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Ultrasound biomicroscopy (part 2): primary angle closure

Patients with primary angle closure or primary angle closure glaucoma [PAC(G)] comprise a significant subgroup affecting around 10% of glaucoma patients amongst Caucasians. Assessment of the patient with angle closure, or narrow angles, requires gonioscopy. However, whilst identifying the presence...

Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

The management of watery eye in an infant with facial dysmorphism

A six-month-old child with facial dysmorphism is brought to the eye clinic with history of watery right eye since birth. How will you manage this child? Causes for watery eye in an infant 1. Overproduction of tears a. Infections b....

How to diagnose and treat Acanthamoeba keratitis

Corneal ulceration caused by Acanthamoeba is on the rise, and recent publications indicate an outbreak in the UK over the last few years [1]. Since Acanthamoeba keratitis often presents with atypical features, diagnosis from slit-lamp examination alone can often be...

Cataract surgery supervision

Senior trainees supervising other more junior trainees’ cataract surgery is a skill which needs to be taught and developed with care. It is beneficial for senior trainees as it provides an opportunity to develop supervision techniques prior to consultancy and...

Time is vision in central retinal artery occlusion

Central retinal artery occlusion (CRAO) is a rare but devastating vascular episode that can have severe impact on vision. Treatment is very time-limited and needs to be initiated very quickly to salvage any vision. The majority of patients present to...

Understanding medical negligence in the UK: a brief overview

Medical negligence, or clinical negligence, refers to a breach of duty of care by healthcare professionals that results in harm or injury to a patient. In the UK, medical negligence is a serious issue that can have profound consequences for...

The results of the last survey Dec23

*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. Hopefully by...

The results of the last survey Feb24

Thank you to all those who participated in this edition’s survey and for those of you who attended my recent Medico-legal Seminar at the Royal College of Ophthalmologists. It was a fascinating and educational day, made a success by the...

Trabeculectomy with erroneous Mitomycin-C concentration – a near miss

Trabeculectomy is the most commonly performed surgical procedure for glaucoma in the United Kingdom and worldwide. Modifications to the technique have been made since its introduction in 1963, perhaps the most significant being the adjunctive use of mitomycin-C (MMC), which...