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Avoiding investigations through history taking and examinations to differentiate serious from comparably benign aetiology

1 December 2022 | | EYE - General
*Joint first authors. Introduction Anisocoria can be a sign of neurological deficit, necessitating numerous investigations [1]. This case report explores how expensive and time-consuming investigations can be avoided by thorough history taking and examination to differentiate serious from comparably benign...

Pituitary adenoma causing compression of the optic chiasm

1 April 2019 | | EYE - Neuro-ophthalmology, EYE - General
A 21-year-old girl presented to her general practitioner (GP) with a three-month history of headaches, becoming more frequent and associated intermittent vomiting that did not improve with simple analgesics. There was a strong family history of migraines. She was initially...

The last three patients: general medicine (Patient Two)

5 June 2023 | | EYE - General
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...

Unilateral central scotoma following dengue fever

12 October 2023 | | EYE - Neuro-ophthalmology
Case report A 16-year-old Caucasian male was referred to the eye casualty at Nottingham University Hospitals NHS Trust by the infectious diseases unit in September 2013. He gave a history of photophobia, pain on eye movements and central blurred vision...

Implications of missed foreign bodies under the upper eyelid

9 August 2023 | | EYE - Paediatrics, EYE - Oculoplastic
Children aren’t the best historians. As a result, clinicians sometimes rely on the accounts of parents regarding problems. Missed foreign bodies due to poor histories or incomplete examinations may result in irreversible loss of vision. This case report shines light...

Ophtherminator 3 - Rise of the Machines

3 June 2021 | | EYE - Vitreo-Retinal, EYE - Imaging, EYE - General
“Bring back life form, priority one, all other priorities are rescinded.” Film buffs will spot this as a chilling quote spoken by Ash (Ian Holm) from the classic sci-fi horror movie Alien (1979). Ash (spoiler alert) is a Hyperdyne Systems...

Effecting change

1 June 2017 | | EYE - Cataract, EYE - Cornea, EYE - Glaucoma, EYE - Imaging, EYE - Neuro-ophthalmology, EYE - Oculoplastic, EYE - Oncology, EYE - Orbit, EYE - Paediatrics, EYE - Pathology, EYE - Refractive, EYE - Strabismus, EYE - Vitreo-Retinal, EYE - General
I took a picture of my new identity badge and sent it to everyone I knew. In fact, I put it up on Facebook as well. The two key words were ‘Consultant Ophthalmologist’ and let us ignore for now that...

Cura Te Ipsum – Physician, Heal Thyself

1 August 2015 | | EYE - Cataract, EYE - Cornea, EYE - Glaucoma, EYE - Imaging, EYE - Neuro-ophthalmology, EYE - Oculoplastic, EYE - Oncology, EYE - Orbit, EYE - Paediatrics, EYE - Pathology, EYE - Refractive, EYE - Strabismus, EYE - Vitreo-Retinal, EYE - General
I wasn’t on call and my bleep went off. I knew without looking that it was the directorate office. Immediately my heart sank, for these calls were always about bad things. They never called to say “well done Gwyn you’re...

Is ophthalmology still a vocation?

1 December 2018 | | EYE - General
People seem to be interested in medicine for different reasons. There does seem to be a spectrum in ophthalmology in which people range from ‘do it for the pay’ all the way to ‘do it for the patients’, with some...

Cyanoacrylate nail glue accidentally instilled into the eye instead of eye drops

1 April 2016 | | EYE - Cataract, EYE - Cornea, EYE - General, EYE - Glaucoma, EYE - Imaging, EYE - Neuro-ophthalmology, EYE - Oculoplastic, EYE - Oncology, EYE - Orbit, EYE - Paediatrics, EYE - Pathology, EYE - Strabismus, EYE - Refractive, EYE - Vitreo-Retinal
Three hundred thousand cataract operations take place each year in the UK alone and each patient will receive a four week course of drops in order to cover them for any postoperative inflammation or infection. Accidental instillation of cyanoacrylate glue...

‘Getting a head start’: ways medical students can boost their chances of entering ophthalmology training

5 October 2020 | | EYE - General
Ophthalmology is one of the most competitive medical specialities in the UK, with 3.74 applicants per place in 2018 [1]. Given the competitive nature of this highly specialised field, medical students who are interested in pursuing a career in ophthalmology...

The first on-call

1 December 2022 | | EYE - General
You’ve made into ophthalmic specialist training and before you know it, it’s your first on-call shift. You are expected to provide the specialist on-call service out of hours and there is a new wave of responsibility, with, let’s be honest,...