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Progressive myelination of the retinal nerve fibre layer: Acquired or incidental?

*Co-first authors.Myelinated retinal nerve fibres are retinal nerve fibres encased by a myelin sheath, located anterior to the lamina cribrosa [1]. First described by Virchow in 1856, a myelinated retinal nerve fibre layer (RNFL) appears as a whitish, feathery patch...

A near miss

A 55-year-old gentleman presented with a ‘blurry patch’ to his left eye which he had noticed for the past two months. The visual acuity with correction was 6/5 in the right eye and 6/6 in the left eye on the...

Ophthalmology history and examination – a guide for medical students

*First author Students have very little exposure to ophthalmology during their years at medical school. Teaching consists of a handful of lectures followed by a short placement in which students are expected to practise histories and examinations on patients with...

Optic nerve swelling – your survival guide (part 2)

In this second article we will discuss bilateral optic nerve swelling, its aetiology, various investigations and possible treatments. We will also discuss various protocols used in the management of suspected optic nerve swelling cases. (Part one of this topic available...

Results of corneal cross-linking in very steep corneas

Corneal cross-linking (CXL) has been shown to be a safe and valid treatment option for progressive keratoconus and have shown an arrest of progression with a low failure rate of 0% to 2.8% in mild to moderate keratoconus. A Kmax...

Corneal cross-linking for treatment of corneal ulcers

This was an observational cohort study looking at the usefulness of photo activated chromophore for infectious keratitis-corneal collagen cross-linking (PACK-CXL) in reducing the time to heal in suppurative corneal ulcers. This study, conducted in a tertiary care centre in South...

Shifting the paradigm of managing patients in medical retina: how real-world data can help us to improve clinical practice

The ophthalmic subspecialty of ‘medical retina’ has undergone dramatic changes in recent years. With the introduction of ranibizumab (Lucentis, Novartis), a specialty formerly dominated by laser-based therapies has been transformed to become, in large part, pharmacotherapy-based. To date, these pharmacotherapies...

How to examine the visual system Part 2: Accommodation, pupils, fundoscopy and additional tests

Examining the visual system can be a tricky skill for medical students to master, yet it is a task that is frequently tested in examinations. This is the second of a two-part series of articles, which together aim to improve...

My experience of the transition into a specialist orthoptist role

Michelle Dent discusses the process of transitioning into a new role and the pros and cons along the way. An opportunity arose for a permanent, full time, band 7 specialist role in the medical retina (MR) team in the Newcastle...

Assessing everyday visual function in dry AMD – what matters to the person?

Age-related macular degeneration (AMD) is the primary cause of blindness in the developed world and is accountable for more than one half of sight impairment registrations within England and Wales [1]. AMD is prevalent in people aged 60 years and...

Air or SF6 in DMEK

This retrospective study compared descemet’s membrane endothelial keratoplasty (DMEK) outcomes in 136 consecutive eyes of 68 patients. All patients underwent DMEK for Fuch’s endothelial dystrophy, where consecutive eyes received 100% air bubble during first eye surgery and 20% sulphur hexafluoride...

PACK-crosslinking for infectious keratitis

Corneal cross-linking with riboflavin and UV-A light (CXL) is a technology that has been initially developed to treat corneal ectatic disorders [1]. Its effect in stabilising diseases such as keratoconus was reported in numerous trials with excellent long-term outcomes and...