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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...

Brain abnormality as risk factor for consecutive exotropia

The authors evaluated and compared the cerebral MRI findings in operated infantile esotropia cases with and without consecutive exotropia. This was a retrospective study of 28 patients. Group 1 had 17 cases of consecutive exotropia with a mean follow-up of...

Neuro-ophthalmology: the extended role of an orthoptist

Neuro-ophthalmology has always been a speciality of interest during my studies and now in my career. In 2018, I started a Band 7 post which gave me an extended role in neuro-ophthalmology and the responsibility of developing an orthoptic led...

Conservative management of concomitant strabismus

The aim of management for all patients with strabismus should centre around four goals: to prevent amblyopia, to alleviate symptoms, to restore binocular single vision (BSV) and to improve ocular alignment. The conservative management options available for strabismus include observation,...

The most frequent complaints and claims in ophthalmology – a Medical Protection Society (MPS) analysis

The authors look at the reasons behind medico-legal cases reported to MPS and share key learning points. Complications following ophthalmology surgery are rare, however, medico-legal cases are not uncommon due to the significant impact they can have on patients’ lifestyles....

Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

Assessing possibility of deferring lumbar puncture in mild idiopathic intracranial hypertension

This was a retrospective review of patients consecutively presenting with idiopathic intracranial hypertension (IIH) to a tertiary neuro-ophthalmology clinic without a lumbar puncture (LP) over an eight-year period. Inclusion criteria included true optic disc oedema, retinal nerve layer thickness ≤300µm,...

The results of the last survey Dec22

I am regularly faced with litigation whereby the claimant’s cornea has decompensated after cataract surgery. The procedure may have been complicated but sometimes it is not. The eye may have been high risk, for example, a shallow anterior chamber with...

Neurofibromatosis type 2 – diagnosis, features and MDT approach

NF2 is a genetic condition caused by mutation in a single gene (NF2 gene) on chromosome 22. The NF2 gene provides instructions to produce a protein called merlin, also known as schwannomin. This protein functions as a tumour suppressor, preventing...

“I can see fine. Why do I need my eyes tested?”

Are routine eye examinations really necessary? The author asks whether frequent appointments in low-risk patients with normal results are actually cost-effective. It’s recommended that most people should get their eyes tested every two years.” [1] This message is widely publicised...

In conversation with Salman Waqar

Hari Kaneshayogan interviews Salman Waqar, a Consultant Ophthalmologist with a keen interest in medical innovation. He is the inventor of the Waqar suture removal forceps, which combines suture cut and removal in one instrument. He has also created an injection...

Bridging the gap – Supporting our patients across the primary / secondary care divide

Providing the best care for patients is surely a fundamental goal for all healthcare professionals. When waiting-times are long and getting longer, clinics are full, colleagues are off with stress-related illness and patients are complaining, is it possible to still...