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Randomisation, confounding & observational methods in ophthalmic epidemiology

Randomisation and confounding Understanding the relationship between an exposure and an outcome of interest is the central challenge in ophthalmic epidemiology. The exposure may be aetiological, taking the form of a putative risk biological factor, or therapeutic, in the form...

The last three patients: general medicine (Patient Two)

For the second reflection in this series (see Patient One here), Professor Jonathan Rees recounts his experiences of the last patient he saw as a medical registrar, telling the tragic story of a young man’s death and the risks that...

Neuro-ophthalmology: the extended role of an orthoptist

Neuro-ophthalmology has always been a speciality of interest during my studies and now in my career. In 2018, I started a Band 7 post which gave me an extended role in neuro-ophthalmology and the responsibility of developing an orthoptic led...

Immunoglobulin G4-related ophthalmic disease – what is it? (Part 2)

Part 2: Clinical presentation and treatment (see part 1 here) Introduction IgG4-related disease (IgG4-RD) is understood to have a vast clinicopathological spectrum; nearly every organ has had reported involvement. Similarly, IgG4-related ophthalmic disease (IgG4-ROD) is known to affect nearly every...

Aqueous misdirection: a case series of unexpected surgical complications

Aqueous misdirection (AM), also known as malignant glaucoma, is a form of secondary glaucoma that typically presents with shallowing of the anterior chamber (AC), raised intraocular pressure (IOP), and reduced visual acuity (VA) in the presence of patent peripheral iridotomies...

A new observation point: updating the nomenclature and classification with OCT

The evolution of ophthalmic imaging technologies has been particularly rapid over the last few years. The author provides an update of the current terms for common signs and pathologies observed using optical coherence tomography. My experience as an ophthalmic technician,...

Measuring patient-reported outcomes after refractive surgery to assess patient satisfaction

Patient-reported outcomes enable surgeons to evaluate patients’ symptoms and satisfaction after laser vision correction. The great majority of patients are pleased with their outcomes from laser vision correction, whether it is with photorefractive keratectomy, laser in-situ keratomileusis (LASIK), or small...

A semi-automated algorithm for identifying glaucoma patients with blindness

Patients with sight impairment (previously referred to as partial sightedness) or severe sight impairment (previously referred to as blindness) are eligible for a certificate of visual impairment (CVI). Certification confers eligibility for a wide range of benefits administered by local...

My Top Five: Key insights from recent research into uveitis in adults

Uveitis, characterised by inflammation of the uvea – the eye’s middle layer comprising the iris, ciliary body, and choroid – remains a leading cause of visual impairment worldwide [1]. It primarily affects adults aged 20–50 years. Untreated uveitis may cause...

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....

Transferring imaging from primary to secondary care (part 2)

Transferring clinical imaging from high street optometrists to secondary care is an increasingly requested option, especially in the context of the COVID-19 pandemic. A wide variety of solutions exist to allow this, each with their own merits and shortcomings. In...

My Top Five: Promising gene therapies for ocular conditions

Gene therapy, a pivotal advancement in modern medicine, particularly shines in ophthalmology. By targeting defective genes with engineered vectors, this approach promises significant strides in treating inherited retinal diseases. This article reviews the top five gene therapies in late-stage trials,...