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A paradigm shift in the way we approach cataract surgery
Cataract surgery is the most common elective surgical procedure in the UK [1], with in the region of 350,000 cases being conducted each year. With an ageing population, this figure will only continue to rise over time. Cataract surgery is...Headaches in ophthalmology (part 1)
Ophthalmologists see a large number of patients with headaches or facial pain in the ophthalmic outpatient clinics or in emergency clinics. Over two articles, I will discuss several causes of headaches, ocular manifestations and proposed management and referral options. It...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...
Inhibiting high-risk corneal allografts
The cornea is an immune privileged site and as such corneal transplants are very successful. However, in situations where this privilege is lost the failure rises substantially. To combat rejection inhibition of the immune responses depends on steroids and other...
Injection of methotrexate into silicone oil-filled eyes for grade C PVR
Methotrexate (MTX) is an antineoplastic antimetabolite with immunosuppressant properties. Folate antagonism is known to contribute to the antiproliferative effects of MTX, and release of adenosine from cells and inhibition of polyamines may explain its anti-inflammatory effects. These activities contribute to...
Pain control during orbital implant surgery
This is a study based on existing evidence that pre-emptive pain control has advantages over traditional post-surgical analgesia. The authors compared pain scores in three groups of randomly assigned and masked patients all undergoing orbital implant surgery under general anaesthesia...
Effect of topical diclofenac on postoperative PRK pain: RCT
A major disadvantage of excimer laser photorefractive keratectomy (PRK) is pain and discomfort after the surgery, which is thought to be due to damage to corneal sensory nerve fibres or local release of inflammatory substances. Pain only resolves once corneal...The ophthalmologist’s elbow: a potentially painful point of contact
Three months ago I leant, in the customary manner, on the box of my indirect lens at the slit lamp to examine a patient’s fundus. An acute and severe pain in the tip of my elbow immediately interrupted me. I...The management of possibly progressive pterygium
A 43-year-old Sudanese male patient is referred by his GP with a fleshy lesion encroaching the nasal cornea for the last six months. History Make note of: risk factors, i.e. UV exposure and ocular irritation - history of living in...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...
