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The final step

Not long after securing my fellowship in London I was successful at interview for a consultant post at Singleton Hospital, Swansea. The interview took place before I had actually started in London and besides the basic things that are asked...

How to survive the fluorescein round

One of the highlights of the medical retina fellowship programme at Moorfields is the Tuesday morning 8am fluorescein round. It is both exhilarating and terrifying. Exhilarating because they are slick presentations of the most interesting cases that each of the...

Informed consent – the Brexit test

The Medical Defence Union (MDU) runs courses on various medicolegal topics. I would guess people only ever attend these courses if they have an exam or an interview approaching as the subject matter is exceedingly dry for clinicians. I myself...

Rite of passage

The Lakota Sioux people of Dakota have one of the best preserved Native American cultures in the United States and when people think of the ‘American Indian’ it is to the culture of the Lakota Sioux that people mostly turn....

The Irlen Experience

My father used to say that humanity is divided into those that see the world through a moral framework and recognise their place within it, and Tories. When a concerned mother came to the paediatric clinic bearing literature from the...

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...

Lessons from ARVO 2025

Conferences abroad are wonderful indeed. You get to escape from the crushing grind of reality at the NHS coalface for a few days and learn about the cutting edge of your subspecialty. By the end of these events, I actually...

Jun/Jul 2018 Quiz

History A 35-year-old woman had a long-standing left blind eye following extensive exudative retinal detachment in the past. She later developed increasing pain in her blind eye. Her medical history includes pheochromocytoma resected five years ago, and she is currently...

Oct/Nov 2018 Quiz

History A 37-year-old male was referred from the Emergency Eye Clinic with a swollen right upper eyelid. Symptom relieved with nonsteroidal anti-inflammatory drugs (NSAIDs). The initial clinical diagnosis was dacryoadenitis. The patient presented again six weeks later with 3mm proptosis,...

Quiz Jun/Jul 2024

History A one-year-old girl originally presented with a red eye, initially bilaterally and later in the left only. On examination a membrane was found on the tarsal conjunctiva of the upper eyelid (Figure 1). Figure 1: Anterior segment. Serum plasminogen...

Quiz Oct/Nov 2024

History An 83-year-old female was previously treated by surgical excision and plaque brachytherapy for her left conjunctival lesion. She presented to her ophthalmologist with a recurrence some years later and underwent a lid sparing orbital exenteration, which was sent to...

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...