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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...

Managing a dislocated intraocular lens

A 70-year-old male patient is referred from the optician with a history of onset of double vision and examination shows a dislocated / subluxated IOL. How will you manage this patient? If the double vision is causing serious concern to...

Ophthalmology in the COVID-19 pandemic

The novel coronavirus pandemic has affected the whole world and forced all of us to think of new ways to manage our day to day personal as well as professional life. I am not going to talk about the clinical...

Toxic nutritional optic neuropathy (TON)

Toxic optic neuropathy are a group of conditions manifested by reduction of visual functions secondary to damage to the anterior visual pathways from exposure to a toxin. The implicated toxin could be work-based, food or drink related, or iatrogenic medication....

Internuclear ophthalmoplegia: a case study

A 44-year-old patient presents with binocular, mostly horizontal diplopia when fixating on moving objects. This has been ongoing for approximately five years. He is known to have multiple sclerosis and had an episode of optic neuritis six years prior in...

Step-by-step guide to mastering skills with the Goldmann applanation tonometer

Ophthalmology is a highly specialised field that requires proficiency in various diagnostic skills for numerous conditions. Entrants into ophthalmology at ST1 often possess minimal to no ophthalmic experience beyond what they learned in medical school. Consequently, they may face significant...

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...

How does your practice compare?

One of the lovely things about clinical meetings and conferences is the ability to meet with your peers and ask questions of them about their practice. Often the questions are not earth shattering, for example, it could be as simple...

Ophthalmology survey results June/July 2019

Firstly may I thank all of you who took the time to answer the survey. I hope you will agree that the findings are very interesting. From a medicolegal perspective we always consider the Bolam test which can be summarised...

Ophthalmology survey results August/September 2019

I am delighted to see another great response to the practice variance survey. I am extremely grateful to all of you who took part and would encourage those of you who didn’t to try this survey. It literally takes mere...

The results of the last survey Aug 2019

Thank you once again for participating in the survey. Some fascinating results once again. Almost one in five of us do not cancel cataract surgery on the day if the blood pressure (BP) is high, which I am surprised about....

The results of the last survey Apr 2020

As ever, I would like to thank all those who participated in the last edition’s survey. A lot of data was generated and I do not intend to go through each individual finding. What is staggering again is the degree...