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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....

Binocular single vision (BSV)

Introduction In this article I will try to summarise some of the definitions, tests and assessments performed in the strabismus clinic to assess patient binocular potential. This is a key feature of strabismus assessment, especially in adults, and it will...

Acetylcholine receptor antibodies in the diagnosis of ocular myasthenia gravis at the Manchester Royal Eye Hospital

Myasthenia gravis (MG) is the commonest autoimmune condition to affect the neuromuscular junction. In the UK, its prevalence is 15 per 10,000 [1,2] and recent studies have shown that rates are steadily increasing [3,4]. Aims of this audit The aim...

Ophthalmic viscoelastic devices: Useful insights for a novice cataract surgeon

Ophthalmic viscoelastic devices (OVDs) are essential in many different stages of cataract surgery. This article discusses the categories of OVDs and their respective properties, and highlights their uses in different scenarios faced in cataract surgery. Ophthalmic viscoelastic devices are gel-like...

Learning from litigation: ocular drug toxicity

Being the subject of litigation is stressful and upsetting. Having to look back over your previous decisions and justify the care you delivered in good faith can be difficult. Sadly, we all live with the sword of Damocles above us...

Aqueous misdirection: a case series of unexpected surgical complications

Aqueous misdirection (AM), also known as malignant glaucoma, is a form of secondary glaucoma that typically presents with shallowing of the anterior chamber (AC), raised intraocular pressure (IOP), and reduced visual acuity (VA) in the presence of patent peripheral iridotomies...

Lessons from an unusual case of syphilis

The rise of syphilis transmission rates over the past two decades has been one of public health’s great puzzles. In the UK, the situation has reached epidemic levels, with a 126% increase between 2013 and 2018 [1]. We present a...

Pigmented paravenous retinochoroidal atrophy

Presentation A 46-year-old Caucasian female was referred to the eye clinic by her local optician following a routine sight test. She was noted to have pigmentary retinal changes in both eyes but was asymptomatic with no visual complaints. At presentation...

Corneal hysteresis: An emerging biomarker in the management of glaucoma

Corneal hysteresis (CH) is gaining recognition as a valuable parameter in the management of glaucoma. Corneal hysteresis is defined as the difference between the inward and outward pressure responses of the cornea during deformation. This measurement reflects the viscoelastic properties...

The VISION 2020 LINKS Programme: Cascading leadership training in Calabar, Nigeria

The VISION 2020 LINKS Programme has initiated ‘LEAD FORWARD’, an innovative leadership development project incorporating a commitment to cascade training and participate in achievable quality or service improvement projects. The project provides opportunities to apply leadership skills in practice as...

Preventing blindness from diabetes: planning a programme of service development and research across Malawi

In sub-Saharan Africa 19.4 million people have diabetes; this is projected to rise to 28.6 million by 2030 [1]. Sight loss from diabetes devastates the lives of working people, affecting the financial stability of the families and communities who depend...

Glaucoma-NET: a novel way of improving glaucoma management in sub-Saharan Africa

Background Glaucoma is the second most common cause of blindness worldwide [1]. People with untreated glaucoma suffer from irreversible, progressive loss of sight. The disease is characterised by progressive loss of visual field, with pathological cupping of the optic disc...