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How good does my vision have to be to drive this thing? Visual standards for various occupations

We can all picture that moment in clinic: you are about to tell someone that they’re no longer legally able to drive, ready to deploy our ‘breaking bad news’ techniques. For some patients this may have been expected, or they...

Sclerochoroidal calcification masquerading as ocular malignancy

Case 1 A 68-year-old Caucasian gentleman was urgently referred to eye casualty by his optometrist after seeing an unusual incidental finding of protruding lesions from the retina, suspecting choroidal melanoma. He was asymptomatic and this was his first eye test...

Certifying patients as visually impaired: the start of a journey

In March 2017 there were 290,475 people registered as either visually impaired or severely visually impaired in the UK [1]. Patients registered as sight impaired benefit from financial support as well as practical help. Practical help is provided by social...

On becoming a man

It was at the height of the gender debate, with Donald Trump banning transsexuals from serving in the US army and parts of the first world indulging in controversies on whether separate transgender toilets are needed, that a 40-year-old lady,...

A closed angle seldom comes alone

Case report An 89-year-old lady with dementia was referred to me out of hours by her GP with a few days history of an angry looking left eye for suspected elevated intraocular pressure (IOP). I discovered that this lady first...

A log in the eye

"My friend wanted to show how far he could throw that log. So, he helicoptered it over his head, faster and faster and when he let go, it hit my eye at full speed,” a young lady of 19 years...

Take this waltz

My last weekend on-call was the busiest I can remember for a very long time. We were just completely swamped with patients. The weather was not too good that Saturday and it felt like every second inhabitant of our ocean...

A tale of two membranes

It was the best of times, it was the worst of times... It was the season of Light, it was the season of Darkness... I am fortunate to work on a vitreoretinal firm at the moment and only a few...

Anisometropia following cataract surgery and its non-surgical treatment

The desired result of cataract surgery is improved visual acuity without the use of spectacles. In practice most patients following initial cataract extraction are likely to be symptomatic of anisometropia giving rise to prismatic effects (anisophoria) and unequal retinal image...

Fusarium keratitis in a patient with alcohol dependence

Treatment of fungal keratitis secondary to the Fusarium species remains a challenge. Although relatively more common in warmer climates, this corneal infection is rare in the UK. Most cases have been reported in farmers and are often preceded by trauma....

How to pass FRCOphth Part 1 on the first attempt

Studying for this exam makes one wonder how there is so much to know about such a small organ. The FRCOphth Part 1 examination is notorious for its low pass rate, with only 20–40% of candidates succeeding at each sitting....

Under pressure: a tool to aid the 
non-ophthalmic practitioner in the timely management of acute angle closure

Acute angle closure is a true ophthalmic emergency that mandates timely diagnosis and treatment. The priority in initial management is to lower the intraocular pressure in an expeditious matter using medical treatments. The risk of irreversible glaucomatous optic neuropathy is...