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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...

The lived experience of benign essential blepharospasm

Benign essential blepharospasm (BEB) is a rare neurological condition which causes involuntary sustained or intermittent muscular contraction of both eyelids and upper facial muscles which cause closure of eyelids, abnormal facial expressions and distress [1]. The term dystonia is an...

Demodex blepharitis: A transatlantic comparison of treatments available in the UK and US

Demodex blepharitis is widely recognised among eyecare professionals as an important cause of chronic lid margin inflammation, dry eye and ocular surface diseases. The characteristic feature for diagnosis is the presence of waxy deposit at the lash bases on slit...

Cataract surgery in corneal disease

Cataract surgery in the presence of corneal disease presents multiple challenges, from determining whether symptoms are lenticular or corneal in origin, to decisions regarding timing of surgery, intraocular lens (IOL) power calculation, IOL selection, surgical technique and perioperative care. Realistic...

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...

Non-organic visual loss

Patients can present to eye departments with various signs and symptoms (mostly symptoms) with no obvious organic cause. These patients can be labelled with any of a wide range of diagnoses such as functional visual loss, functional overlay, psychosomatic reaction...

Recurrent unilateral preseptal cellulitis secondary to herpes simplex virus infection

Introduction Periorbital (sometimes called preseptal cellulitis) is a common condition which on its own is not normally an ophthalmic or surgical emergency, however it has the potential to cause severe and serious morbidity in cases where the infection has crossed...

Oculogyric crisis with B12 deficiency

An oculogyric crisis (OGC) is a dystonic movement disorder of the eyes which can last from seconds to hours. Although there is no published diagnostic criteria for OGC, typically the onset is acute, and it is characterised by conjugate upward...

Optic nerve swelling – your survival guide (part 2)

In this second article we will discuss bilateral optic nerve swelling, its aetiology, various investigations and possible treatments. We will also discuss various protocols used in the management of suspected optic nerve swelling cases. (Part one of this topic available...

Decoding the red eye

Red eye, or hyperaemia, is one of the most common presentations to primary care [1] and the emergency department [2]. However, despite this the underlying cause is often misdiagnosed which can lead to severe, sight-threatening conditions being missed [1]. Thorough...

My Top Five: Red flag presentations all resident doctors must know

Ophthalmic emergencies are time-critical situations where delays in recognition or management can lead to permanent vision loss [1]. For resident doctors and medical students, identifying these red flags can be daunting, especially given the complexity of the eye and its...

Beyond vision loss: Why doctors should know about Charles Bonnet Syndrome

Over 250 years have passed since Charles Bonnet’s seminal essay, in which he described the symptoms of the syndrome that now takes his name [1]. Charles Bonnet Syndrome (CBS) describes the occurrence of visual hallucinations in people with significant visual...