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Headache: the clue is in the eyes

A worrying cause of headache is raised intracranial pressure (ICP). Papilloedema is a vital clue for accurate diagnosis and performing fundoscopy is essential in detecting this sign. The authors review the use of fundoscopy in their own district general hospital....

The management of antiplatelets and anticoagulation in elective ophthalmic surgery

Clinical scenario: A 57-year-old gentleman who is scheduled to have Mohs micrographic surgery and reconstruction for a medial canthal basel cell carcinoma (BCC) has been started on aspirin and clopidogrel following a coronary stent three weeks ago. Does the antiplatelet...

Ocular electrophysiology

A 34-year-old woman, who is a CEO in a multinational firm, has been losing vision over the last 12 months. She has seen her opticians, who initially tried different glasses but could not improve things. Clinical examination is unremarkable. How...

The assessment of pupils and 
pupillary reactions

Understanding pupillary reactions is vital in understanding basic neuro-opthalmology. It is a skill required in eye casualty, clinics and perhaps most importantly, exams. To start at the beginning, the pupil is the central aperture of the iris, its size controlling...

Corporate M&A pace gathers momentum

Intensifying franchise competition, maturing product development pipelines and looming loss of exclusivity spur renewed merger and acquisition (M&A) activity in the ophthalmics sector. Rod McNeil reviews recent deals and related strategic developments. AbbVie to acquire Allergan in $63 billion mega-combination,...

The interpretation and use of ultrasound biomicroscopy (part 1)

Ultrasound Biomicroscopy (UBM) has become increasingly important for the diagnosis of a variety of anterior segment pathologies. Most ophthalmologists are familiar with conventional B-scan ultrasonography techniques, which operate at lower sound frequencies (7.5 to 20MHz). UBM is an ultrasound technique...

Feb/Mar 2016 Quiz 2

History A 30-year-old male presents with a phthisical left eye and undergoes enucleation. He has some lesions in his right eye that are under ophthalmic surveillance. Figure 1 is a low power of the enucleation. Figures 2, 3 and 4...

An update on idiopathic intracranial hypertension

The incidence of Idiopathic intracranial hypertension (IIH) is increasing, likely in line with the worldwide epidemic of obesity. To date, there have been revisions in the terminology used and diagnostic criteria for IIH; these recognise the need to exclude secondary...

Optic nerve swelling – your survival guide (part 1)

Assessment of optic nerve appearance and functions is a daily routine in neuro-ophthalmology. Following a recent high profile court case there has been a significant increase in the amount of referral to ophthalmology departments to assess the optic nerve and...

Screening for Sickle Cell Retinopathy (SCR): Why we do wide-field imaging, OCT/OCT-A for SCR – Newcastle upon Tyne Hospitals NHS Foundation Trust

I have been working in ophthalmology for over five years as a photographer and research co-ordinator, and it is fascinating, rewarding, and interesting to learn all about the different diseases associated with the eye. One condition that has been a...

The power of the full blood count

Vishal Shah walks us through his thought process whilst highlighting the importance of routine investigations when dealing with unusual retinovascular presentations. Retinal changes can arise in anaemia, leukaemia, lymphoma, myeloproliferative and myelodysplastic syndrome. They are often the first manifestation of...

The last three patients: general medicine (Patient Two)

For the second reflection in this series (see Patient One here), Professor Jonathan Rees recounts his experiences of the last patient he saw as a medical registrar, telling the tragic story of a young man’s death and the risks that...