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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...

High-stakes scenarios in retinal vein occlusion: A survey of medico-legal implications

Central retinal vein occlusion (CRVO) is the second most common retinal vascular disease after diabetic retinopathy, and its clinical complexity often intersects with medico-legal scrutiny [1]. Missteps in timely diagnosis, inadequate follow-up or poor documentation can lead to patient harm...

“We try our best”, but we should still be open and transparent

In a recent discussion with colleagues, someone recognised that many, when asked what they do, say, “I am a doctor”. Rather than “I work as a doctor”. This sense of belonging, pride and duty comes with responsibility. Becoming a surgeon,...

Localising the cause of bloody tears

The authors present two cases of ‘idiopathic’ bloody tearing. The paper presents the potential causes of bloody tearing, highlighting the difficulty that can be encountered in diagnosing and managing these patients. The authors use punctal plugs in these cases which...

William’s syndrome

William’s syndrome is a congenital multisystem disorder involving the cardiovascular, connective tissue and central nervous systems. The aim of this study was to evaluate the frequency and severity of ophthalmic manifestations and associated diseases as well as provide epidemiology data...

Divergence insufficiency esotropia is increasingly more common and new theory of aetiology

The authors present a retrospective case review of acquired esotropia. An internal database was reviewed for cases of esotropia and divergence insufficiency between 1978 and 2018 and seen by a single ophthalmologist. Patients with initial presentation of esotropia onset after...

A paradigm shift in the way we approach cataract surgery

Cataract surgery is the most common elective surgical procedure in the UK [1], with in the region of 350,000 cases being conducted each year. With an ageing population, this figure will only continue to rise over time. Cataract surgery is...

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...

Safety and efficacy of a nurse-led intravitreal injection service using an Precivia® injection assist device

Nurse-led intravitreal injections have become of great importance for busy eye units. In this article, the authors present safety data from five years of a nurse-led service with the use of the Precivia® intravitreal injection assist device. Intravitreal injections of...

Ombudsman comments on government announcement of duty of candour review

Parliamentary and Health Service Ombudsman Rob Behrens comments on the Department of Health and Social Care's announcement about a review into duty of candour.

Single muscle surgery for hypertropia

The authors undertook partial tenotomies combined with graded marginal recession of single vertical rectus muscles to treat small angle hypertropia in four adults with fusion potential. They report dose response, surgical technique and outcomes. Dose response closely matched the theoretical...

Bisphosphonates can cause orbital inflammation

The authors describe four patients with bisphosphonate induced orbital inflammation and review a further 25 cases in the literature. Intravenous zoledronate was the most common precipitant (76% of cases) with the mean time until onset of inflammation being three days...