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Inhibiting high-risk corneal allografts

The cornea is an immune privileged site and as such corneal transplants are very successful. However, in situations where this privilege is lost the failure rises substantially. To combat rejection inhibition of the immune responses depends on steroids and other...

Injection of methotrexate into silicone oil-filled eyes for grade C PVR

Methotrexate (MTX) is an antineoplastic antimetabolite with immunosuppressant properties. Folate antagonism is known to contribute to the antiproliferative effects of MTX, and release of adenosine from cells and inhibition of polyamines may explain its anti-inflammatory effects. These activities contribute to...

Pain control during orbital implant surgery

This is a study based on existing evidence that pre-emptive pain control has advantages over traditional post-surgical analgesia. The authors compared pain scores in three groups of randomly assigned and masked patients all undergoing orbital implant surgery under general anaesthesia...

The ophthalmologist’s elbow: a potentially painful point of contact

Three months ago I leant, in the customary manner, on the box of my indirect lens at the slit lamp to examine a patient’s fundus. An acute and severe pain in the tip of my elbow immediately interrupted me. I...

The management of possibly progressive pterygium

A 43-year-old Sudanese male patient is referred by his GP with a fleshy lesion encroaching the nasal cornea for the last six months. History Make note of: risk factors, i.e. UV exposure and ocular irritation - history of living in...

Managing cataract surgery in a patient with diabetic maculopathy

A 56-year-old type 2 diabetic with previously treated bilateral diabetic maculopathy develops a cataract requiring surgery in the right eye. He has had grid laser previously, followed intermittently by intravitreal triamcinalone, Avastin and more recently Lucentis in both eyes. His...

RPE atrophy onset in treated nAMD

In this study the authors aim to evaluate the role of various factors for the development of retinal pigment epithelium (RPE) atrophy over a period of five years in patients with nAMD. Fifty-two newly diagnosed nAMD patients with complete absence...

Triamcinolone (TA) deposits following subcutaneous injection to treat chalazion

Chalazia are chronic lipogranulomatous inflammations of the eyelid secondary to a blocked meibomian gland. Whilst most resolve spontaneously, certain chalazia warrant treatment. Options include incision and curettage (I&C), lesion excision, intralesional steroid injections, and botox injections [1]. I&C is usually...

Cataract surgery in patients with Vogt-Koyanagi-Harada

This retrospective, interventional case series of 286 patients (408 eyes) assessed visual outcome and prognostic factors in patients with Vogt-Koyanagi-Harada (VKH) undergoing cataract surgery between September 2008 and December 2017. Two groups were reviewed. The first group (352 eyes) had...

Patterns of binocular diplopia in giant cell arteritis (GCA)

Giant cell arteritis (GCA) is a granulomatous vasculitis that targets medium and large sized vessels. Binocular diplopia has been reported in a small number of patients with visual manifestations of GCA. It can be caused by ischaemia in any segment...

My Top Five: Key insights from recent research into uveitis in adults

Uveitis, characterised by inflammation of the uvea – the eye’s middle layer comprising the iris, ciliary body, and choroid – remains a leading cause of visual impairment worldwide [1]. It primarily affects adults aged 20–50 years. Untreated uveitis may cause...

An interview with Professor John Forrester

What made you choose ophthalmology as a career and how did your interest in academia develop? During Medical School at Glasgow University, I was getting progressively disillusioned with the career options while my colleagues and friends all seemed to quickly...