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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...

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...

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...

Refractive surprise after cataract surgery caused by posterior capsular striae

Cataract removal with intraocular lens (IOL) implantation is one of the most frequently performed surgeries in current clinical practice [1,2]. New microsurgical techniques and refined IOL power calculations allow excellent refractive outcomes. Refractive surprise following cataract surgery is uncommon [1-3]...

Usefulness of gonioscopy to investigate cause of corneal oedema after cataract surgery

A 72-year-old man with ocular hypertension presented three months after routine right phacoemulsification and toric intraocular lens (IOL) implantation with a two-week history of an irritated right eye and a sudden deterioration in right vision. His preoperative spherical equivalence was...

Preparing for the Duke Elder Award

The Duke Elder examination is an undergraduate ophthalmology exam, conducted by the Royal College of Ophthalmologists (RCOphth) and undertaken by students with an interest in ophthalmology. It is a two-hour, 90-question, multiple choice exam with a broader curriculum than that...

Optimising an acute eye service in the current COVID-19 crisis

With the current global pandemic of COVID-19 we have all had to redesign and reorganise our normal working practices. Non-urgent hospital work has been postponed to allow redistribution of resources, redeployment of hospital staff and to reduce the risk of...