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Informed consent – the Brexit test

The Medical Defence Union (MDU) runs courses on various medicolegal topics. I would guess people only ever attend these courses if they have an exam or an interview approaching as the subject matter is exceedingly dry for clinicians. I myself...

Third nerve palsy

Case scenarios A 71-year-old female presented to a nearby eye emergency unit with two days history of partial ptosis in her left eye with diplopia. She saw her GP earlier that day and he asked her to go to the...

The results of the last survey Oct21

This edition’s survey questions moved away from the deep and ethically charged questions of the recent surveys and focussed on simple and straightforward issues. This is really where the surveys began in exploring the minor practice variations which we have...

The medical student syndrome

It is often said that “a little learning is a dangerous thing,” but being super savvy can’t put us at the brink of harm, can it? Each year as thousands of students commence their medical degrees, they begin a journey...

Preventing refractive surprises by real time biometry during cataract surgery

A few months ago a retired lady presented for second eye cataract surgery. I noted on the pre-op ward round that the outcome of her first eye’s surgery looked like a refractive surprise as her spherical equivalent in that eye...

Herpes zoster ophthalmicus: the essentials

Herpes zoster, also referred to as shingles, is a common infection most typically caused by the reactivation of varicella zoster virus that lies dormant (sometime for decades) in the dorsal root nerve ganglion following primary chickenpox infection [1]. In 10-20%...

“I can see fine. Why do I need my eyes tested?”

Are routine eye examinations really necessary? The author asks whether frequent appointments in low-risk patients with normal results are actually cost-effective. It’s recommended that most people should get their eyes tested every two years.” [1] This message is widely publicised...

Sixth nerve palsy versus decompensating distance esophoria

Orthoptists see a wide range of conditions that can range from reduced binocular single vision (BSV) that may be solved with exercises, to more extreme neurogenic cases requiring further intervention. Because of this variety, it is important to be able...

The results of the last survey Dec20

The responses to the first question in this survey demonstrate the need for it and the significant variation in practice we see in even relatively simple management decisions. Patients are seen regularly with occludable drainage angles and listed for YAG...

Systemic sarcoidosis presenting with acute myopia and angle closure

Case report A 40-year-old Asian man presented to the Emergency Department with a one day history of sudden onset visual disturbance in his right eye. He complained of image distortion and noted that objects now appeared smaller. He also described...

The challenge of chorioretinal folds in virtual eye clinics

Chorioretinal or choroidal folds are parallel striations involving the retina, retinal pigment epithelium (RPE), Bruch’s membrane, and inner choroid [1]. They can arise from compressive stress on these layers, and their presence often serves as a diagnostic marker for underlying...

A case of ‘60-day glaucoma’

Neovascular glaucoma (NVG) has been called ‘90-’ or ‘100-day glaucoma’ in the past due to its typical development three months after the onset of central retinal vein occlusion (CRVO). In reality, NVG can occur anywhere between two weeks and two...