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It’s easy when you know the rules

As I was travelling along a deserted road on a Sunday last month I saw in my peripheral vision a disconcerting flash of light behind me. Much as I tried to convince myself that the flash was due to the...

Do we really need the College to be Royal?

It is taken for granted in this country that all the best medical colleges are Royal. That they have the royal seal of approval from on high and therefore must be the best. I have been somewhat confused for a...

Managing a dislocated intraocular lens

A 70-year-old male patient is referred from the optician with a history of onset of double vision and examination shows a dislocated / subluxated IOL. How will you manage this patient? If the double vision is causing serious concern to...

The results of the last survey Apr 2020

As ever, I would like to thank all those who participated in the last edition’s survey. A lot of data was generated and I do not intend to go through each individual finding. What is staggering again is the degree...

The results of the last survey Feb21

Once again, I am grateful for the responses and read the results with interest. I am always surprised by the amount of practice variation I see. I fully accept there is art in what we do and there is no...

The results of the last survey Aug22

The first question really highlights how we can become enshrined in the way we do things. I genuinely thought that everyone was using a cohesive viscoelastic for their cataract surgery. It was what I was taught, and I believe everyone...

A single intravitreal bevacizumab in the treatment of breast carcinoma related choroidal metastasis

Case report Choroidal metastasis represents a common form of intraocular malignancies occurring in up to 10% of patients with systemic metastasis [1]. The most common primary sites of ocular metastasis are breast carcinoma in women and lung carcinoma in men,...

Cortical blindness

Cortical blindness is a rare but recognised entity. Cerebrovascular accident is a well-known risk factor. We report a case of an 84-year-old lady with bilateral cortical blindness with multiple cardiovascular risk factors. Case report An 84-year-old lady was admitted under...

Paraproteinaemia: a patient with atypical corneal findings

A Bence Jones protein is a monoclonal globulin protein or immunoglobulin light chain found in the urine, with a molecular weight of 22-24 kDa [1]. Detection of Bence Jones protein may be suggestive of multiple myeloma or Waldenström’s macroglobulinemia. Multiple...

Traumatic ‘toy’ gun injury leading to permanent vision loss

Pseudoxanthoma elasticum (PXE) is a progressive, inherited disorder of connective tissue that affects the skin, cardiovascular system and retina. Ocular manifestations of the disease are related to Bruch’s membrane, a thin elastic tissue layer located between the retinal pigment epithelium...

Macular imagery: observing the visual sensations pre- and post-Jetrea injections

A 63-year-old woman, a professional painter, was diagnosed with vitreomacular traction (VMT) in 2017. She had a history of metamorphopsia, drop in visual acuity (VA) in the left eye (6/6 in the RE; 6/18 in the LE), foveal vitreomacular traction...

A rare neonatal presentation of bilateral dacryocele and choanal atresia

Following a routine pregnancy, a newly delivered baby boy, born at term, was found to have increased work of breathing, stridor and a left medial canthal swelling. The baby required 100% oxygen via a face mask to maintain oxygen saturations....