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Aug/Sep 2015 Quiz 1

History A 60-year-old woman was referred to ophthalmology with a suspected left eye choroidal naevus. Visual acuity was unaffected in both eyes and she was asymptomatic. Ocular history and medical history were unremarkable. Questions Figure 1: Fundus photograph. 1. What...

A look into the IOL space

Advances in the design and performance of intraocular lenses (IOLs) continue to be driven by demand for better outcomes, presbyopia correction and spectacle independence, alongside a better understanding of the dynamics of the crystalline lens, newer theories of accommodation and...

Advances in the understanding, diagnostic and treatment of keratoconus

*Joint first authors Keratoconus is a bilateral and asymmetric eye condition in which the cornea’s structure is affected and thinned, causing a cone-shaped bulge to develop. This results in progressive loss of vision and impairs the ability of the eye...

Typical or surprisingly uncharacteristic presentations of neuro-ophthalmic emergencies

Irrespective of geographical location or patient cohort, emergency departments are high risk locations capable of inspiring extreme anxiety and dread in patients and doctors alike. The stress multiplies when a walk-in or referred case is suspected of underlying neurological pathology....

The Case of Dr Bawa-Garba – Where does the buck stop?

The case of Hadiza Bawa-Garba has left all of us in the UK medical profession with an uncomfortable taste in our mouths. We all know that we work under pressure and we will inevitably make mistakes. We all know that...

Understanding amniotic membrane grafts

Safa Elhassan gives a brief review of amniotic membrane grafts and their application in theatre and clinic-based settings. Amniotic membrane (AM) transplant has been an established adjuvant treatment for many corneal, conjunctival and scleral disorders in ophthalmic clinical practice with...

Optic nerve swelling – your survival guide (part 1)

Assessment of optic nerve appearance and functions is a daily routine in neuro-ophthalmology. Following a recent high profile court case there has been a significant increase in the amount of referral to ophthalmology departments to assess the optic nerve and...

Breakthroughs in the genetics of angle-closure glaucoma

Angle closure glaucoma (ACG) is not widely known to be a familial condition, yet the recent explosion of genetic data and large scale genome wide investigations have confirmed at least 13 genetic loci associated with ACG [1], and provided some...

An update on inherited retinal disorders (part 2): Approaches to therapy for IRDs

Part 1 of this topic can be found here There are currently no proven cures for inherited retinal disease (IRD). However, multiple avenues of research are being investigated to better understand disease mechanisms and trial potential therapies that may slow...

A closer look at the new wave of glaucoma surgery – radical or old school?

Glaucoma is a challenging condition to treat because the exact pathophysiology remains unclear and the only readily modifiable factor is the intraocular pressure (IOP). Additionally, most glaucoma patients are completely asymptomatic, yet are often subjected to lifelong medical therapy. The...

Optimising the ocular surface by managing meibomian gland dysfunction

Meibomian gland dysfunction (MGD) is ubiquitous. Ocular surface inflammation and irritation are prevalent in most ophthalmology clinics: corneal, cataract, glaucoma, oculoplastic, paediatric, vitreo-retinal, medical retina and refractive surgery. These patients also represent roughly one third of those attending for emergency...

Pathophysiology of diabetic macular oedema: why combination therapy may be better

The prevalence of diabetes has continued to increase over the years. It is currently estimated that there are 382 million with diabetes worldwide in 2013, and that this figure is expected to rise to 592 million by 2035 [1]. In...