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Setting up successful safe & efficient nurse-led intravitreal injection service

In September 2019, we organised a training course at Great Western NHS Hospital (GWH), Swindon, which provided presentations, discussions and hands-on wet lab experience on how to perform intravitreal injection using intravitreal assisted device (INVITRIA) for nurses and doctors from...

Just sign here: the intricacies of consent in the post-Montgomery era

The consent process is a vital part of the patient pathway and is far more than just getting the patient to sign on the dotted line. In my work in litigation I often see issues around informed consent resulting in...

Treatment of diabetic macular oedema

Diabetic macular oedema (DMO) is a common complication associated with diabetic retinopathy, and the most common cause of visual impairment in diabetes [1]. With predicted rising levels of diabetes (in England by 2025 the estimated population with diabetes will be...

Unique case of steroid-induced intraocular pressure spike causing NAION

The literature describes previous cases of nonarteritic anterior ischaemic optic neuropathy (NAION) following rapid rises in intraocular pressure (IOP) leading to reduced optic nerve head perfusion and disruption. This is commonly following ophthalmic procedures, acute glaucoma or steroid eye drops....

Psychiatric Consequences of Ophthalmic Disease

In part two of this series on ophthalmology and psychiatry, the authors will cover the possible psychiatric consequences of ophthalmic disease. The following conditions will be discussed: a. Black patch psychosis b. Psychological state in blindness c. Phobias in the...

The implementation of postoperative day 1 vitrectomy telephone follow-up consultations

In this pre-COVID-19 study, the authors argue that some follow-up consultations can be done by telephone without compromising patient safety. Thirty years ago, a study by Isernhagen et al. [1] found that 52% of patients required some form of unexpected...

Celebrating eight years of the nurse-led intravitreal injection service

Moorfields Eye Hospital NHS Foundation Trust in London celebrated the eighth year of its nurse-led intravitreal (IVT) injection service in 2020. In collaboration with Beaver-Visitec International (BVI), Moorfields’ comprehensive one-day course for non-medical staff has blossomed into a thriving success....

Trabeculectomy with erroneous Mitomycin-C concentration – a near miss

Trabeculectomy is the most commonly performed surgical procedure for glaucoma in the United Kingdom and worldwide. Modifications to the technique have been made since its introduction in 1963, perhaps the most significant being the adjunctive use of mitomycin-C (MMC), which...

The approach to trabeculectomy postoperative complications

Performing a trabeculectomy is like giving birth to a baby. It may be traumatic and there is scope for devastating error but once the operation is completed only then does the real work begin. The bleb must be nurtured into...

Don’t ignore the black lesion! It might be mucormycosis

Keeping mucormycosis infection in the foreground of your differential diagnosis, especially in those more vulnerable patients, will help save their lives if recognised and managed appropriately. Mucormycosis is a fulminant infection caused by the fungi of the family Mucoraceae. It...

Vitreous loss fire drills – ophthalmic simulation improves trainee surgical competence and confidence with posterior capsule rupture scenarios

Ophthalmic trainees have reported limited exposure and low confidence regarding the management of cataract complications such as posterior capsule rupture (PCR) / vitreous loss (VL). This report evaluates the impact of a simulation-based educational training event on these concerns. Introduction...

The role of injection assistant devices in establishing a nurse-led AMD service

The author shares his experience of setting up a nurse-led service to deliver anti-VEGF intravitreal injections and how injection assistant devices supported training. Age-related macular degeneration (AMD) has become a leading cause of irreversible blindness [1]. It is estimated that...