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The results of the last survey Apr21

There was a really fascinating response to the last edition’s practice variance survey. Strictly speaking, I cheated and this was not really about practice variation, but more about your impressions about what represents negligent practice. For the first time ever,...

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...

Flashes and floaters in community optometry – diagnosing a posterior vitreous detachment

Managing patients who attend a practice with symptoms of flashes and floaters is a regular occurrence in community optometric practice. It’s often very distressing for patients; symptoms can be quite dramatic and an internet search can indicate imminent blindness from...

Gene therapy for inherited retinal disease: the Manchester Ocular Gene Therapy Group MDT service

The authors describe the process set up in Manchester for the optimum delivery and assessment of a new gene therapy treatment for patients with RPE65 IRD. Inherited retinal dystrophies (IRDs) are the second commonest cause of severe visual impairment in...

Sustainability in eyecare: Intraocular gases and the climate emergency

In 2020 the NHS became the first national health system to commit to delivering ‘net zero’ carbon emissions by 2040. The author investigates how the impact of ophthalmic surgery can be reduced. Medical gases have been used in ophthalmic surgery...

Optical coherence tomography – reinventing the eye examination

It has been 25 years since Huang et al. presented the first optical coherence tomography (OCT) images in Science [1]. With vast improvements in OCT technology over the years, it is now possible to acquire high-resolution cross-sectional images of the...

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...

PACK-crosslinking for infectious keratitis

Corneal cross-linking with riboflavin and UV-A light (CXL) is a technology that has been initially developed to treat corneal ectatic disorders [1]. Its effect in stabilising diseases such as keratoconus was reported in numerous trials with excellent long-term outcomes and...

Retinal prosthetics: science fiction or a vision for the future?

“Is it a fact – or have I dreamt it – that, by means of electricity, the world of matter has become a great nerve, vibrating thousands of miles in a breathless point of time?” – Nathaniel Hawthorne, The House...

Assessing everyday visual function in dry AMD – what matters to the person?

Age-related macular degeneration (AMD) is the primary cause of blindness in the developed world and is accountable for more than one half of sight impairment registrations within England and Wales [1]. AMD is prevalent in people aged 60 years and...

The treachery of images – making sense of OCT imaging

In 1929 Belgian surrealist Rene Magritte produced his painting La Trahison des Images. It depicted an old fashioned pipe for smoking tobacco and underneath were the words “ceci n’est pas une pipe”, this is not a pipe. You may wonder...

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...