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The gift of family

“Your kids look just like you!” is an oft-heard phrase at family gatherings. Setting aside the obvious explanation of basic genetics, similarities and recurrent character traits are well recognised within a family unit. Shared positive mutual experiences shape these attitudes...

Optical coherence tomography – reinventing the eye examination

It has been 25 years since Huang et al. presented the first optical coherence tomography (OCT) images in Science [1]. With vast improvements in OCT technology over the years, it is now possible to acquire high-resolution cross-sectional images of the...

End stage glaucoma management

A 48-year-old female has had multiple drug treatment for glaucoma and is still losing field of vision. How do you manage this over time? This patient is at high-risk for going blind and should be managed aggressively to protect remaining...

How to pass the Refraction Certificate

Unfortunately, I had the pleasure of getting to know this exam intimately. With adequate preparation this does not have to be the case for most people. The exam has recently changed to consist of 10 OSCE style stations (previously 12)....

Old dogs

It is always nice to get a thank you card, especially so when it comes from someone at the tail end of an overbooked clinic who had waited patiently well past their appointed slot. Such was the case when I...

Unexpected diagnoses – stroke in children and homonymous hemianopia

We present the case of a 12-year-old child presenting with a few days history of left-sided visual loss. Upon further investigation with magnetic resonance imaging (MRI) she was unexpectedly diagnosed with a right-sided chronic posterior cerebral arterial territory infarct, causing...

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...

More sensitive visual acuity test for age-related macular degeneration

Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world. Primarily associated with ageing, genetic factors and lifestyle choices such as smoking also play a contributory role. Patients with early AMD, characterised by the development of...

The Gambia-Swansea VISION 2020 LINK: building eye care services and international friendships

History The VISION 2020 LINK between the Sheikh Zayed Regional Eye Care Centre (SZRECC), Banjul, The Gambia and the Ophthalmology Department, Singleton Hospital, Swansea started in 2008 under the guidance of the VISION 2020 LINKS Programme at the International Centre...

Somatostatin protects retinal pericytes

Diabetic retinopathy (DR) is a complication of diabetes, caused by high blood sugar levels damaging the retinal microvasculature. Mechanisms, such as oxidative stress and deposition of advanced glycation end products, leads to glial cell activation and neuronal apoptosis. Pericytes, contractile...

Paediatric spectacle dispensing: more than a frame and lenses

It’s incredibly rewarding to fit a child’s first pair of spectacles and see their face light up; looking around to see the wider world for the first time. Sometimes it is so obvious that even the most reluctant parent will...

Pituitary tumours: why are they so often missed?

Part 2: Clinical varieties, anatomical considerations and case report (see also Part 1 and Part 3) For ophthalmologists there are four types of pituitary tumour to be considered, three of which are named according to the hormone secreted, along with...