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Making sense of the orthoptic assessment

Following the Specialty Trainee article on this topic in the February/March 2020 issue, Joe Smith provides a more detailed breakdown of the orthoptic report. Orthoptists investigate, diagnose and manage a wide variety of patients with varying problems. In this article,...

Avoiding investigations through history taking and examinations to differentiate serious from comparably benign aetiology

*Joint first authors. Introduction Anisocoria can be a sign of neurological deficit, necessitating numerous investigations [1]. This case report explores how expensive and time-consuming investigations can be avoided by thorough history taking and examination to differentiate serious from comparably benign...

Typical or surprisingly uncharacteristic presentations of neuro-ophthalmic emergencies

Irrespective of geographical location or patient cohort, emergency departments are high risk locations capable of inspiring extreme anxiety and dread in patients and doctors alike. The stress multiplies when a walk-in or referred case is suspected of underlying neurological pathology....

Headaches in ophthalmology (part 2)

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...

Strabismus and ocular motility, demystified

I am a former orthoptist, now trained in medicine and working as a foundation doctor. In my previous work, I was frequently approached by ophthalmology trainees eager for guidance with strabismus and ocular motility. Drawing on my clinical experience, I...

Myopia management

With the growing prevalence of myopia at epidemic levels in some countries and increasing number of research publications on myopia control, there is a lot of controversy regarding the management of myopia. As none of them are at present available...

Roche UK Medical Education in Ophthalmology nurse and allied health professional meetings

Roche UK is holding the fourth in a series of medical education meetings across the coming months for nurses and allied health professionals working in Ophthalmology. Speakers include: Jenny Nosek RGN, OND, Pdip, MHS – Nurse Consultant Sandy Taylor MBE...

Pituitary tumours: why are they so often missed?

Part 3: Clinical features, assessment and management (see also Part 2, and Part 1) As previously mentioned in this treatise [1] pituitary tumours are common, occur in all age groups and can present with anything from minimal visual symptoms to...

The orthoptic report – what does it all mean?

An orthoptist report may well look like a piece of Japanese Shodo, however, it does in fact contain some extremely useful information. This piece will briefly explain some of the common brush strokes seen on a report. There is some...

Radiotherapy for orbital apex cavernous haemangiomas

This is a review of six patients with cavernous venous malformations (haemangiomas) involving the orbital apex who were treated with fractionated stereotactic radiotherapy. Patients were diagnosed on MRI imaging with only one having had previous surgery to debulk the lesion....

A case of Miller Fisher Syndrome and bilateral asymmetric globe retraction

Miller Fisher syndrome (MFS) is a rare, acquired nerve disease that is considered to be a variant of Guillain-Barré syndrome. It was first recognised by James Collier in 1932 as a clinical triad of ataxia, areflexia and ophthalmoplegia. Later, it...

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...