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Grading of ocular inflammation in uveitis: an overview

Anterior uveitis is the commonest form of uveitis, which can lead to severe morbidity if not treated appropriately [1]. Data from general ophthalmology practices suggest around 90% of uveitis encountered by comprehensive ophthalmologists is anterior uveitis [2]. Intermediate (vitreous), posterior...

Effect of topical diclofenac on postoperative PRK pain: RCT

A major disadvantage of excimer laser photorefractive keratectomy (PRK) is pain and discomfort after the surgery, which is thought to be due to damage to corneal sensory nerve fibres or local release of inflammatory substances. Pain only resolves once corneal...

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...

Fenofibrate and diabetic retinopathy

Fenofibrate is an agonist of peroxisome proliferator-activated receptor-alpha (PPARα) which is used as a lipid-lowering agent. By reducing blood lipid levels, it can decrease retinal hard exudates which is beneficial in diabetic retinopathy (DR). FIELD and ACCORD studies show that...

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...

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...

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...