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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...

Large series profiling skew deviation

A retrospective notes review was completed for patients identified as having skew deviation. The authors outline their exact definition of skew deviation within the methods of the paper. One hundred and fifty-seven patients were identified, it is not clear over...

New AI in ophthalmology resource goes live

The Royal College of Ophthalmologists has launched a new free resource, sharing and signposting artificial intelligence as medical device (AIaMD) tools for use in ophthalmology. The online AI directory is an evolving catalogue of AIaMD tools used in research or...

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...

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....

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,...

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...

Progression of macular atrophy in Stargardt disease

The authors present a study of a cohort of patients with genetically proven ABCA4 gene mutation related Stargardt disease. They aimed to quantify the effect of lesion location and topography on disease progression using fundus autofluorescence imaging. One hundred and...

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...

“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...

Doctor at large

“In 1930, the Republican-controlled House of Representatives, in an effort to alleviate the effects of the… Anyone? Anyone?... the Great Depression, passed the… Anyone? Anyone? The tariff bill? The Hawley-Smoot Tariff Act? Which, anyone…?” In this memorable scene, the monotonous...