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Typical and atypical optic neuritis – diagnosis and initial management

Optic neuritis is a relatively common presentation to ophthalmologists in the acute setting. The vast majority are cases of ‘typical’ optic neuritis (ON) but a smaller group of conditions, so-called, ‘atypical’ optic neuritides require a different work-up and management strategy....

Optic nerve swelling – your survival guide (part 1)

Assessment of optic nerve appearance and functions is a daily routine in neuro-ophthalmology. Following a recent high profile court case there has been a significant increase in the amount of referral to ophthalmology departments to assess the optic nerve and...

Supranuclear ocular motility disorders

Figure 1: Bilateral INO Introduction Complex ocular motility disorders are a diagnostic challenge. These patients come with very complex ocular motility presentations and require a careful and detailed assessment in order to find the correct diagnosis and arrange appropriate investigations....

Commonest mistakes during the refraction certificate exam

Ophthalmology specialty trainees are required to pass the refraction certificate exam within the first two years of training. If one passes this exam before entering a training programme, this can add two points to the portfolio during applications. In this...

The role of aspirin in the treatment of NAION: Benefits and controversies

Non-arteritic anterior ischaemic optic neuropathy (NAION) is the most common acute optic neuropathy in individuals over 50 with estimated prevalence of 2–10 per 100,000 people, characterised by sudden, unilateral vision loss due to ischaemic injury to the optic nerve head....

SOS (Simplified Ophthalmic Statistics) Part 4: How to present your statistical analysis

This is the last in this series of short guides which we hope provide some guidance in relation to statistical issues researchers may encounter when conducting research, audit or indeed quality improvement projects. Here we focus on an issue that...

How to maximise points for your ophthalmology portfolio as a medical student

Ophthalmology is an extremely popular and competitive career option, with one of the highest competition ratios at ST1 level entry (10:1 in 2023) [1]. It is also a highly rewarding speciality, involving: a mixture of medicine and surgery in a...

The Case of Dr Bawa-Garba – Where does the buck stop?

The case of Hadiza Bawa-Garba has left all of us in the UK medical profession with an uncomfortable taste in our mouths. We all know that we work under pressure and we will inevitably make mistakes. We all know that...

Ophthalmology in the COVID-19 pandemic

The novel coronavirus pandemic has affected the whole world and forced all of us to think of new ways to manage our day to day personal as well as professional life. I am not going to talk about the clinical...

Choroidal melanoma – breaking bad news

Case report A 55-year-old Caucasian female presented to her general practitioner with a three-month history of headaches and worsening blurred vision in the left eye. On further close questioning, she reported no eye pain, intermittent floaters and flashes of light...

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]...

Iris chafing from displaced single-piece acrylic IOL

A 74-year-old man had persistent 3+ cell one month following left eye cataract extraction, complicated by anterior capsular rent and zonular dialysis at 7 o’clock, with single-piece acrylic intraocular lens implantation (IOL) in the capsular bag. Figure 1: Haptic-like transillumination...