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Feb/Mar 2015 Quiz 1

A 79-year-old male presented to the ophthalmic emergency department with a three week history of left eye pain. He also reported visual deterioration in the left eye over the same period. He suffered from degenerative myopia, with his spectacle prescription...

Aug/Sep 2014 Quiz 2

History A 27-year-old man presented to the emergency department with blurred vision and central scotoma in the right eye (RE) over the previous weeks. He had no relevant medical history and he was not on any current medication. However, he...

The management of chronic uveitis

A 40-year-old company executive is referred from another unit with recurrent anterior and posterior uveitis for 12 months and the inflammatory markers are raised. Review of systems This is a case of chronic uveitis which needs a thorough workup and...

The perfect interview to land the dream consultant job

Eight top tips for consultant interviews: 1. A person is not just an ophthalmologist. Trusts are appointing the person not just the ophthalmologist. On a consultant interview panel (AAC) there will be non-ophthalmologists (e.g. medical director, chief executive, lay chair)...

End stage glaucoma management

A 48-year-old female has had multiple drug treatment for glaucoma and is still losing field of vision. How do you manage this over time? This patient is at high-risk for going blind and should be managed aggressively to protect remaining...

Dark circles and facial rejuvenation

A 45-year-old socialite lady comes for cosmetic consultation and wants a remedy for dark circles and facial ageing. How do you manage this patient? Issues of dark circles and facial ageing should be addressed separately. Facial ageing should be considered...

The screening and treatment of retinopathy of prematurity

A male child is born at 31 weeks and requires 100% oxygen supplementation with intensive care. What would be the ophthalmic management of this child? In the first instance, it will be useful to know the screening criteria and protocol....

Traumatic optic neuropathy

In neuro-ophthalmology we get asked a lot about management of patients who suffered significant trauma and presented with loss of vision secondary to presumed traumatic optic neuropathy (TON). TON happens usually in the context of significant craniofacial trauma. The incidence...

How to nearly (but not quite) get into ST1 ophthalmology training – some reflections

Ophthalmology is often considered to be an elite, highly competitive specialty, with little room for failure. Candidates and trainees tend to cultivate a certain urbane and confident style, and the bottleneck at ST1 can feel rather intense. The majority of...

Demyelinating optic neuropathy

Introduction Optic neuritis (ON) is an inflammatory process affecting the optic nerve. After glaucoma, it is the most common optic neuropathy affecting patients under the age of 50. The usual presentation of typical ON is unilateral subacute loss of vision...

Commonest mistakes during the refraction certificate exam

Ophthalmology specialty trainees are required to pass the refraction certificate exam within the first two years of training. If one passes this exam before entering a training programme, this can add two points to the portfolio during applications. In this...

The role of aspirin in the treatment of NAION: Benefits and controversies

Non-arteritic anterior ischaemic optic neuropathy (NAION) is the most common acute optic neuropathy in individuals over 50 with estimated prevalence of 2–10 per 100,000 people, characterised by sudden, unilateral vision loss due to ischaemic injury to the optic nerve head....