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Will it change management?

Like most doctors I have read and am a fan of Samuel Shem’s House of God, with my favourite Rule being Rule 10: “If you don’t take a temperature you can’t find a fever.” If you don’t intend to treat...

East of Ealing

“And Cain said unto the Lord, my punishment is greater than I can bear. Behold, thou hast driven me out this day from the face of the earth; and from thy face shall I be hid. And Cain went out...

Turn up anytime

When I was starting off in ophthalmology my then boss had a standard spiel after completing a cataract case. It did not vary and I do not recall an instance of it not taking place. “The operation went well and...

Choosing a subspecialty

It is quite worrying how many registrars reach the final years of training without choosing a subspecialty. Sometimes this is because they love everything and cannot countenance giving any of it up, but more commonly this is due to various...

Feb/Mar 2014 Quiz 2

History A 65-year-old lady presented with a ten year history of nonspecific visual disturbance and mild symptoms of dry eyes. Questioning revealed progressive nyctalopia. Previous medical history of note included Crohn’s disease requiring two bowel resections including small intestine. Figure...

Internuclear ophthalmoplegia: a case study

A 44-year-old patient presents with binocular, mostly horizontal diplopia when fixating on moving objects. This has been ongoing for approximately five years. He is known to have multiple sclerosis and had an episode of optic neuritis six years prior in...

The results of the last survey Jun23

*Please be aware that this data does not form part of a peer reviewed research study. The information therein should not be relied upon for clinical purposes but instead used as a guide for clinical practice and reflection. I continue...

A refractive surprise after vitrectomy and capsulectomy

Figure 1: Right posterior capsule small aperture. We report a case of a pseudophakic patient who underwent vitrectomy and posterior capsulectomy. In spite of good visual acuity and absence of floaters, he was unhappy with the visual outcome. Case report...

Traumatic ‘toy’ gun injury leading to permanent vision loss

Pseudoxanthoma elasticum (PXE) is a progressive, inherited disorder of connective tissue that affects the skin, cardiovascular system and retina. Ocular manifestations of the disease are related to Bruch’s membrane, a thin elastic tissue layer located between the retinal pigment epithelium...

Refractive surprise after cataract surgery caused by posterior capsular striae

Cataract removal with intraocular lens (IOL) implantation is one of the most frequently performed surgeries in current clinical practice [1,2]. New microsurgical techniques and refined IOL power calculations allow excellent refractive outcomes. Refractive surprise following cataract surgery is uncommon [1-3]...

Retinal sequelae of high voltage electric current injury

Introduction High-voltage electrical currents may result in significant ocular complications, ranging from mild cataracts to vision-threatening retinal and optic nerve problems [1]. The severity of damage depends on various factors, including intensity and type of current, duration of exposure, entry...

A connected workplace - Part 2

In Part 1 of this topic (bit.ly/ENconnected) the need for a mature ophthalmic imaging network was described. Here, I provide a scoring scheme that can be used to articulate the maturity of existing devices. As with any scoring system, the...