEGF in non- or poor responders

This study aimed to describe the outcomes of a switch back from DEXi (dexamethasone implant) to anti-VEGF therapy in eyes that were treated temporarily with DEXi after an initial poor response to anti VEGF. Twenty-three eyes of 17 patients were...

Governments missing opportunity to increase economic progress

Report calls on governments to invest in eye health to address $410.​​​9​​ billion loss in economic productivity.

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...

The management of watery eye in an infant with facial dysmorphism

A six-month-old child with facial dysmorphism is brought to the eye clinic with history of watery right eye since birth. How will you manage this child? Causes for watery eye in an infant 1. Overproduction of tears a. Infections b....

Adaptive optics imaging: resolving single cells in the living eye

The human retina is unique in the central nervous system (CNS) in that it can be directly visualised non-invasively. Technological advances of several imaging modalities, including optical coherence tomography (OCT), multichannel scanning laser ophthalmoscopy (SLO) and fundus photography, have afforded...

A missed intraocular telescope – an opportunity to re-focus the evidence

Intraocular telescopes allow magnification of the image so that it would be projected into a larger area of the macula, this makes the central defect caused by dry age-related macular degeneration (AMD) smaller. The most common approach is a Galilean...

Evolving towards an interventional glaucoma mindset

Traditionally, a newly diagnosed glaucoma patient would be treated first with medical therapy. As the disease progressed or the initial intervention failed to adequately control intraocular pressure (IOP), clinicians would add more drops, selective laser trabeculoplasty (SLT), repeated SLT and...

Minimally Invasive Glaucoma Surgery: What options are there and when might they be considered?

In recent years there has been a rapid expansion in a group of operations termed ‘minimally invasive’ or ‘micro invasive’ glaucoma surgery (MIGS). These options generally offer less significant IOP reduction, but with a more favourable safety profile when compared...

Ultra-widefield imaging in glaucoma: Documenting hypotony-related choroidal effusions after microshunt surgery

Ultra-widefield (UWF) imaging provides extended visualisation of the posterior segment beyond the traditional 30–50° field of view. It captures a broad view of the posterior pole and periphery in a single, quick, non-mydriatic acquisition. While its role in diabetic retinopathy...

Corneal keloid: Report of natural history and Outcome of Surgical Management in Two Cases

Corneal keloids are rare and typically reported following trauma (including post-surgical) and has been reported without any trauma or previous surgery. A corneal keloid differs from a hypertrophied scar in that it occurs months/years after the injury, enlarges over time...