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Apr/May 2014 Quiz 1

History A 45-year-old man presents with left-sided epiphora. During a dacrocystorhinostomy (DCR), the wall of the lacrimal sac was noted to be bulky. The sac wall is biopsied and sent for routine histopathology examination. The pathologist notes a distinctive feature...

Considerations in the management of retinal disorders

Vision research presentations and publications explore practice considerations in the management of AMD and diabetic retinopathy. Over the past two decades in Europe there has been a decreasing prevalence of age-related macular degeneration (AMD) and an improvement in visual acuity...

Infection prophylaxis and first visit timing for strabismus surgery

The authors undertook this study to characterise the practice patterns of paediatric ophthalmologists regarding their use of infection prophylaxis and timing of the first postoperative visit after strabismus surgery. A 10-question multi-choice questionnaire was circulated via American Association for Pediatric...

Managing cataract surgery in a patient with diabetic maculopathy

A 56-year-old type 2 diabetic with previously treated bilateral diabetic maculopathy develops a cataract requiring surgery in the right eye. He has had grid laser previously, followed intermittently by intravitreal triamcinalone, Avastin and more recently Lucentis in both eyes. His...

Diagnosis of ocular tuberculosis

This review article provides an update on the methods diagnosing ocular tuberculosis (TB), the difficulties in making the diagnosis and makes recommendations to a more accurate diagnosis by combining the available diagnostic tests. Today ocular TB remains a presumptive clinical...

Brexit, for richer, for poorer: prospects for post-withdrawal Britain

The people of the United Kingdom voted by 52% to 48% to leave the European Union (EU) in June 2016, a referendum decision intended by a slim majority to restore national self-determination and achieve what many believed to be a...

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...

Ophthalmic entrepreneurship: Reflections from an ophthalmic surgeon

For many ophthalmic trainees and newly appointed consultants, the idea of medical entrepreneurship can feel distant and sometimes uncomfortable. We are trained in a profession centred on patient care, ethics and service. The word entrepreneur, by contrast, often brings to...

Non-infectious Uveitis: Well Known, Weird and Wonderful meets You, Me and the Balloons

Installation view from Manchester International Festival 2023 exhibition Yayoi Kusama: You, Me and the Balloons at Aviva Studios. Images © David Levene. On an uncharacteristically salubrious 5 July 2023, the date of the 75th Anniversary of the UK’s NHS, a...

Video consultations after COVID-19

In the context of the COVID-19 pandemic, video consultations (VC) in eye care have been adopted in some regions and hospitals as a way of replacing some face to face ophthalmic consultations. I would like to use this column to...

Leadership skills training through the COECSA-RCOphth LINK

The Lead Forward project was an initiative of the VISION 2020 LINKS Programme, funded by the Department for International Development (DFID) via the Tropical Health Education Trust (THET). It aimed to improve the quality of medical leadership within VISION 2020...

Acanthaemoeba keratitis

In the second of this series I describe a case of Acanthaemoeba keratitis (AK) that was misdiagnosed for a prolonged period which resulted in a devastating outcome. This is one of half a dozen similar medico-legal cases I have dealt...