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Learning from litigation: ocular drug toxicity

Being the subject of litigation is stressful and upsetting. Having to look back over your previous decisions and justify the care you delivered in good faith can be difficult. Sadly, we all live with the sword of Damocles above us...

Crystalline keratopathy in monoclonal gammopathy of undetermined significance

Monoclonal gammopathies encompass a group of plasma cell disorders characterised by the excessive production of abnormal monoclonal immunoglobulins in the bloodstream [1]. This category includes multiple myeloma, monoclonal gammopathy of undetermined significance (MGUS), amyloidosis and other lymphoproliferative disorders. Monoclonal gammopathy...

Life as a Global Citizen Consultant Ophthalmologist: a personal view of working in Scotland and Tanzania

Global Citizen post - a new challenge I was looking for a new challenge. I had been in the same consultant post with a subspecialty interest in paediatrics and strabismus for 17 years and was rattling around in an empty...

Across the globe and into the world of international eye grading

Decades have passed and the influence of analysing fundus images by grading consultants and retinal image specialists has grown worldwide. Their job is to specialise in assessing hundreds of diagnosed eye disease disorders and to read thousands of eye images,...

How the development of Glaucoma Guidelines, Glaucoma Toolkit and GLASS training and the Glaucoma nurse training can effect change in Nigeria

In July 2024, a combined training, led by Fatima Kyari, was run in Abuja, Nigeria to facilitate a multifaceted upskilling in glaucoma management. The first week comprised of inviting 36 doctors practising glaucoma from around Nigeria’s 36 states, including the...

Macular holes: A brief review

The classification of macular holes has been modernised by OCT findings. This is a brief review and encompasses the historical literature on macular holes. A macular hole is an anatomical discontinuation of the neurosensory retina at the centre of the...

The assessment of pupils and 
pupillary reactions

Understanding pupillary reactions is vital in understanding basic neuro-opthalmology. It is a skill required in eye casualty, clinics and perhaps most importantly, exams. To start at the beginning, the pupil is the central aperture of the iris, its size controlling...

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...

The Eye Health Network – an ‘optometry-first’ approach to eye care

Historically, in NHS Grampian, ophthalmology and optometry worked separately, with even the process of optometry referral to hospital occurring only at the behest of the patient’s general practitioner (GP). Criteria for referral were not discussed and feedback after referral was...

Diary from my elective: a Parisian experience

The author explains how a research institute’s dedication to multidisciplinary collaboration helped him to discover a passion for academic ophthalmology. The elective aspect to the final year of a medical degree, through its change of scenery and immersion into another...

Do patient demographics influence AMD clinic attendance during COVID-19 lockdown?

The authors assess the impact of the COVID-19 pandemic on adherence to scheduled clinic appointments among age-related macular degeneration patients in a clinic in North Wales. The COVID-19 pandemic has significantly affected the population, affecting economic and social wellbeing, whilst...

Sustainability in eyecare: Intraocular gases and the climate emergency

In 2020 the NHS became the first national health system to commit to delivering ‘net zero’ carbon emissions by 2040. The author investigates how the impact of ophthalmic surgery can be reduced. Medical gases have been used in ophthalmic surgery...